The Texas Controlled Substance Act deals with drug-related offenses. It is considered a crime to possess, distribute, or manufacture controlled substances. Furthermore, controlled substances are divided into Schedules. According to Texas Health and Safety Code, “Controlled Substance” means a substance, including a drug, an adulterant, and a dilutant, listed in Schedules I through V or Penalty Groups 1, 1-A, or 2 through 4. The term includes the aggregate weight of any mixture, solution, or other substance containing a controlled substance. But if an RN is involved in such an offense, he/she needs a nurse attorney for the defense.
At the time of the incident, An RN was employed as a Registered Nurse at a medical facility in Garland, Texas, and had been in that position for six (6) years and four (4) months.
On or about January 13, 2018, January 14, 2018, and March 22, 2018, the RN withdrew two (2) syringes of Morphine 3mg/3ml for a patient and one (1) injection of Midazolam 2mg/2ml for another patient from the medication dispensing system but failed to follow the facility’s policy and procedure for wastage of the unused portions of the medications. The RN’s conduct left medications unaccounted for, could have misled the hospital pharmacy, and placed the pharmacy in violation of Chapter 481 (Controlled Substances Act) of the Texas Health and Safety Code.
On or about March 22, 2018, the RN withdrew one (1) injection of Midazolam 2mg/2ml for the patient from the medication dispensing system without documenting the physician’s verbal order. The RN’s conduct was likely to injure the patient, in that the administration of medications without a valid documented physician’s order could result in the patient suffering from adverse reactions, and in addition, the RN’s conduct placed the hospital in violation of Chapter 481 (Controlled Substances Act) of the Texas Health and Safety Code.
On the same day (March 22, 2018), the RN withdrew one (1) injection of Midazolam 2mg/2ml to a patient from the medication dispensing system but failed to document and/or accurately and completely document the administration of the medications in the patient’s Medication Administration Record (MAR) and/or Nurses’ Notes. The RN’s conduct resulted in an incomplete medical record and was likely to injure the patient in that subsequent care givers would rely on his documentation to further medicate the patient, which could result in an overdose.
In response to the incidents, the RN states that any error in documentation of medication administration and/or waste was purely unintentional and likely due to the hectic nature of the shift(s) with high acuity patients. The RN states that on March 22, 2018 the provider gave him emergency verbal orders for a one-time dose of both morphine and midazolam, which he withdrew and administered to the patient. He entered the verbal order for the morphine in the patient’s chart which the provider signed off on, but mistakenly did not enter the midazolam order, making it appear as though he withdrew the medication without an order. In wasting the unused portion of the midazolam, He also states that he accidentally entered the amount administered to the patient instead of the amount being wasted. Prior to the allegations herein, he had never been counseled or disciplined for medication transactions. No harm came to any of the RN’s patients as a result of the allegations herein.
As a result, the RN will be sanctioned due to the evidence received is sufficient cause pursuant to Section 301.452(b)(10)&(13), Texas Occupations Code, and to take disciplinary action against the RN by the Board. Every RN who is facing such situation should know that a nurse attorney is a great help to such cases. That is why you should not hesitate in asking for help from an expert, a nurse attorney.
Do you have questions about the Texas Board of Nursing disciplinary process? Contact The Law Office of RN License Attorney Yong J. An for a confidential consultation by calling or texting 24/7 at (832) 428-5679 and ask for attorney Yong.