OIG Plans to Review Nursing Facilities’ Administration of Atypical Antipsychotic Drugs

Former Director of Nursing Sentenced to 3 Years in Prison for “Convenience Drugging”

On January 9, 2013, California Attorney General Kamala D. Harris issued a Press Release describing why a former Director of Nursing (DON) at a skilled nursing facility was sentenced to three years in state prison. The DON entered a plea of “no contest” to a felony count of elder abuse with an added allegation that the abuse contributed to the death of a nursing home resident. One of the criminal counts against the former DON was “assault with a deadly weapon, to wit, Risperdal, a psychotropic medicine.” The facility’s former medical director and a former pharmacist were also charged with elder abuse, resulting in death; elder abuse with infliction of injury; and assault with a deadly weapon (the psychotropic medications).

The former DON “ordered” psychotropic medications for 22 residents “not for therapeutic reasons, but instead to control and quiet them for the convenience of staff,” according to the Attorney General’s (AG) Office. When at least one of those residents refused the medications, he was “held down and injected with the psychotropic medicine by force.” Additionally, three residents died as a result of the “convenience drugging,” while the others suffered serious adverse effects, such as weight loss, lethargy and dehydration, according to official documents.

According to a sworn declaration filed by a Special Agent for the California Department of Justice, who conducted an investigation, the former DON would initiate Interdisciplinary Team (IDT) meetings to discuss the behavior of some of the facility’s residents. During these meetings, she directed the pharmacist to write prescriptions for psychotropic medications for some of the residents. The pharmacist then wrote the orders and the nurses administered the medication to the residents.

On multiple occasions, residents were forcibly injected with the psychotropic medications, according to the Special Agent. The medical director signed the orders after the IDT meetings – sometimes, three weeks after the medication was given. Additionally, he failed to examine the residents to determine if the psychotropic medications were medically necessary, according to the AG.

The facility’s former CEO was alleged to have allowed the forcible “convenience drugging” to continue after she knew about its existence. She was charged with conspiracy to commit an act injurious to the public health based on her failure to adequately supervise the DON, whom she had hired. After pleading “no contest,” the former CEO was sentenced to three years formal probation and 300 hours of volunteer service. The former medical director was also sentenced to 300 hours of volunteer service and was placed on probation by the California Medical Board. As a condition of probation, he is prohibited from practicing medicine in skilled nursing facilities, convalescent homes and assisted living facilities during his probation.

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