Health officials in at least three countries are investigating a travel nurse who is suspected of handling and potentially contaminating vials and syringes with opioid painkillers in two hospitals, and then return the vials to vials where they could unknowingly administer them to patients.
One hundred patients who may have been exposed to contaminated syringes at Johnson City Medical Center in Tennessee last year were asked to be tested for hepatitis and HIV. state documents obtained by KHN through a request for public records.
The documents also reveal that Raleigh General Hospital in West Virginia gave ampoules to law enforcement agencies this year to test evidence of tampering. These results have not been published.
Travel nurse Jacqueline Brewster, 52, of Belfry, Kentucky, was arrested by her local sheriff’s office on unpublished charges on Tuesday in response to an arrest warrant from Washington County, Tennessee, where allegations of manipulation began, according to prison and court records. . Brewster was released Wednesday with orders to report to Tennessee within 10 days.
“I didn’t run from anything,” Brewster said in court. “I don’t know how I can be on the run.”
According to documents submitted by the Tennessee and West Virginia health authorities to their respective health committees, Brewster is suspected of repeatedly opening hospital vials to withdraw vials or syringes of the opioid painkiller, Dilaudid, allegedly taking some of the drug to he could use it or steal it. and then returning the vials or syringes, possibly after backing the cap. In an interview with KHN, the general manager of one of the affected hospital systems claimed that the travel nurse had added additional fluid to the syringes – possibly in an effort to cover the tracks.
The previously unreported allegations against Brewster come at a time when a coronavirus pandemic has forced many U.S. hospitals to rely more than ever on travel nurses, who often cross state borders, to work in short-staff hospitals for months. As the virus flooded hospitals with patients and exacerbated the shortage of nurses, many hospitals turned to travel nurses to fill in the gaps, often at dramatically increased costs.
“Despair” in recruiting nurses has also exacerbated existing shortcomings in the government’s infrastructure to hold nurses accountable, said John Benson, co-founder of Verisys, a data management company that examines potential employees for health care systems.
Brewster is suspected of repeatedly opening hospital vials to pull out vials or syringes of the opioid painkiller, Dilaudid, allegedly removed some of the drug to use or steal it, and then returned the vials or syringes, presumably after the cap was affixed. .
Nurses and other health professionals are licensed, investigated and disciplined at the state level. However, investigators are not communicating well across national borders, Benson said, so when more nurses began traveling during the pandemic, it was easier to “overtake” the investigation by getting a new job in another state long before the allegations of wrongdoing became public.
“The system was broken in front of Covid,” Benson said. “It just broke more during Covid.”
Brewster, a registered nurse, has been licensed in Kentucky since 2004 and holds a license that allows her to work in more than 30 states. to participate in the nurses’ license pact. After being accused of manipulation at Raleigh General last month, the West Virginia sister council suspended Brewster’s ability to practice in the state. A few days later, Tennessee health officials acted on a complaint they received from Johnson City Medical Center last July, initiating professional disciplinary action that could deprive Brewster of his ability to work in that state later this year.
Since Wednesday, Brewster’s multi-state license has been “investigated” in Kentucky, but otherwise unrestricted, meaning that she could still work as a nurse in most countries. It is not known where else Brewster could have worked as a travel nurse, including seven months after she was first charged with manipulation in Tennessee.
Brewster could not be reached and commented, and it is not clear if she has a lawyer. A Knoxville attorney listed as Brewster’s attorney in records stored on the Tennessee Board of Nursing denied representing the nurse.
She chose Dilaudid and replaced it with another substance that looked transparent like Dilaudid, and replaced the vials in the Omnicell system. One of our nurses noticed that something in one of the bottles looked different and immediately reported it to the pharmacy.
– Alan Levine, General Manager, Ballad Health
One hospital that became heavily dependent on travel nurses during the pandemic was Johnson City Medical Center. Ballad Health, which owns the hospital, said last summer that the pandemic had increased the number of travel nurses the company employed from 150 to 400.
Brewster was among the hired. According to records, she was employed by Jackson Nurse Professionals, a travel nursing company in Orlando, Florida, and worked at Johnson City Medical Center for three months before the alleged manipulation was discovered.
Ballad Health CEO Alan Levine told KHN that another nurse had labeled the suspect vial in the hospital’s medical cabinet and an internal investigation had linked the vial to Brewster.
“She removed Dilaudid and replaced it with another substance that looked clear as Dilaudid, and replaced the bottles in the Omnicell system,” Levine said. “One of our nurses noticed that something in one of the vials looked different, and she immediately reported it to the pharmacy.”
Ballad Health released Brewster and alerted law enforcement and the Tennessee Department of Health, according to the company. She sent five Dilaudid syringes to the Tennessee Bureau of Criminal Laboratories, which confirmed that the amount of the drug was not “in accordance with the product label”, according to the nursing board’s documents.
The hospital said it tried to give Brewster a drug test. She first provided an insufficient urine sample, as stated in the documents, and then after providing the second sample, Brewster “accused the laboratory technician of being corrupt”, took the sample from his hand and threw it in the sink.
“This is my *** [sic]Brewster said when she took the sample back according to the documents.
The Tennessee Department of Health filed a professional disciplinary case against Brewster’s Nursing Board on March 31. He is scheduled to attend a board hearing on August 24 and risks losing his nursing license.
At one point, when she was released from Johnson City Medical Center, Brewster began working at Raleigh General, an unrelated hospital about 120 miles north of Beckley, West Virginia.
Last month, the hospital told a nursing board in West Virginia that the Dilaudid bottles in its first aid kits were apparently being handled, according to a board order suspending Brewster’s license. Some vials lacked tops, and others had tops marked with a residue that “looked like glue,” the board says.
The internal investigation again “led” directly to Brewster, as ordered by the board.
Raleigh General “disposed of many vials of Dilaudid to protect patients from contamination” and provided several vials to law enforcement agencies for testing. The results were not published.
Jackson Nurse professionals did not respond to comment requests. It is not clear whether Brewster still works for the company.
Raleigh General Hospital in West Virginia said it was still investigating Brewster and cooperating with the authorities, but declined to answer questions about the case.
(KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Together with policy analysis and public opinion polling, KHN is one of the three main operational programs in KFF (Kaiser Family Foundation). KFF is a subsidized non-profit organization that provides information about the nation’s health problems.)