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A former registered nurse pleaded guilty Tuesday in federal court to stealing opioids from a hospital and using the drugs herself.
Sarah Jean Moses, also known as Sarah Nalvanko, 42, of Cedar Rapids, pleaded to two charges of a 13-count superseding indictment. She was convicted of tampering and attempting to tamper with hydromorphone, an opioid medication, and making false statements relating to health care matters.
Moses, as a registered nurse with a Cedar Rapids hospital, diverted the opioids from Sept. 6 to Oct. 12, 2017, and used the drugs herself, according to the plea agreement. She used her own fingerprint and/or pass code to obtain the drugs from a dispensing machine.
She punctured vials of hydromorphone with needles to withdraw the drug and then refilled the vials with a saline solution to make them appear to be full, the plea stated.
In September 2017, within weeks of starting her job at the hospital, which isn’t identified in any court documents and prosecutors have declined to name, she obtained unauthorized access to the drug vials, the plea stated.
For example, on Sept. 26, 2017, after other employees discovered four vials had been tampered with, the pharmacy director and a technician replaced all the vials. But the next day Moses accessed medical records of patients that were not hers to obtain drugs ordered by doctors.
The following day, another inventory was conducted and they found the vials had been punctured to remove some of the drug and clear liquid had replaced it, according to the plea.
Hospital officials reviewed surveillance camera footage that showed Moses in the room where the vial dispensing machine was kept on those dates. She was scheduled to stay with the ambulance for her entire shift and had gone in early and not clocked in.
According to the plea, Moses on Sept. 27, 2017, also made false statements in connection with health care benefits and pharmacy records to cover up the fact that she took the drugs for her own use.
The hospital fired her Oct. 10, 2017 and reported it to the Iowa Board of Nursing. Reasons for termination included unsatisfactory work performance, failure to follow her nurse manager’s instructions, questionable use of accessing drug machine and “exhibiting signs that she was diverting hydromorphone.”
In Iowa Board of Nursing documents filed in April 2019, hospital officials said their investigation found Moses, on at least one occasion, was the only one to access the narcotic in question.
When her employer asked her to submit a urine sample for testing, Moses admitted to taking the narcotic not prescribed to her, according to the board documents.
The board included another incident in which Moses diverted narcotics while working at a different hospital, also not identified, from Sept. 10 through Nov. 22, 2018. At that hospital, Moses was accused of removing medications from patients she wasn’t assigned, failing to account for those removed and failing to document pain assessments, the board stated.
In April 2019, the board indefinitely suspended Moses’ nursing license pending completion of recommended treatment.
Moses, who was issued her nursing license in 2006, voluntarily surrendered her license in May of last year, according to board documents.
She also was convicted in October 2020 in Linn County District Court for drunken driving, a serious misdemeanor, and ordered to serve 48 hours in jail and pay fines.
In July of last year, a federal prosecutor asked the court to revoke Moses’ pretrial release because of probation violations, which a judge found she committed, but he didn’t revoke her pretrial release.
Moses was to have additional substance abuse evaluation and increased drug testing and monitoring left up to the discretion of the U.S. Probation Office.
Moses also was indicted last July on a separate charge of theft of government funds.
She pleaded in November to falsely reporting her income to receive increased unemployment benefits from April through August of last year, according to court documents. Moses received at least $4,368 because of increased benefits during the coronavirus pandemic.
No sentencing date is set on the theft charge at this time.
In the opioids case, Moses faces up to 10 years on the tampering charge and five years on the false statements. Sentencing will be set after a presentencing report is completed.