A registered nurse hired into a hospital intensive care unit in the fall of 2014 was terminated in March 2016 after the hospital identified problems in the nurse's documentation of controlled substances. The nurse denied any wrongdoing and later sued the hospital for wrongful discharge, breach of contract, defamation and related claims.
The issue surfaced through the hospital's routine monitoring. Its automated dispensing cabinet logs each withdrawal, and staff must scan or manually record administration and waste. A report run in March 2016 showed the nurse's fentanyl removal rate over the prior year was atypically high compared with coworkers. A review committee of a nurse manager, a pharmacist and a nurse examined 16 charts and reported that small quantities of fentanyl, lorazepam and hydromorphone could not be accounted for, and that 66 of 669 medications had not been scanned as administered.
At a meeting on March 28, 2016, the nurse was presented with the findings and told the matter would be reported to the Board of Nursing as suspected diversion unless the drugs could be accounted for. A state Division of Criminal Investigation agent, contacted by the hospital under its controlled substance policy, also questioned the nurse. The hospital's policy called for notifying the Department of Health, Board of Pharmacy, DEA, licensing agency and DCI of possible diversion.
The circuit court granted summary judgment to the hospital on all claims, and the South Dakota Supreme Court affirmed on June 17, 2020, noting the nurse was an at-will employee. The opinion is a civil employment decision; it does not record a criminal conviction or a licensing board finding of diversion.