A Campbell River nurse has been found guilty of professional misconduct for falsifying medical records in order to divert prescription painkillers away from patients.
An investigation by the British Columbia College of Nursing Professionals found that Amanda Parniak diverted a “significant” quantity of hydromorphone away from vulnerable patients at the North Island Hospital Campbell River.
The college investigated more than 100 instances where Parniak either diverted hydromorphone from a patient, withdrew the powerful injectable narcotic while not on duty or withdrew multiple doses of the opioid less than five minutes apart for the same patient.
The nurse, who started working at the hospital in March 2017, was fired by Island Health in May 2018.
Parniak is facing professional discipline following an investigation and disciplinary hearing by the college. The offences happened over a six-month period from October 2017 to March 2018 while Parniak was working as a medical/surgery nurse.
“Ms. Parniak’s falsification of patient medical records created serious risks to patient safety and continuity of care,” the college wrote in its disciplinary report.
Hydromorphone, sold under the brand name Dilaudid, is an opioid narcotic that is five times more potent than morphine and highly addictive. The college noted that there is an illegal market for hydromorphone because of concerns with the illicit drug supply being laced with fentanyl.
However, the disciplinary report produced no evidence on what Parniak was doing with the hydromorphone. Her supervisor said Parniak showed no signs of impairment or intoxication while she was working.
Concerns first arose in November 2017 when a registered nurse attempted to withdraw hydromorphone for a patient who was in pain. She discovered that Parniak had had already signed out the medication — even though she was not working on the unit that day.
The hospital has automated dispensing cabinets that require a person’s fingerprints to log in. Access to the dispensing cabinets is not restricted to the unit on which the nurse is scheduled to work, but can be accessed throughout the hospital with the same log-in details.
The withdrawal was also not recorded in the medication administration record. Parniak told her colleague she had taken out the medication on another unit and must have taken it out under the wrong patient name.
The nurse testified to the college that the confusion caused almost a one-hour delay in the patient receiving his pain medication.
Parniak said she would call the hospital pharmacy about the discrepancy but she never did.
Another concern was flagged in March 2018, when Parniak made three withdrawals of hydromorphone within a short period of time from a location where she was not scheduled to be working.
When the hospital’s site director confronted Parniak, she said she had disposed of the medication in the presence of another nurse. However, the other nurse said she did not see Parniak dispose of the medication.
After this incident, Parniak was placed on paid leave and an investigation was started.
The hospital analyzed all hydromorphone withdrawals by Parniak and found that on multiple occasions, the nurse had made withdrawls that never made it to patients. An Island Health pharmacy manager who testified said it’s likely Parniak’s conduct began long before the suspicious activity was flagged.
Parniak did not attend the disciplinary hearing, which took place in February at the college’s office in Vancouver. The college heard evidence from the Campbell River Hospital’s site director, a colleague of Parniak, Island Health’s manager of pharmacy services and a college investigator who looked into the original complaint.
Parniak faced a total of 36 allegations. Twenty-two were substantiated as unprofessional misconduct under the Health Professions Act. The conduct was also reported to the RCMP but no charges have been laid.
The discipline panel found Parniak’s misconduct “represents a pattern of professional misconduct which is disgraceful, dishonourable and unbecoming of a member of the profession.”
Parniak is no longer a registered nurse.