Nurse swaps fentanyl with saline, then emergency patient gets tampered drug, feds say

While working as a registered nurse at a Wisconsin hospital, a woman stole fentanyl and replaced the drug with saline, according to federal authorities.

Then she resealed the vials with what appeared to be superglue before putting the drugs back in dispensing machines for future patient use, authorities said in a Sept. 14 news release.

At least one patient received one of her tampered vials from the emergency room’s machine in November 2021, according to court records.

Earlier this year, she pleaded guilty to one count of product tampering, records show.

Now, the 54-year-old Janesville woman has been sentenced to one year and three months in federal prison, according to a news release from the U.S. Attorney’s Office for the Western District of Wisconsin. She has also been fined $30,000 and ordered to one year of supervised release following her time in prison.

Her defense attorney did not immediately respond to a request for comment from McClatchy News on Sept. 15.

The tampered vial of fentanyl that was given to a patient was one of two tampered vials discovered over two days, according to the woman’s plea agreement.

The vial given to the patient had “a substance appearing to be glue on top of the vial,” authorities said.

Another vial “had a clear crusty substance, which appeared to be superglue, on top of the vial,” according to court records. The vial’s stopper had been punctured or pushed down, the amount of liquid seemed “off” and the liquid appeared to be more yellow in color, the court documents said.

During an audit, authorities said they found another tampered vial in a different department. The vial had glue on the top, a puncture in the stopper and too much liquid, according to court documents.

Investigators also discovered that the nurse “had an excessive pattern of fentanyl overrides and wastes when compared to other employees in 2021,” according to the release.

The Food and Drug Administration took the three tampered vials, which were then sent to analysis, authorities said. The concentration of fentanyl in one of the vials was equal to 2.2% of the declared amount, and a second vial had 5.6% of the declared amount, according to court records. The third vial did not have enough liquid to be tested.

Hospital management confronted the nurse and asked her to take a drug test in November 2021, authorities said. She refused to take the test and resigned from the hospital.

During her sentencing hearing Sept. 14, she “expressed remorse for her actions and noted that her illegal conduct was driven by her addiction to opioids,” according to the release. “She indicated that the harm she caused to her patients by her actions will haunt her for the rest of her life.”

U.S. District Judge William M. Conley said “he understood that she acted out of character because of her addiction,” according to the release. “However, he also noted that her decision to steal fentanyl, and then tamper with the vials and return them to the medication dispenser for use with patients, was the reason he was sentencing her to prison.”

“Fentanyl is associated with a high likelihood of dependency, abuse, and addiction,” according to the American Addiction Centers. Many patients given the drug for severe pain, typically during cancer treatment or after surgery, need addiction treatment even after following doctor instructions.

As many as 15% of medical workers will abuse drugs or alcohol during their career, according to the AAC. Healthcare workers stealing fentanyl “has been a major issue concerning patient safety in hospitals.”

“The theft and replacement of fentanyl (usually with saline) causes suffering to the patient that is unknowingly untreated for their pain, while the healthcare workers who steal fentanyl for personal use are at risk of overdose,” the AAC said.

Janesville is about 75 miles southwest of Milwaukee.

This story was originally published September 15, 2023 at 10:56 AM with the headline "Nurse swaps fentanyl with saline, then emergency patient gets tampered drug, feds say."