Health officials failing to protect patients from opioid-addicted caregivers

Hypodermic-NeedleAs the epidemic of prescription drug abuse spreads nationwide, public health authorities are failing to protect patients from the criminal wrong-doing of opioid-addicted caregivers, the Denver Post has reported.

The paper launched an investigation because of several prominent cases in the region, including a Colorado surgical technologist who infected hospital patients with hepatitis in 2008 and 2009 by injecting herself with fentanyl, an opioid painkiller, and leaving behind dirty needles. Further, the uproar over criminal conduct by addicted caregivers spread over several states in the region when a surgical tech at a major medical center in suburban Denver recently was reported to have stolen syringes containing fentanyl, and replaced them. This led the hospital to offer free HIV and hepatitis blood tests to about 2,900 patients because the tech carries an unidentified blood-borne illness.

The Post says that Colorado public health officials have been too eager to hush up cases involving addicted caregivers. Even when hospitals report incidents, including required reports of missing or stolen drugs, the officials fail to bring in police and prosecutors. This contradicts federal regulations, which require hospitals and other facilities to report to the Drug Enforcement Administration when controlled substances go missing or are believed to have been stolen.

Health officials, the Post said, also let hospitals quietly try to take care of wrong-doers on their own, declining, for example, to operate a rigorous registry and screening system so those suspected or found to steal and abuse drugs can’t hopscotch from one bad situation to another, going from hospital to hospital and state to state.

Meantime, the paper also found that the Colorado nursing board has taken a soft-line in dealing with its licensees who get in trouble with drugs. The agency gives them a second chance, if they will enter a treatment and monitoring program. The Post describes instances of nurses who successfully went through the program, and kept their licenses─even as large quantities of powerful painkilling drugs disappeared around them, and patients suffered as a result.

New York’s woes with oversight on nurses

Colorado’s inability to crack down on problem caregivers is not unique. ProPublica, the online investigative news site, recently published an expose about lax oversight of New York nurses.

As ProPublica discovered about the nursing board there:

Unlike many states, New York does not require applicants for nursing licenses to undergo simple background checks or submit fingerprints, tools that can identify those with criminal histories and flag subsequent legal problems. And it often takes years for New York to discipline nurses who provide inept care, steal drugs or physically abuse patients.

I’ve written before about state licensing boards, particularly for MDs, and how ineffectual they can be. Aggrieved patients can and should complain to them. But if these boards and other public health authorities can’t step up to better protect patients, other remedies may be needed. If states don’t want to cede oversight of practitioners’ professional credentials, perhaps they should work with federal authorities about a national database on caregivers’ criminal clearance, at minimum. Sadly, it may take some big verdicts in the civil justice system to rectify this problem, which seems to worsen by the day.

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