FINACT18A-1402091-NUR.pdf

18A-1402091-NUR · State Board of Nursing · 2018-02-02

Doug Ducey Joey Ridenour Governor Executive Director

Arizona State Board of Nursing 1740 West Adams Street, Suite 2000 Phoenix. AZ 85007 Phone (602) 771-7800 Fax (602) 771-7888 E-Mail: [email redacted] Home Page: http://www.azbn.gov

TO: Case Management Office of Administrative Hearings

FROM: Trina Smith Legal Assistant Hearing Department

DATE: January 31, 2018

RE: Alfonso Olivares Marquez Docket No. 18A-1402091-NUR ______________________________________________________________________________

On January 26, 2018, the Board considered the Administrative Law Judge Decision (“ALJ Decision”), which recommended that the Board Revoke registered nurse license number RN180543 issued to Alfonso Olivares Marquez.

The Board adopted the Findings of Fact in its entirety. The Board accepted Conclusions of Law 1 through 6 in its entirety.

The Board rejected Conclusion of Law No. 7 (recommending revocation) and issued a Decree of Censure against Respondent’s registered nurse license number RN180543. ARIZONA STATE BOARD OF NURSING 1740 West Adams Street, Suite 2000 Phoenix AZ 85007 602-771-7800

IN THE MATTER OF REGISTERED FINDINGS OF FACT, NURSE LICENSE NO. RN180543 ISSUED TO: CONCLUSIONS OF LAW AND ALFONSO OLIVARES MARQUEZ, ORDER NO. 18A-1402091-NUR RESPONDENT. A hearing was held before Velva Moses-Thompson, Administrative Law Judge (“ALJ”), at 1400 West Washington Suite 101, Phoenix Arizona, on November 28, 2017. Elizabeth Campbell, Assistant Attorney General, appeared on behalf of the State. Alfonso Olivares Marquez

(“Respondent”) appeared in person on his own behalf.

On January 11, 2018, the ALJ issued Findings of Fact, Conclusions of Law and Recommendations. On January 26, 2018, the Arizona State Board of Nursing met to consider the ALJ’s recommendations. Based upon the ALJ’s recommendations and the administrative record in this

matter, the Board makes the following Findings of Fact and Conclusions of Law.

FINDINGS OF FACT 1. On October 2, 2017, the Arizona State Board of Nursing ("Board") issued a Notice of Hearing setting the above-captioned matter for hearing at 1:00 p.m. on November 28, 2017. The Notice

of Hearing provides that the issue for hearing is, "whether grounds exist to take disciplinary action,

including suspension or revocation against Alfonso Olivares Marquez, registered nurse license number RN180543 to perform as a nurse in the State of Arizona."

2. On or about February 17, 2014, the Board received a complaint from Amanda Currier, Registered Nurse ("RN"), the nurse manager at the University of Arizona Medical Center in Tucson, AZ ("UAM"). 1

3. Ms. Currier made several allegations regarding Respondent Alfonso Olivares Marquez's

conduct while working at UAM on September 3, 2013 and February 14, 2014. The Board conducted an investigation. 4. In September of 2013, Alfonso Olivares Marquez ("Mr. Marquez") was employed at

UAM as a RN.

5. On September 30, 2013, Mr. Marquez was caring for Patient GM. A tourniquet was placed on Patient GM at 3:30 a.m. Mr. Marquez documented on the chart that he completed a restraint check at 8:00 a.m. At approximately 9:30 a.m., Ms. Currier, Mr. Marquez's supervisor, discovered that Patient GM was swollen and had a tourniquet tied to his arm. Ms. Currier believed that if Mr. Marquez

had completed a restraint check at 8:00 a.m., he would have noticed the tourniquet. Patient GM was

referred for a surgical consult. 6. On February 14, 2014, a case manager overheard Mr. Marquez use curse words with a patient while in the patient's room.

7. At hearing, Mr. Marquez testified on his own behalf. The Board presented the testimony

of Ms. Currier, Board Investigator, Ruth Kish, RN, and submitted exhibits 1 through 5. 8. Ms. Currier has been an RN for approximately 7 years. Ms. Currier was Mr. Marquez's supervisor at UAM during the time that both incidents occurred. Ms. Currier testified that when a nurse

completes a restraint check, the nurse checks for movement, circulation, sensation and skin integrity.

Ms. Currier testified that the restraint check cannot be completed without removing the restraint. Ms. Currier testified to the effect that because the tourniquet had been left on the patient for approximately The University of Arizona Medical Center is currently Banner University Medical Center.

six hours, the patient was placed at risk of compartment syndrome, a serious condition that can lead to increased pressure in the muscle compartment. Ms. Kish has been a Board Investigator for six years. Ms. Kish interviewed Mr. Marquez during her investigation. Ms. Marquez told Ms. Kish hat he inserted

his fingers in the restraint, but did he did not remove it. Ms. Kish testified that a nurse must remove the

joints of the restraint to check for circulation and movement. 9. Mr. Marquez testified that he did not agree that Patient GM's blood was drawn at 3:30 a.m. on September 30, 2013. Mr. Marquez testified that at around 7:30 a.m., he completed a bedside

report with the nurse who was leaving. Mr. Marquez stated that Patient GM's skin was intact and there

was no blistering on Patient GM's arm. 10. Mr. Marquez admitted that he was hasty as it was early in the morning. Mr. Marquez admitted that he did not remove the restraints. 11. Mr. Marquez testified that with regard the February 14, 2014 incident, it was his second

day of having working with the patient. He stated that he was not making excuses for his conduct. Mr.

Marquez testified that he worked from 7 am to 9 pm without a lunch or break for water. Mr. Marquez stated that he endured a lot of abuse from the patient and called security 7 times. Mr. Marquez conceded that using profane language with the patient was a mistake. Mr. Marquez stated that he

should have walked out. Mr. Marquez testified that it was a stressful time and that he could have

received help from management.

CONCLUSIONS OF LAW 1. This matter lies within the Board's jurisdiction under ARIZ. REV. STAT.§ 32-1606. 2. The Board bears the burden of persuasion to establish cause to penalize Mr. Marquez's registered nurse license. ARIZ. REV. STAT.§ 41-1092.07(8)(2);

3. The Board's burden is a preponderance of the evidence. ARIZ. ADMIN. CODE§ R2-19- 119. 4. A preponderance of the evidence is:

The greater weight of the evidence, not necessarily established by the greater number of witnesses testifying to a fact but by evidence that has the most convincing force; superior evidentiary weight that, though not sufficient to free the mind wholly from all reasonable doubt, is still sufficient to incline a fair and impartial mind to one side of the issue rather than the other. BLACK'S LAW DICTIONARY 1373 (10th ed. 2014).

5. The facts, as set forth previously, establish that Mr. Marquez committed unprofessional

conduct as defined by ARIZ. REV. STAT. section 32-1601 (26)(d), (j); A.AC. R4-19-403(7)(9)(31 ). 6. Because Mr. Marquez has committed unprofessional conduct, the Board has authority to revoke his registered nurse license. ARIZ. REV. STAT. § 32-1663(D); and § 32-1664(O).

ORDER In view of the Findings of Fact and Conclusions of Law, the Board issues the following Order:

Pursuant to A.R.S. § 32-1664(N), it is ordered that a DECREE OF CENSURE is entered

against Respondent’s license no. RN165051 RIGHT TO PETITION FOR REHEARING OR REVIEW Pursuant to A.R.S. § 41-1092.09, Respondent may file, in writing, a motion for rehearing or review within 30 days after service of this decision with the Arizona State Board of Nursing.

The motion for rehearing or review shall be made to the attention of Hearing Department,

Arizona State Board of Nursing, 1740 West Adams Street, Suite 2000, Phoenix AZ 85007, and must set forth legally sufficient reasons for granting a rehearing. A.A.C. R4-19-608. For answers to questions regarding a rehearing, contact the Hearing Department at (602)

771-7844. Pursuant to A.R.S. § 41-1092.09(B), if Respondent fails to file a motion for rehearing

or review within 30 days after service of this decision, Respondent shall be prohibited from seeking judicial review of this decision. This decision is effective upon expiration of the time for filing a request for rehearing or

review, or upon denial of such request, whichever is later, as mandated in A.A.C. R4-19-609.

DATED this 26th day of January, 2018. ARIZONA STATE BOARD OF NURSING SEAL

Joey Ridenour, R.N., M.N., F.A.A.N Executive Director

COPIES mailed this 29th day of January, 2018, by Certified Mail No.[account number redacted] 1335 and First Class Mail to:

Alfonso Olivares Marquez 3522 N. Fiesta Del Sol East Tucson, AZ 85750 Respondent

COPIES of the foregoing mailed this 29th day of January, 2018, to: Case Management Office of Administrative Hearings 1400 W Washington Ste 101 Phoenix AZ 85007 Elizabeth Campbell Assistant Attorney General Arizona Attorney General’s Office 2005 North Central Avenue SGD/LES Phoenix, Arizona 85004

By: T. Smith