A travel nurse has been arrested over allegations that she tampered with vials of a highly powerful painkiller at hospitals in two-states in the Appalachian region.
Jacqueline Brewster, 52, from Kentucky, took up a post at Johnson City Medical Center, Tennessee, in April last year, but was fired just three months into the role after her colleagues noticed a vial of one of their drugs ‘looked different’.
Jacqueline Brewster, 52, was arrested after she was accused of tampering with stocks of a painkiller at hospitals in two states
Hospital officials said some syringes had been opened and re-sealed with glue before being returned to storage. An unknown liquid was also alleged to have been added to some of the tampered with vials.
After being fired in Tennessee, Brewster was re-employed at Raleigh General Hospital in Beckley, West Virginia.
But she was once again let go when other nurses reported that some vials in storage had their tops removed.
Both hospitals said vials of hydromorphone — a powerful painkiller that can be used as a heroin substitute — had been tampered with.
Brewster refused to take a drug test at the Tennessee hospital, even pouring a urine sample down the sink to prevent it from being checked. A separate sample in West Virginia did not pick up any signs of drug misuse.
She was arrested by her local sheriff’s office in Kentucky last Tuesday on un-disclosed charges. Brewster, who has served as a nurse for 18 years, must now report to Tennessee before Friday this week.
A total of 100 patients at Johnson City Medical Center had to be tested for hepatitis and HIV after the tampered vials were spotted. Raleigh General Hospital said hundreds of vials were thrown away to protect patients.
It is not clear whether any patients received medication from the tampered with vials or syringes.
She was employed by Johnson City Medical Center, Tennessee, for three months until nurses there noticed some vials in cabinets had been tampered with
But despite the allegations the nurse was re-employed by Raleigh General Hospital, West Virginia, and remained in post until she was also accused of tampering with vials there
Brewster was arrested following a fugitive warrant from Tennessee, which is issued from one jurisdiction to require someone to be arrested in another area.
She said in court, reports KHN: ‘I didn’t run away from anything. I don’t know how I’m a fugitive.’
State documents revealed ‘several’ vials were reported missing from cabinets, and that the seals of ‘multiple’ syringes had been ‘tampered with’.
Alan Levine, CEO of Ballad Health, which runs the Tennessee hospital — told KHN: ‘She was removing the Dilaudid and replacing it with another substance that looked clear like Dilaudid, and replacing the vials in the Omnicell system.
‘One of our other nurses noticed that something looked different in one of the vials, and notified the pharmacy immediately.’
What is the painkiller with a ‘high like heroin’ hydromorphone?
Hydromorphone is a powerful painkiller used to treat moderate or severe pain.
A type of opioid, it is normally given to cancer patients or others who are suffering from chronic pain.
The drug — sold under the brand name Dilaudid — is available as a liquid for injection or oral administration and a tablet.
Doctors prescribing the medication will start patients on a low dose, and gradually raise this until it helps to ease the pain sufficiently.
Officials say it is two to eight times more potent than morphine, but does not last as long.
The Drug Enforcement Administration says it can be used as a ‘substitute for heroin’.
They have found cases of its tablets being crushed and dissolved in a solution for administration, with its street names including Dillies, Dust, Footballs, Juice and Smack.
Dilaudid is the brand name for the powerful painkiller hydromorphone.
Five of the vials were sent for testing at state laboratories, which revealed the amount of fluid within them was ‘inconsistent’ with the manufacturers label.
Brewster was asked to take a drugs test by the hospital, but the first urine sample she supplied was insufficient.
When she handed the physician a second sample and was told it was enough for the test, Brewster grabbed it from their hand and poured it down the sink.
The travel nurse also worked at Raleigh General Hospital for a period that is yet to be revealed.
But in early March she was also removed from this position after vials were found in cabinets at the hospital with no tops, that appeared to be tampered with, or with residue that ‘looked like glue’.
An investigation found more than 120 occassions when the cabinet was opened but medication ‘was not taken’.
And 47 vials were found to have been removed from storage for more than an hour — leaving ample time for them to be tampered with.
A urine test on Brewster was also carried out at the West Virginia hospital, but it revealed no evidence of drugs abuse.
It was not clear when she started working at Raleigh General Hospital, although it is thought to be after her position ended in Tennessee.
West Virginia’s nursing board suspended Brewster at the end of March, forbidding her from practicing in the state.
It was at this time that the Tennessee Department of Health acted on a complaint about the nurse from the Johnson City Medical Center. It had not previously been made public that she had also tampered with vials there.
Brewster was able to work in both states under the Nurse Licensure Compact, allowing nurses to be employed across 30 different states.
States notoriously struggle to communicate across borders about which nurses are no longer allowed to practice.
West Virginia’s nursing board has now suspended her right to practice, while the Tennessee Department of Health has filed a disciplinary case against her. Kentucky says it is ‘investigating’ her license.
Brewster was employed by Jackson Nurse Professionals, a travel nurse company in Orlando, Florida, when she worked at Johnson City Medical Center.
Hospitals across the U.S. were left with no option but to rely on travel nurses over the pandemic amid surging Covid admissions.
These nurses are normally employed just for a few months at a time at vastly inflated rates to plug staffing shortages. Workers in these roles often shift between states.
Johnson City Medical Center became heavily dependent on the back-up staff during the pandemic, with the number of traveling nurses in its ranks jumping more than two-fold from 150 to 400.
It still is not known what Brewster’s motives were, or where the missing drugs went.
The Appalachian region she operated in has significantly struggled with drug abuse problems over the past decade, though, fueling the overdose crisis that has struck the U.S. as a whole.
West Virginia and Tennessee in particular have struggled with opioids, finding themselves among the national leaders in drug overdose deaths per capita, according to data from the Centers for Disease Control and Prevention.
Opioid drugs like hydromorphone have ravaged the region, being the main contributor to the 84.9 deaths per 100,000 West Virginians and 56.4 deaths per 100,000 Tennesseans from November 2020 to 2021.