ALJDEC decisions subject to certification as final
18A-1402091-NUR · State Board of Nursing · 2018-01-11
IN THE OFFICE OF ADMINISTRATIVE HEARINGS
IN THE REGISTERED NURSE LICENSE NO. RN180543
ISSUED TO:
ALFONSO OLIVARES MARQUEZ,
RESPONDENT
No. 18A-1402091-NUR
ADMINISTRATIVE LAW JUDGE DECISION
HEARING: November 28, 2017 with the record held open until
December 22, 2017.
APPEARANCES: Respondent Alfonso Olivares Marquez appeared on behalf of himself. Assistant Attorney General Elizabeth Campbell appeared on behalf of the Arizona State Board of Nursing.
ADMINISTRATIVE LAW JUDGE: Velva Moses-Thompson
_____________________________________________________________________
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”).
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 six hours, the patient was placed at risk of compartment syndrome, a serious condition that can lead to increased pressure in the muscle compartment. 8. 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 7am 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
This matter lies within the Board’s jurisdiction under Ariz. Rev. Stat. § 32-1606.
The Board bears the burden of persuasion to establish cause to penalize Mr. Marquez’s registered nurse license. Ariz. Rev. Stat. § 41-1092.07(G)(2);
The Board’s burden is a preponderance of the evidence. Ariz. Admin. Code § R2-19-119.
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).
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.A.C. R4-19-403(7)(9)(31).
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).
Considering the facts and circumstances of this matter, it is recommended
that Mr. Marquez’s registered nurse license number RN168273 be revoked.
RECOMMENDED ORDER
Based on the foregoing, the Administrative Law Judge recommends that the Board revoke Alfonso Olivares Marquez’s registered nurse license number RN180543.
In the event of certification of the Administrative Law Judge Decision by the Director of the Office of Administrative Hearings, the effective date of the Order will be five days from the date of that certification.
Done this day, January 11, 2018
Velva Moses-Thompson
Administrative Law Judge
Transmitted electronically to:
Joey Ridenour, RN, MN, Executive Director
State Board of Nursing