Drug Diversion from the Healthcare Workplace A Multi-Victim Crime. Keith H. Berge MD

Transcription

1 Drug Diversion from the Healthcare Workplace A Multi-Victim Crime Keith H. Berge MD Consultant in Anesthesiology- Mayo Clinic Rochester, MN Chair- Mayo Clinic Medication Diversion Prevention Committee Past-President- MN Board of Medical Practice Chair- ASA Task Force on Chemical Dependency 2013 MFMER slide-1

2 Disclosures Nothing to disclose 2013 MFMER slide-2

3 Diversion means: The transfer of a controlled substance from a lawful to an unlawful channel of distribution or use. (Uniform Controlled Substances Act (1994) 2013 MFMER slide-3

4 Introduction We have an ongoing epidemic of prescription drug diversion and abuse in America This puts patients in significant danger Some of those becoming addicted work in the healthcare setting Some of these addicted health care workers divert (steal) drugs from their patients and their employers to support their addiction 2013 MFMER slide-4

5 Faces of Drug Diversion Capt. Jon Dale Jones, CRNA 16 confirmed Hepatitis C infections Sentenced to 41 months in prison 2013 MFMER slide-5

6 Faces of Drug Diversion Kristen Parker, Surgical Tech, Gets 30 Years For Infecting Patients With Hepatitis 2013 MFMER slide-6

7 Faces of Drug Diversion Mayo Clinic Radiation Tech Steven Buemel gets 30 years for 5 Hepatitis C infections 2013 MFMER slide-7

8 Faces of Drug Diversion Hepatitis C Outbreak: Radiation Technician David Kwiatkowski- Recently sentenced to 39 years 2013 MFMER slide-8

9 Faces of Drug Diversion Capt. Jon Dale Jones, CRNA 16 confirmed Hepatitis C infections Sentenced to 41 months in prison 2013 MFMER slide-9

10 Faces of Drug Diversion Kristen Parker Surgical Tech, Gets 30 Years For Infecting Patients With Hepatitis 2013 MFMER slide-10

11 Faces of Drug Diversion Steven Beumel Mayo Clinic radiation tech gets 30 years for 5 Hepatitis C infections 2013 MFMER slide-11

12 Faces of Drug Diversion David Kwiatkowski Recently sentenced to 39 years for infecting at least 45 people with Hepatitis C 2013 MFMER slide-12

13 Mayo Clinic Proceedings Volume 89, Issue 7 (July 2014) 2013 MFMER slide-13

14 Six outbreaks of disease related to drug diverting healthcare workers Two outbreaks infected 34 patients with Gram Negative Bacteremias Four outbreaks infected 84 patients with Hepatitis C 2013 MFMER slide-14

15 Take Home Points Drug diversion put our patients in danger The four HCW with HCV resulted in the required notification of Wait for it. 30,000 patients who needed BBP testing This results in a large financial burden, and may bankrupt a healthcare facility 2013 MFMER slide-15

16 Diversion is a Crime While some call addiction a victimless crime, supporting that addiction by drug diversion from the heath care workplace is a multi-victim crime It puts at risk the patient It puts at risk the addicted diverter It puts at risk their co-workers It puts at risk the their employer It puts at risk society in general 2013 MFMER slide-16

17 Why the Epidemic? Availability Perception of safety in relation to street drugs Profit motive 2013 MFMER slide-17

18 Addiction comes to work Any healthcare facility which houses controlled substances is at risk for diversion Any employee is capable of diversion Vigilance is mandatory Diversion often happens by seducing co-workers into policy violations e.g. virtual witnessing of waste Often these are otherwise stellar employees 2013 MFMER slide-18

19 MN Dept of Health/DEA from DEA form 106 data 2013 MFMER slide-19

20 MN Coalition to Prevent Drug Diversion MN Department of Health MN Hospital Association divroadmap pdf 2013 MFMER slide-20

21 When/How to involve Law Enforcement? Significant Loss must be reported to DEA within one business day ANY THEFT must be reported to DEA 2013 MFMER slide-21

22 Mass General to Pay $2.3 million over drug thefts Boston Globe 9/28/ MFMER slide-22

23 In Summary Theft of controlled substances is common in the health care workplace If you look, you will find it Many divert, even employees with no access to drugs Learn from each episode- diverters are often very clever Waste stream is under constant attack Desperate people will raid dirty sharps containers 2013 MFMER slide-23

24 Desperation meets Opportunity Dirty Sharps Container from Emergency Department 2013 MFMER slide-24

25 Questions? 2013 MFMER slide-25