SUMMARY: The Nursing Care Quality Assurance Commission of the Washington state Department of Health has charged registered nurse Deborah M. Asrari with unprofessional conduct for allegedly appropriating the prescription opiate hydomorphone for her unauthorized use while on duty at Auburn Regional Medical Center, and allegedly practicing nursing while affected by that drug. In several instances, the state alleges, the drugs were intended for patients under her care. Asrari declined to respond the commission within the required 20 days and state officials say the next step is a hearing within five months, after which disciplinary actions may be taken.

BACKGROUND: The Washington state Department of Health maintains an online database of disciplinary proceedings against health care providers, which includes original source documents. It can be used based on names or license numbers of alleged violators which are given in regular press releases issued by the department.

KEY LINK: Statement of charges against Deborah M. Asrari, Washington State Department of Health, Nursing Care Quality Assurance Commission, released June 9, 2011

KEY FINDINGS:

• In a statement of charges dated May 9, 2011 and publicly released June 9, 2011, the Nursing Care Quality Assurance Commission of the Washington state Department of Health alleged that while on duty in March, 2009 at Auburn Regional Medical Center, registered nurse Deborah M. Asrari engaged in unprofessional conduct by repeatedly appropriating the prescription opiate hydomorphone for her unauthorized personal use, and by practicing nursing while affected by drugs.
• The statement of charges alleges that from March 14, 2009 though March 19, 2009, Asrari appropriated the opiate hydromorphone seven times without documenting as required the administration of the dosages to a patient, or the wastage of the amount withdrawn. In three of the seven instances, the drug was supposed to be administered to a patient. (Hydromorphone is described as a potent, centrally-acting opioid narcotic, which is manufactured under trade names including Dilaudid.)
• On March 17th and 18th, the statement of charges alleges that Asrari twice withdrew the prescription anti-anxiety drug Ativan. One time the 2 mg dose was for a patient but she documented the administration of only .5 mg, to the patient. The disposition of the second 2 mg dose was undocumented.
• On March 18th, the statement of charges alleges Asrari withdrew morphine sulfate for a patient but did not document the administration or wastage of the dose.
• A urine test was administered to Asrari March 20, 2009 for the presence of any of the following opiates for which she did not have a prescription: codeine, morphine, hydromorphone, hydrocordone. The test results were positive. The nursing board alleges that between March 14th and 19th she diverted hydromorphone for her personal use.
• In a January 6, 2010 written statement, Asrari admitted diverting opiates one time while on duty at the facility.
• Asrari did not respond to the board’s charges within the 20-day window. The next step is a disciplinary hearing, after which state actions can be taken. The hearing has not yet been scheduled; typically they occur within four or five months of the charges being formally stated.

RELATED: Auburn Regional Medical Center’s Chief Nursing officer Jill McWilliams declined to state to a reporter whether Asrari is still employed there, saying it was against the hospital’s personnel policies to divulge that information.