A Travel Nurse Leaves Fears of Hospital Drug Tampering Across Three States

Health and fitness officers in at the very least a few states are investigating a vacation nurse suspected of tampering with and perhaps contaminating vials and syringes of opioid painkillers in two hospitals, then returning the vials to medicine cabinets the place they could be unknowingly provided to clients.

Just one hundred individuals who might have been uncovered to contaminated syringes very last 12 months at Johnson City Professional medical Centre in Tennessee had been urged to get tested for hepatitis and HIV, according to state documents acquired by KHN through a community documents ask for.

The documents also reveal that Raleigh Common Hospital in West Virginia this yr gave vials to regulation enforcement to test for evidence of tampering. Individuals results have not been designed general public.

The vacation nurse, Jacqueline Brewster, 52, of Belfry, Kentucky, was arrested by her area sheriff’s office environment on undisclosed charges Tuesday in reaction to a fugitive warrant from Washington County, Tennessee, where by the allegations of tampering began, according to jail and court docket information. Brewster was released Wednesday with orders to report to Tennessee inside 10 times.

“I did not run away from everything,” Brewster stated in court. “I really don’t know how I’m a fugitive.”

According to files submitted by Tennessee and West Virginia overall health authorities with their respective nursing boards, Brewster is suspected of regularly opening clinic medicine cupboards to withdraw vials or syringes of an opioid painkiller, Dilaudid, allegedly removing some of the drug to either use or steal, and then returning the vials or syringes, perhaps after gluing a cap back again on. The CEO of one particular of the impacted hospital techniques alleged in an interview with KHN that the journey nurse additional another liquid to syringes ⁠— perhaps in an attempt to deal with her tracks.

The allegations in opposition to Brewster, which have not been beforehand noted, occur at a time when the coronavirus pandemic compelled lots of U.S. hospitals to depend a lot more than at any time on vacation nurses, who usually cross state strains to work months-prolonged stints in brief-staffed hospitals. As the virus flooded hospitals with patients and worsened nursing shortages, several hospitals turned to travel nurses to fill the gaps, usually at a substantially amplified charge.

But “desperation” to recruit nurses also exacerbated present flaws in the government infrastructure intended to keep nurses accountable, explained John Benson, co-founder of Verisys, a info management corporation that researches probable staff for health care methods.

Nurses and other healthcare industry experts are accredited, investigated, and disciplined at the state level. But investigators do not talk properly throughout state lines, Benson stated, so as a lot more nurses began to vacation through the pandemic, it became less complicated to “outrun” investigations by having a new occupation in a further condition lengthy before allegations of wrongdoing became general public.

“The program was broken right before covid,” Benson said. “It just acquired much more damaged in the course of covid.”

Brewster, a registered nurse, has been certified in Kentucky because 2004 and holds a license permitting her to get the job done in additional than 30 states that participate in the Nurse Licensure Compact. After she was accused of tampering at Raleigh Standard previous month, the West Virginia nursing board suspended Brewster’s potential to apply in the point out. Days later on, Tennessee health and fitness officials acted on a criticism they obtained from Johnson Town Professional medical Center final July, launching a qualified disciplinary continuing that could revoke Brewster’s ability to perform in that point out afterwards this 12 months.

As of Wednesday, Brewster’s multistate license was “under investigation” in Kentucky but usually unrestricted, meaning she could continue to do the job as a nurse in most of the country. It is unidentified where by else Brewster may have worked as a vacation nurse, which includes in the seven months following she was 1st accused of tampering in Tennessee.

Brewster could not be arrived at for comment and it is unclear no matter whether she has an legal professional. A Knoxville law firm mentioned as Brewster’s lawyer in information filed with the Tennessee Board of Nursing denied representing the nurse.

Just one medical center that turned greatly dependent on travel nurses during the pandemic was Johnson City Health-related Middle. Ballad Wellbeing, which owns the hospital, stated previous summertime the pandemic increased the range of journey nurses the organization utilized from about 150 to 400.

Brewster was amongst individuals employed. She was employed by Jackson Nurse Pros, a vacation nurse enterprise in Orlando, Florida, and worked at the Johnson Metropolis Health-related Center for three months ahead of the alleged tampering was found out, in accordance to the information.

Ballad Overall health CEO Alan Levine told KHN one more nurse flagged a suspicious vial in the hospital’s health-related cabinet, and an interior investigation connected the vial to Brewster.

“She was eliminating the Dilaudid and changing it with another substance that looked obvious like Dilaudid, and changing the vials in the Omnicell system,” Levine reported. “One of our other nurses observed that a thing seemed distinctive in one of the vials and notified the pharmacy quickly.”

Ballad Health and fitness fired Brewster and alerted legislation enforcement and the Tennessee Division of Overall health, according to a assertion from the enterprise. It despatched five Dilaudid syringes to the Tennessee Bureau of Investigation’s crime lab, which confirmed the total of medicine in was “inconsistent with the manufacturer’s label,” in accordance to the nursing board documents.

The medical center noted that it also tried to give Brewster a drug examination. She at first supplied an insufficient urine sample, the paperwork allege, and then immediately after offering a 2nd sample Brewster “accused the lab technician of becoming corrupt,” grabbed the sample out of his hand, and dumped it down the sink.

“This is my *** [sic],” Brewster explained as she took again the sample, according to the paperwork.

The Tennessee Section of Well being submitted the professional disciplinary scenario in opposition to Brewster with the Board of Nursing on March 31. She is scheduled to show up Aug. 24 at a board listening to and challenges losing her nursing license.

At some issue, following she was fired from Johnson Metropolis Clinical Middle, Brewster started to operate at Raleigh Standard, an unrelated hospital about 120 miles to the north in Beckley, West Virginia.

Final month, the healthcare facility reported to the West Virginia nursing board that Dilaudid vials in its medication cupboards appeared to have been tampered with, in accordance to a board purchase suspending Brewster’s license. Some vials were being missing tops and many others experienced tops marked with a residue that “looked like glue,” the board alleges.

The moment yet again, an inner investigation “led directly” to Brewster, in accordance to the board get.

Raleigh Common “disposed of several vials of Dilaudid in purchase to guard patients from contamination” and delivered some vials to regulation enforcement for tests. Success have not been disclosed.

Jackson Nurse Professionals did not react to requests for comment. It is unclear no matter if Brewster nonetheless is effective for the company.

Raleigh Normal Clinic in West Virginia unveiled a assertion that it was continue to investigating Brewster and cooperating with authorities but declined to solution questions about the situation.

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