Hospital nurse suspected in opioid theft was hired without a background check

An eastern Iowa hospital has been cited by the state for hiring, without a full background check, a nurse who was later fired for the suspected theft of opioid narcotics.

The Iowa Department of Inspections and Appeals reports that in January a registered nurse working at Iowa City’s Mercy Hospital procured a 100-microgram vial of Fentanyl – a powerful opioid used to treat severe pain – for a patient and then reported disposing of the medication 90 minutes later without having administered any of it. The patient in question had no physician order for Fentanyl.

Twelve days later, the same nurse procured another 100-microgram vial of Fentanyl for a different patient who had no physician order for the drug. The hospital records indicate that patient never received the Fentanyl and there’s no indication what happened to it.

A single high dose of Fentanyl is considered to be in the range of 20 to 50 micrograms.

Both incidents were treated as “suspicious” by the hospital and the nurse was later fired. However, according to state inspectors, the hospital failed to report the incidents to the Department of Inspections and Appeals as potential acts of dependent adult abuse.

State inspectors reviewed the hiring process used last fall to employ the nurse and found that Mercy Hospital had failed to conduct a complete background check on the individual.

An initial check by a third-party agency revealed the nurse had two criminal convictions, although the publicly available inspection reports don’t indicate what the convictions were for or how serious the crimes were. After the convictions were discovered, the hospital failed to secure the required state approval to hire the nurse and she was added to the staff.

At the same time, the hospital also failed to check the whether the nurse had any non-criminal findings of abuse on their record and failed to check whether the nurse was on the state’s Sex Offender Registry.

Although the state has cited the hospital for two regulatory violations related to patient abuse and employee background checks, no fines or penalties have been imposed. Under Iowa law, hospitals are not subject to state fines for regulatory violations.