Drug Diversion: Response Strategies to Protect Reputation and Patient Trust

January 1, 2015

by Jennifer Busick

At a health care center in Florida, patients who were undergoing radiology procedures believed they were receiving injections of a narcotic painkiller, fentanyl. What they didn’t know was that a radiology technician at the clinic was injecting himself with the fentanyl and then refilling the syringes with saline solution.

Although fentanyl is a painkiller rather than a lifesaving treatment medication, the switch was deadly, because the technician was infected with hepatitis C virus (HCV). One liver transplant patient who underwent a radiology procedure at the facility subsequently battled hepatitis C for four years and died. This death finally brought the criminal act to light. Thousands of patients were then tested; two, including the liver transplant patient, were found to have contracted the disease from the technician, who was ultimately arrested and charged with multiple crimes, including tampering with a consumer product resulting in death.

A loss-control problem with serious organizational consequences

At the root of this tragic scenario is drug diversion— the theft of prescription drugs by health care workers. The majority of drug diversion occurs in outpatient pharmacies—workers steal medications with a high “street value” for illegal resale. Usually, addressing outpatient drug diversion is strictly a loss-control issue. But drug diversion in inpatient facilities is a different, and potentially much larger, problem. Drug diversion in an inpatient setting is far more likely to arise out of employee addiction and to involve workers stealing injectable narcotics for their personal use. The CDC has identified 16 outbreaks of HCV that resulted from drug diversion between 2008−2012, resulting in 117 outbreak-associated cases and notification of over 80,000 exposed patients.

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