Anesthesia Resident Arrested

Started by San Marzano
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San Marzano

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komonews.com

UW resident doctor charged with diverting fentanyl from young patients

A UW resident doctor at Seattle Children’s Hospital is accused of diverting fentanyl and other controlled substances while treating children.
komonews.com komonews.com

Chances are if you've been in this field long enough you've personally met someone who was diverting. Never heard of someone getting arrested for it though.
 
From the link.

“The attending physician observed Voegel-Podadera draw up an excessive amount of fentanyl into syringes that would not be needed for their patients that day. With concerns Voegel- Podadera was diverting, Seattle Children’s arranged for all the substances returned as wastage to be tested that day and found the waste syringes were filled with saline solution,” the complaint said.“

It sounds like he wasn’t surreptitiously underdosing the kids. He drew up too much, likely dosed the kids appropriately, diverted some for himself, and surreptitiously wasted saline. So he was probably diverting from “waste”, not diverting from actual patients.

Ironically Seattle Children’s is the vanguard of the opioid free movement.

More Than 10,000 Opioid-Free Outpatient Surgeries

5.5.21 | Seattle Children’s is proud to report we have surpassed a milestone of more than 10,000 opioid-free outpatient surgeries at our Bellevue Clinic and Surgery Center.
www.seattlechildrens.org www.seattlechildrens.org
 
Last edited by a moderator:
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Don’t mess with the Feds and narcotics in this profession even if you don’t cause any harm to the patient.

You can be a drunk with multiple dui arrested and not get in any real big trouble as long as u don’t cause any harm.
 
aneftp said:
Don’t mess with the Feds and narcotics in this profession even if you don’t cause any harm to the patient.

You can be a drunk with multiple dui arrested and not get in any real big trouble as long as u don’t cause any harm.
Click to expand...
Or you could be Diddy and face minimal charges.
 
An older resident get caught when I was just a ca1. He quietly went to rehab; our program had "a one strike and you're out" policy. They got him into an IM program and he's done quite well.

This resident won't ever practice again
 
Almost every place I worked at has had some one with a history of anesthesia drug problem either locums or full time with the last 36-48 months. They get re hired. And pass through the system
 
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There is a pattern. Initially, the person skims off the top like you describe. A little for them…just what would be the “leftovers” skimmed at the front end. Then it’s “half for me, half for the patient.” Then it becomes “I’ll take it all and give the patient saline with some beta blocker so no one will notice.” The longer they go before getting caught, the less drug the patient is getting. It escalates quickly and they are typically pretty far gone within six months or a year. This is based on what I have heard about multiple scenarios.
 
Gern Blansten said:
There is a pattern. Initially, the person skims off the top like you describe. A little for them…just what would be the “leftovers” skimmed at the front end. Then it’s “half for me, half for the patient.” Then it becomes “I’ll take it all and give the patient saline with some beta blocker so no one will notice.” The longer they go before getting caught, the less drug the patient is getting. It escalates quickly and they are typically pretty far gone within six months or a year. This is based on what I have heard about multiple scenarios.
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Agree that is the most common scenario that I have heard about.We only get to hear about the ones that get caught. We don’t know about those that don’t get caught. E.g. the person that skims a little who sells it or is just a recreational user who doesn’t up their diversion. We just don’t know what we don’t know.
 
Lab Lover said:
Agree that is the most common scenario that I have heard about.We only get to hear about the ones that get caught. We don’t know about those that don’t get caught. E.g. the person that skims a little who sells it or is just a recreational user who doesn’t up their diversion. We just don’t know what we don’t know.
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Only the "smartest person in the room" thinks they won't get caught eventually. Fentanyl addicts need 6 doses a day to maintain the craving. Hard to hide that for very long. Due to the short action and addiction potential, recreational use quickly escalates. Anyone with the least amount of common sense would never get started taking fentanyl.
 
Lab Lover said:
Agree that is the most common scenario that I have heard about.We only get to hear about the ones that get caught. We don’t know about those that don’t get caught. E.g. the person that skims a little who sells it or is just a recreational user who doesn’t up their diversion. We just don’t know what we don’t know.
Click to expand...
Fentanyl is virtually free. Opiate naive users are ODing on 2 dollar pills (street pricing). My understanding is virtually everyone that starts diverting spirals out of control within 6 months because their tolerance builds so rapidly.

I think it’s pretty clear these people should be forced to go into a different field. That’s already plenty generous enough imo.
 
I wish our field had some sort of accepted guidance or framework for how to identify this situation early and help these people. In three years of residency we lost two residents to overdoses, one of them in the actual OR. We got an email saying there were counselors available if we wanted to talk, but otherwise the day would continue normally.
 
Blackmateria said:
I wish our field had some sort of accepted guidance or framework for how to identify this situation early and help these people. In three years of residency we lost two residents to overdoses, one of them in the actual OR. We got an email saying there were counselors available if we wanted to talk, but otherwise the day would continue normally.
Click to expand...
It’s hard to identify when you have super smart people whose main goal is NOT to be discovered. Sometimes their spouse is even aware but they become “in cahoots” because their entire lives are on the line and the spouse doesn’t understand that death is a very high risk if the behavior persists. The offender will often convince the spouse that they have quit after the spouse’s discovery of the problem occurs. It is very tempting for the spouse to believe them because they can see the finish line ahead (end of residency) and the beginning of a much better and more prosperous life as payoff for all of the years of sacrifice on both of their parts. It can become that family’s dirty little secret and the spouse is convinced that they are okay and can beat the problem.
Because their source is the hospital, they appear to be the model employee. The person who always arrives early and stays late. The person willing to do the big cases (where more opioid can be justified). The person willing to give breaks for dinner. The person who will take the calls you need covered. Initially, the charting is meticulous in order to make sure all opioids are accounted for. It is not until the very advanced stages that the addict loses the ability to hide the problem from their colleagues at work.
In my experience, it is often a complete shock because the addict has been a stellar resident and has a reputation as a super hard worker (although I have also seen it in a resident that was a constant behavioral problem as well).
It is most often best detected by fellow residents and family members who can better notice the subtle changes earlier.
The best deterrent, in my opinion, is frequent discussions of the issue with the resident group, to include the spouses. In addition, I feel like the threat of random drug screens, even if infrequent, is a very good deterrent.
I also feel strongly that intravenous abuse of opioids should be a disqualifier for a return to the field of anesthesiology. Death being the first sign of relapse has been reported to be 20%. I feel like the risk is too high for our patients and for the individuals. I have also found that treatment centers will almost always recommend that the program accept them back into residency. I don’t trust their advice or their motivations.
 
My hospital actually does random testing on returned, aka wasted, controlled substances to ensure proper content and drug concentration. OR pharmacist once asked me questions about the typical induction practice of the dept to answer their question about some contamination results of drugs a resident returned.
 
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CopaceticOne said:
My hospital actually does random testing on returned, aka wasted, controlled substances to ensure proper content and drug concentration. OR pharmacist once asked me questions about the typical induction practice of the dept to answer their question about some contamination results of drugs a resident returned.
Click to expand...
Yeah as soon as the VA pharmacy gave me a hard time about a wisp of propofol in a fentanyl stick I returned (from the stopcock I originally used for propofol), all my patients suddenly started receiving all their narcotics.
 
San Marzano said:
komonews.com

UW resident doctor charged with diverting fentanyl from young patients

A UW resident doctor at Seattle Children’s Hospital is accused of diverting fentanyl and other controlled substances while treating children.
komonews.com komonews.com

Chances are if you've been in this field long enough you've personally met someone who was diverting. Never heard of someone getting arrested for it though.
Click to expand...


Also never heard of an arrest. I know of one case where the doctor was found impaired at work. She tried to drive home after she was told she had to leave. Her car had to be blocked into its parking spot and the sheriffs were called. She still wasn’t arrested.
 
nimbus said:
Also never heard of an arrest. I know of one case where the doctor was found impaired at work. She tried to drive home after she was told she had to leave. Her car had to be blocked into its parking spot and the sheriffs were called. She still wasn’t arrested.
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Another anesthesia icu doc bites the dust getting arrested. Same stuff. Fentanyl

Just a dime a dozen. Thad’s your chief quality officer lol previously for a major academic institution

Hca lawnwoon was a cash cow for locums last year as well. 40-50k a week. I missed that gravy train. But so many gravy trains to hop on these days.

cbs12.com

Florida doctor charged after allegedly stealing fentanyl from ICU patient

A Florida doctor has been formally charged with a felony after allegedly siphoning fentanyl from an ICU patient's IV line during a night shift.
cbs12.com cbs12.com
 
As a resident someone would trade his day work for my busy call night and post call day off. I was like, no need to ask me twice, I'm all over that. Not long after the Chairman came into morning conference telling us that said resident has left the program and won't be coming back. Blew my mind, but it did clear up my confusion over who would want to pick up more residency call.

Different hospital crna comes in the room late in the day all eager to give me a break. "We gotta stick together and help everyone." Case was about finished, but ok, whatever, sure. I come back for wake up of whatever simple case it was, and tells me he gave the patient the rest of the fentanyl to wake up smooth. Um, the whole 250mcg?? This guy was out of the textbook, sweat shirts, eager to give breaks, inappropriate "dosing," etc. I went to the chairman and he just didn't want any part of it. The guy later on ended up in rehab. The chairman's response was perplexing....

....until years later I worked with a guy a while back that had lost his job elsewhere because he made a stupid comment one day, and just off of that was brought in for an intervention. To keep his job he would have had to go spend like 3 or 4 days with addicts in inpatient observation for full evaluation and clearance. He told them something like go kiss my rear and went on his way to look for work elsewhere, but lost his career at that hospital which apparently wasn't easy on him. So then I understood a little better why my previous chairman in paragraph 2 wanted no part of getting involved. I still don't agree with his inaction, but I do have a better idea why. An incorrect accusation of drug use in our field is devastating.

Anyway, drug issues are plentiful in our line of work.
 
We'llBeDoneIn15Minutes said:
As a resident someone would trade his day work for my busy call night and post call day off. I was like, no need to ask me twice, I'm all over that. Not long after the Chairman came into morning conference telling us that said resident has left the program and won't be coming back. Blew my mind, but it did clear up my confusion over who would want to pick up more residency call.

Different hospital crna comes in the room late in the day all eager to give me a break. "We gotta stick together and help everyone." Case was about finished, but ok, whatever, sure. I come back for wake up of whatever simple case it was, and tells me he gave the patient the rest of the fentanyl to wake up smooth. Um, the whole 250mcg?? This guy was out of the textbook, sweat shirts, eager to give breaks, inappropriate "dosing," etc. I went to the chairman and he just didn't want any part of it. The guy later on ended up in rehab. The chairman's response was perplexing....

....until years later I worked with a guy a while back that had lost his job elsewhere because he made a stupid comment one day, and just off of that was brought in for an intervention. To keep his job he would have had to go spend like 3 or 4 days with addicts in inpatient observation for full evaluation and clearance. He told them something like go kiss my rear and went on his way to look for work elsewhere, but lost his career at that hospital which apparently wasn't easy on him. So then I understood a little better why my previous chairman in paragraph 2 wanted no part of getting involved. I still don't agree with his inaction, but I do have a better idea why. An incorrect accusation of drug use in our field is devastating.

Anyway, drug issues are plentiful in our line of work.
Click to expand...

I dont think I've encountered anyone so brazenly suspicious for drug diversion. Wow. It's also very eye opening to read all these stories about how people spiral so quickly with their addictions.
 
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