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A judge took under advisement the conviction and sentencing of a former Centra Health nurse who admitted to taking liquid painkiller from hospital syringes and replacing the drug with saltwater, saying Wednesday he wants to first monitor for 12 months her progress in substance abuse treatment.

Autumn Burks Ferguson, 38, of Lynchburg, was arrested in January 2016 after an internal Centra probe of unusual activity at drug-dispensing machines revealed she used her codes to gain access to Dilaudid, or hydromorphone.

Ferguson was accused of removing syringes, which normally are connected to pumps that dispense the medication to patients in measured amounts, and opening their tamper-proof seals. She then used other syringes to take out Dilaudid, covering it up by replacing the liquid with saline solution, prosecutors said.

Ferguson then re-sealed the original syringes, replaced them in the dispenser and canceled the transactions to make it appear as if no syringes had been removed, the officials said.

This took place at least 27 times, according to the hospital probe that led to her arrest. Ferguson first was suspended during the investigation and later was terminated. Centra officials said she admitted to her actions from the start of the probe in November 2015.

Her nurse’s license since has been suspended, and she has undergone inpatient, outpatient and after-care substance abuse programs, including one designed for health care personnel with drug use issues.

Court records show Ferguson entered a no contest plea in July 2016 to obtaining a controlled substance by fraud, a felony. Arguments in Lynchburg Circuit Court on Wednesday centered on whether the felony should be reduced to a misdemeanor charge, partly so she can obtain future employment more easily.

Ferguson said she recognizes she has a substance abuse problem and is fully engaged in 12-step and other programs of recovery despite the lack of a cure for addiction.

“What I did I’m truly sorry for,” she told Circuit Judge F. Patrick Yeatts. “All I can do is keep on going in my program and

[help] other people.”

Deputy Commonwealth’s Attorney Bethany Harrison questioned witnesses from Centra Health about the investigation and the risks to patients caused by Ferguson’s actions.

A key concern expressed by the prosecutor was the potential infection risk to patients from the tampered syringes containing Dilaudid.

A Centra official said the health care system undertook a study of all patient cases that involved the affectedmedication and cross-referenced them against the instances of unauthorized access to the dispenser to determine if any infections occurred at the same time. No infections were linked directly to Ferguson’s actions.

One infection-control official also noted the saline mixture may have led to some patients not getting the results they expected from the painkiller.

Ferguson said she recognized the risks posed by her actions but said the drug and addiction had clouded her judgment.

Yeatts said he was “somewhat torn” on the decision of sentencing her on a felony conviction or waiting to see the outcome of her substance abuse programs. In the end, he said it was better to keep the matter under advisement for a year, at which point if she meets good behavior restrictions, convict her of a misdemeanor instead.

At that point, Yeatts said he would like to make not practicing in health care a condition of Ferguson’s future good behavior requirements. That would satisfy the prosecutor’s concern for shielding patients from future risk while also letting Ferguson’s recovery continue, he said.

Yeatts ordered a hearing to revisit the matter March 5, 2018.