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A Cedar Rapids surgery center has agreed to pay $125,000 to resolve allegations that it violated civil provisions of the Controlled Substances Act stemming from a criminal case of a nurse stealing fentanyl from the center.

The settlement resolved allegations that First Choice Surgery Center, which is affiliated with Fox Eye Laser & Cosmetic Institute at 1136 H. Ave. NE, failed to maintain complete and accurate records concerning the controlled substances it purchased and dispensed. The center also failed to provide effective controls and procedures to prevent theft and diversion of drugs such as fentanyl, according to the civil allegations.

The claims asserted against First Choice are allegations only; there was no determination of liability, according to the U.S. Attorney’s Office.

In August 2019, employees of First Choice discovered that Sabrina Thalblum, a former registered nurse at the center, had been tampering with vials of fentanyl. The fentanyl was kept at First Choice for patient use during outpatient surgical procedures, according to the U.S. Attorney’s Office.

A criminal investigation revealed that Thalblum, a Temple Judah rabbi’s wife, had stolen the fentanyl for her own use. She withdrew fentanyl from the vials, replaced it with saline in the vials and returned them to storage to then be used on patients even though its strength had been depleted.

In January 2021, Thalblum pleaded guilty in U.S. District Court to one count of acquiring and attempting to acquire a controlled substance by misrepresentation, fraud, deception and subterfuge, and one count of adulteration and misbranding with intent to defraud and mislead.

Thalblum, then 52, was sentenced to five years’ probation in January 2022, a much lower sentence than recommended by the 21 to 27 months in prison under sentencing guidelines. U.S. District Judge C.J. Williams gave her the lesser sentence based on her opioid addiction that led to her theft and deception. The judge did order Thalblum to serve six months of her probation on home confinement.

Assistant U.S. Attorney Timothy Vavricek, in his argument for a prison term, said Thalblum could have endangered patients. She not only stole the fentanyl, but also concealed the crime by refilling the vials with saline and reattaching the caps, he pointed out during sentencing.

Thalblum worked at the surgery center from October 2017 to August 2019, according to court documents. She was issued a nursing license by the Iowa Board of Nursing in 2013. The conviction required her to forfeit her license, but it had already expired.

Federal prosecutors said a related civil investigation identified at least 130 separate incidents in which the record-keeping requirements of the Controlled Substances Act were allegedly violated by First Choice. The Drug Enforcement Administration’s investigation found that First Choice employees “batch signed” records indicating they had witnessed the disposal of fentanyl remaining after surgery when it was not the surgical center’s practice to ensure those employees had witnessed it.

Additionally, First Choice failed to make a timely report to DEA after it learned of the fentanyl theft.

“This settlement highlights one part of our office’s efforts to battle the opioid crisis,” U.S. Attorney Timothy Duax said in a statement. “Health care providers must do their part to ensure the safety of our community by maintaining accurate records and safeguarding access to dangerous controlled substances.”

Special Agent in Charge Steven Bell of the DEA Omaha Division, in a statement, said “Lives are unnecessarily put at risk when accuracy and good record keeping habits are brushed aside. These rules are in place for a reason and should provide families with peace of mind that they are receiving the best care possible when they walk in the door of any hospital.”