United States Drug Enforcement Administration

BOSTON - In the largest settlement of its kind involving allegations of drug diversion at a hospital, Massachusetts General (MGH) has agreed to pay the United States $2.3 million to resolve allegations that lax controls enabled MGH employees to divert controlled substances for personal use.  In conjunction with this record monetary settlement, MGH has agreed to implement a comprehensive corrective action plan to prevent, identify, and address future diversions. 

“Under the law, hospitals like MGH have a special responsibility to ensure that controlled substances are used for patient care and are not diverted for non-medical uses,” said U.S. Attorney Carmen M. Ortiz.  “Diversion of these drugs feeds addiction, contributes to potential illegal drug sales, and fuels the opioid epidemic that has had a devastating effect on the Commonwealth.  We commend MGH for disclosing and addressing its diversion problems and for taking steps to ameliorate future diversion by hospital personnel.” 

“The DEA is committed to investigating hospitals that are not in compliance with the Controlled Substances (CSA),” said Special Agent in Charge Michael J. Ferguson.  “Failure to do so increases the potential for diversion and jeopardizes the public health and safety.  The diversion of prescription pain killers, in this case oxycodone, contributes to the widespread abuse of opiates, is the gateway to heroin addiction, and is devastating our communities.  DEA pledges to work with our law enforcement and regulatory partners throughout the Commonwealth and nationwide to ensure that these rules and regulations are followed.”

In 2013, an investigation was launched after MGH disclosed to the Drug Enforcement Administration  that two of its nurses had stolen large volumes of controlled (prescription medications) from the hospital.  Altogether, the two nurses stole nearly 16,000 pills, mostly oxycodone, an addictive painkiller.  Both nurses stole from automated dispensing machines that MGH used to store and dispense prescription medications.  DEA’s ensuing audit of MGH’s controlled substances revealed pill count discrepancies totaling over 20,000, missing or incomplete medication inventories, and hundreds of missing drug records, all in violation of the hospital’s responsibilities under the Controlled Substances (CSA). 

MGH cooperated with the DEA’s investigation and subsequently disclosed additional violations of the CSA.  Specifically, MGH disclosed that a pediatric nurse with a 12-year substance abuse problem had injected himself with Dilaudid at work; a physician had prescribed controlled substances for patients without seeing them and without maintaining medical records; several nurses were able to divert prescription drugs for many years without being detected; and medical staff had failed to properly secure controlled substances, even, on occasion, bringing them to lunch. 

Since the investigation began, MGH has worked cooperatively with the DEA and the U.S. Attorney’s Office to develop a detailed corrective action plan to address the identified deficiencies in MGH’s handling of controlled substances.  Components of the plan include the establishment of an internal drug diversion team; the creation of a full-time drug diversion compliance officer position; mandatory training of all staff with access to controlled substances, including on how to identify the signs and symptoms of substance abuse; enhanced diversion monitoring by supervisors and management; annual external audits to ensure compliance with the CSA; and increased physical controls of controlled substances, including limiting and monitoring access to automated dispensing machines through fingerprint identification. 

DEA SAC Ferguson and U.S. Attorney Ortiz made the announcement today.  The case was handled by Assistant U.S. Attorneys Jessica Driscoll and Christine Wichers of Ortiz’s Civil Division.