2 Recent Cases Question Increase Use of Advanced Practice Providers

Sarasota, FL (WorkersCompensation.com) – Healthcare has seen an upward trend in the utilization of advanced practice providers (APPs) in effort to meet the need of treating patients. Some reports suggest that an APP can do around 85 percent of what a physician does, leaving the physician available to focus solely on the remaining 15 percent that is more complex.

According to a recent report, fewer physicians are working in the emergency departments of hospitals as a side effect of their attempt to lower costs, which means you are more likely to be treated by an APP instead of a physician. In a recent case in Indiana, seeing an APP instead of a physician turned out to be painful.

Former Registered Nurse Jennifer L. Adams was employed in the emergency department at Franciscan Health in Crawfordsville, Indiana from October 2018 to February 2020. According to a recent press release from the Southern District of Indiana Department Of Justice, Adams pled guilty to tampering with consumer products and subsequently sentenced to 3 years in federal prison.

Investigators assert that Adams stole vials of medication that were to be used on patients, gaining access from automated dispensing machine. The medications included injectable fentanyl, morphine, hydromorphone, and ketamine. Instead of administering the injectable pain medications into the patients she was treating, she used them herself.

To conceal the fact that she had used the medication vials, Adams would refill the vials with saline, and then super glue the lids back on. Investigators discovered that Adams used and refilled between 2 and 7 vials of medication every shift that she worked. The investigators believe that Adams used the fake solution on at least 30 to 40 patients in the emergency department.

In yet another disturbing tampering case reported by News 11, former travel nurse Jacqueline Brewster from Kentucky was arrested after a three state investigation into allegations of tampering with vials of painkillers. Additionally, according to court documents in a report from Fierce Healthcare, Brewster may have exposed over a hundred patients to hepatitis and HIV from the contaminated syringes.

One worrisome element about this case is that the Tennessee Department Of Health (TDH) was notified of alleged drug tampering and diversion, but did not take emergency action to suspend her privileges to practice in Tennessee. In fact, no emergency action was taken by the TDH until 17 months after the initial complaint. As a result, Brewster was not listed as having a disciplinary action in the “NURSYS” notification system and 5 months later able to obtain a travel job in West Virginia and Kentucky where she eventually got caught for the same infractions. West Virginia dismissed her license to practice a few weeks later, and Kentucky followed suit less than a month later.

Both Tennessee and Virginia are part of a 30 state cooperative that allows nurses with licenses in their home states to practice in other states. Considering the potential for delays in communication of disciplinary action, especially for travel nurses, along with the increase in utilization of APPs, both of these criminal cases serve as a cautionary tale for healthcare.

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