' 2823732. . oo STATEOF FLORIDA yi DEPARTMENT OF HEALTH Do O Ft oy OE DEPARTMENT OF HEALTH KES, OSA Deg Petitioner, Bio Es ¢. . oe Wy, vs. Case No. 2001-06992 * KIMBERLY KING, RN., - Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, DEPARTMENT OF HEALTH, by and through its undersigned counsel and files this administrative complaint before the Board of Nursing against the Respondent, KIMBERLY KING, R.N., and i in support thereof alleges: 1. The Department of Health (hereinafter referred to as "the Department") is the state agency charged with regulating the practice of nursing pursuant to Section 20.43, Florida Statutes, and Chapters 456 and 464, Florida Statutes. . i. 2. Pursuant to the authority of Section 20.43(3)(g), Florida Statutes, the . Department has contracted with the Agency for Health Care Administration (hereinafter referred to as "the Agency") to provide consumer complaint, investigative, and prosecutorial services required by the Division of Medical Quality Assurance, councils, or boards, as appropriate. 3. KING has at all times pertinent herein been a duly licensed fegistered nurse pursuant to Chapter 464, Florida Statutes, having been issued license number RN . BE ET RT ETRE CREE eee CR TE REE RRR cr oe 4. KING’s last known address is 772 Crestridge Drive, Tarpon Springs, Florida 34689. 5. In May 2001, KING was employed as a registered nurse by St. Petersburg Generali Hospital (hereinafter referred to as "SPGH") located at 6500 38th Avenue North, St. Petersburg, Florida, and assigned to. work in the Emergency Room/Department (hereinafter referred to as "ER"). 6. As a nurse in the ER, one of KING's duties was the withdrawal and administration of ordered medications, including controlled substances, to patients to whom KING was assigned. . 7. On or about May 17, 2001, Dr. Ervin Anthony (hereinafter referred to as "Dr. Anthony"), an ER physician at SPGH, noticed that narcotics had been withdrawn from the Pyxis narcotics storage system for patients for whom Dr. Anthony did not prescribe narcotics. Dr. Anthony notified Debbie Nowlin (hereinafter referred to as “Nowlin"), R.N., Charge Nurse of the ER at SPGH, of the discrepancies i in the narcotics removed from the Pyxis and his treatment of the patients. 8. Nowlin contacted Jodi Harnish (hereinafter referred to as "Harnish"), Clinical Supervisor of the ER at SPGH, regarding the discrepancies noted by Dr. Anthony. Harnish contacted Gigi Laursen (hereinafter referred to as "Laursen"), R.N., Nursing Supervisor of the ER at SPGH and directed her to proceed to the ER and to ‘conduct drug screening of all the ER nursing staff on duty at the time of the discrepancies, including KING. Wer tyee ene es a on 9. KING refused to empty her pockets and to submit to the requested drug screen. KING informed both Laursen and Harnish that KING had “smoked pot " (Marijuana) a few weeks earlier and feared that the drug screen would return positive. 10. KING exited SPGH without submitting to the drug screen. 11.” A review of the narcotic records revealed the following discrepancies in KING's withdrawal and documentation of the administration of controlled substances under her care: a. On or about 5/16/01, at approximately 5:15 a.m., KING withdrew 25 mg. of Phenergan for administration to patient D.B.; Patient D.B. did not have physician's orders for Phenergan to be administered and KING did not document administering or wasting. the Phenergan. b. On or about 5/15/01, at approximately11:25 p.m., KING withdrew 100 mg. of Meperidine (Demerol) and 25 mg. of Phenergan for administration to patient P.R.: Patient P.R. did not have physician's orders for Meperidine or Phenergan to be administered and KING did not document administering or wasting the Meperidine or Phenergan. 12. Marijuana is a Schedule | controlled substance pursuant to Chapter 893, Florida Statutes. A substance in Schedule | has a high potential for abuse and has no currently accepted medical use in treatment in the United States and in its use under medical supervision does not meet accepted safety standards. . 1 3. Demerol is a Schedule |! controlled substances pursuant to Chapter 893, Florida Statutes. A substance in Schedule II has a high potential for abuse and has a 3 RTE TIRE IE Rea eae ceree er teeE F currently accepted but severely restricted medical use in treatment in the United States, and abuse of the substance may lead to severe psychological or physical dependence. 14. | Phenergan is a Schedule IV controlled substance pursuant to Chapter 893, Florida Statutes.’ A substance in schedule IV has a low potential for abuse relative to the substances in Schedule III and has a currently accepted medical use in treatment in the United States, and abuse of the substance may lead to limited physical or psychological dependence relative to the substances in Schedule III. 15. The minimal acceptable standards of Prevailing nursing practice, as defined by Rule 64B9-8.005(1), Florida Administrative Code, require that a Nurse accurately administer controlled substances, and accurately document the amount of controlled substances given to a patient and the amount of controlled substances that was intended for ; a patient, but was wasted instead. Inaccurate documentation of the administration of controlled substances poses a danger to patients, in that it may lead to patients receiving too much or too little of the necessary physician ordered medication. 16. A nurse’s removal of controlled substances for administration to patients and the subsequent failure to accurately document administering or wasting the controlled substances is a strong indication that a nurse is diverting those controlled substances for his or her Own personal use: 17. A subsequent review of KING" S personnel file revealed that at the time of the documentation discrepancies, KING was on probation by the Board of Nursing pursuant to a consent agreement entered into regarding Agency case number 2000- 02247. ENTE ST Mee Re SRR PR eee ge rreE ers 18. The administrative complaint in Agency case number 2000-02247 alleged that in January of 1999, while employed by Delray Medical Center, KING inaccurately recorded the withdrawal and subsequent administration or wastage of controlled substances to patients under her care, including withdrawing and documenting administering controlled substances to patients that did not have physician’s orders for the medications to be administered and withdrawing controlled substances for patients but not documenting the administration or wastage of the substances. KING was charged with violating Section 464.018(1)(h), Florida Statutes as defined by Rule 64B9- 8.005(1), Florida Administrative Code, by inaccurate recording, falsifying or altering patient records. 19. In part the consent agreement in Agency case number 2000-02247 specifies that KING “shall not violate Chapter 455 or 464, Florida Statutes, [or the] rules promulgated pursuant thereto” and that KING was to furnish a copy of the Final Order to her nursing supervisor or supervisors. 20. KING provided her supervisor with an incomplete copy of the Final Order from case number 2000-02247, omitting the administrative complaint that was filed in that case and incorporated into the Final Order by reference. By providing an incomplete copy of the Final Order to her employer, KING has violated the Final Order. 21. KING's withdrawal of controlled substances for patients that did not have orders for those controlled substances, and her subsequent failure to document administering or wasting the controlled substances, constitutes a violation of Section . 464.018(1)(h), Florida Statutes, and therefore a violation of the Final Order entered in case number 2000-02247, TT SORE ARERR TERT CURE HE eRe once Count I 22. Petitioner realleges and incorporates the allegations of fact contained in paragraphs one (1) through twenty-one (21) as if fully restated herein. 23. Based upon the foregoing, KING’s nursing license is subject to discipline pursuant to Section 464.018(1)(j), Florida Statutes, for being unable to Practice nursing with reasonable skill and safety to patients by reason of ‘illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result, tof any mental or physical condition. Count Il 24. Petitioner realleges and incorporates the allegations of fact contained in paragraphs one (1) through twenty-one (21) as if fully restated herein. 25. | Based upon the foregoing, KING’s nursing license is subject to discipline pursuant to Section 464.018(1)(I), Florida Statutes, for knowingly violating a lawfully entered Order of the Board or Department. Count Ill 26. Petitioner realleges and incorporates the allegations of fact contained in Paragraphs one (1) through twenty-one (21) as if fully restated herein. 27, Based upon the foregoing, KING’s nursing license is subject to discipline pursuant to Section 464.018(1)(h), Florida Statutes, by failing to conform to the minimal ~ acceptable standards of prevailing nursing practice by violating Rule 6489-8. 00(1), Florida Administrative Code, inaccurate recording, falsifying or altering patient records. Count IV CERRO TRON PRET PPT RNR reer hee 28. Petitioner realleges and incorporates the allegations of fact contained in Paragraphs one (1) through twenty-one (21) as if fully restated herein. 29. Based upon the foregoing, KING's nursing license is subject to discipline pursuant to Section 464.018(1)(i), Florida Statutes, by engaging or attempting to engage in the possession, sale or distribution of controlled substances under chapter 893 for other than legitimate purposes. WHEREFORE, Petitioner respectfully request that the Board of Nursing enter an Order imposing one or more of the following penalties: Revocation or suspension of Respondent's license, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, costs, and/or any other relief that the Board deems appropriate. Signed this |2Niay of De ginenlac 200. John O. Agwunobi, M.D., MBA Acting Secretary, Department of Health hief Attorney On Behalf of the Agency for Health Care Administration 4) FILED LTH COUNSEL FOR THE PETITIONER: OEP NR MET LEAK Reginald D. Di ‘on, Senior Attorney FBN: 01129 Agency for H ‘ CLERK Lhicft a Ith\Care Administration _ (6) Allied Health Section . , Post Office Box 14229 Tallahassee, Florida 32317-4229 (850) 414-8576. RDD/rd PCP: DOM: 77/9 Me / mr SM PIERRE REET Per Re Ie gE ee ee ey erm ae

Docket for Case No: 01-004815PL