ALJDEC decisions subject to certification as final

22A-201810255-NUR · State Board of Nursing · 2021-12-07

IN THE OFFICE OF ADMINISTRATIVE HEARINGS

IN THE MATTER OF REGISTERED NURSE LICENSE NO. RN198187

ISSUED TO:

MEGAN ELIZABETH HAUG

AKA: MEGAN ELIZABETH GOACHER,

RESPONDENT.

No. 22A-[number redacted]-NUR

ADMINISTRATIVE LAW JUDGE

DECISION

HEARING: October 20, 2021

APPEARANCES: No one appeared for Respondent. Sunita Krishna, Esq. for the Board of Nursing

ADMINISTRATIVE LAW JUDGE: Thomas Shedden

FINDINGS OF FACT

The Arizona State Board of Nursing (“Board”) is the authority for licensing and regulating the practice of nursing in the State of Arizona.

On September 30, 2021, the Board issued a “Complaint and Notice of Hearing, Summary Suspension, Expedited Hearing” setting the above-captioned matter for hearing at 9:00 a.m. October 20, 2021 at the Office of Administrative Hearings in Phoenix, Arizona.

Respondent Megan Elizabeth Haug did not appear at the scheduled hearing time and the matter was convened in her absence at about 9:20 a.m.

The Board presented the testimony of Jason Arnold, RN, Jenny Christ, LPN, and Stephanie Chambers, RN ,who was the Board’s nurse practice consultant that conduct the Board’s investigation.

Ms. Haug holds registered nurse license number RN198187 issued by the Board. The Board summarily suspended Ms. Haug’s license on September 23, 2021.

The Board alleges that Ms. Haug has committed acts of unprofessional conduct within the meaning of the applicable statutes and rules.

On October 23, 2018, the Board received from Northern Arizona Healthcare a complaint about Ms. Haug that led to the Board opening an investigation.

On May 7, 2020, while employed at Good Samaritan Society, Ms. Haug documented that she had administered Oxycodone to patient LR at 6:45 a.m. and again at 12:50 p.m.

On May 14, 2020, while employed at Good Samaritan Society, Ms. Haug documented that she had administered Oxycodone to patient LR at 6:10 a.m., 12:15 p.m., and 6:20 p.m.

LR was under a PRN order for Oxycodone as needed. No other providers reported administering Oxycodone to LR during May 2020.

LR filed a complaint with Good Samaritan showing that she had not requested or received the Oxycodone Ms. Haug reported she had provided.

On July 28, 2020, while employed at Good Samaritan Society, Ms. Haug made three entries in which she documented that she had wasted a large number of Oxycodone and Tramadol pills.

The medical records show that Jenny Christ had witnessed Ms. Haug wasting the medications. Ms. Christ acknowledged that she did sign the medical record, but she testified that she was not at the facility at the time Ms. Haug reported wasting the medication and that she had not witnessed the medications being wasted. Ms. Christ testified that Ms. Haug had told her that another nurse had seen her waste the medication, but had not signed the medical record.

Ms. Christ testified that soon after she signed the medical record she realized that she should not have done so and reported the matter to the Director of Nursing.

The DON determined that the other nurse had not witnessed Ms. Haug wasting the medications.

After reporting the incident to the DON, Ms. Christ learned that other nurses at the facility had concerns that Ms. Haug was engaging in behavior showing that she might not be safe to practice, for example sleeping on shift and taking long breaks in the restroom. She also heard reports that Ms. Haug was engaging in strange behavior outside the workplace.

Mr. Arnold worked at Good Samaritan in July 2020 and although he did not work in the same area as Ms. Haug, he did have interactions with her.

Mr. Arnold testified that at times Ms. Haug appeared sedated and would nod off during conversations.

Mr. Arnold testified that Ms. Haug had asked him to sign a medical record showing that she was wasting Oxycodone, but he was not willing to do so because he did not see her waste the drugs.

Mr. Arnold reported this interaction to the Director of Nursing based on concerns among the nursing staff that Ms. Haug was appearing at work while impaired. Ms. Haug asking Mr. Arnold to sign off on wasting drugs when he had not seen her do so was a huge red flag regarding her ability to safely practice.

On July 29, 2020, Ms. Haug underwent a for-cause drug screen that was positive for Oxycodone.

During July 2020, Good Samaritan’s policy on wasting narcotics required two nurses to observe the action. It is important for narcotics to be properly wasted to prevent others from getting those narcotics.

As part of her investigation, Ms. Chambers received from Good Samaritan Society records showing that Ms. Haug had purportedly wasted the narcotics on July 28, 2020, and the complaint from patient LR showing that she had not received the Oxycodone that Ms. Haug reported she had administered. Included in those records was a statement from Ms. Haug in which she affirmed that she had administered the Oxycodone as she originally reported in the medical records.

Good Samaritan Society also provided the for-cause drug test results showing Ms. Haug had an unauthorized positive test for Oxycodone and related metabolite.

On or about March 18, 2019, Ms. Haug was charged with three counts of Aggravated DUI Child under 15 in the car. Ms. Haug did not report to the Board that she had been charged and was required to do so within ten days of her arrest.

On or about March 28, 2019, Ms. Haug pleaded guilty to “driving or under actual control while under the influence of alcohol or drugs” a class 1 misdemeanor, and was placed on three years of supervised probation.

On March 31, 2020, Ms. Haug submitted to the Board a renewal application in which she answered “No, none of the above apply” in response to a question asking whether she had been involved in any criminal offenses since her last application that had not been reported to the Board. The question specifically identified DUI as a charge that must be reported.

Because Ms. Haug had been convicted of DUI and had not reported that conviction to the Board, she made a false statement on her renewal application.

In the course of her investigation, Ms. Chambers made attempts to contact Ms. Haug.

On August 9, 2019, Ms. Chambers sent letters and a Board Investigative Questionnaire to Ms. Haug’s address of record and another mailing address. Through those letters, Ms. Chambers informed Ms. Haug of the need to return the completed Questionnaire to the Board. Ms. Haug did not respond to the letters of August 9th, and did not return the Questionnaire.

On August 18, 2020, Ms. Chambers sent to Ms. Haug a third address a letter and Questionnaire, again informing her of the need to return the Questionnaire. Ms. Haug did not do so.

On June 11, 2021, Ms. Chambers sent Ms. Haug a letter informing her that Ms. Chambers would presented the matter to the Board without input from Ms. Haug if she did not respond. Ms. Haug did not respond to that letter.

The Board also attempted to contact Ms. Haug through a letter dated October 23, 2018, an email dated June 9, 2021, and a voicemail left on August 13, 2021. Ms. Haug did not respond to any of these.

Considering that Ms. Haug appears to have been impaired while on duty, that she was apparently diverting narcotics, that she lied on her renewal application, and that she did not respond to the Board’s letters and other contacts, Ms. Chambers was of the opinion that public safety necessitated revocation of Ms. Haug’s license.

The Board requested that Ms. Haug’s license be revoked.

CONCLUSIONS OF LAW

The Board bears the burden of persuasion. Ariz. Rev. Stat. § 41-1092.07(G)(2).

The standard of proof on all issues is that of 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 preponderance of the evidence shows that Ms. Haug provided false information on a renewal application, which is unprofessional conduct under Ariz. Rev. Stat. section 32-1601(27)(a)(“Committing fraud or deceit in obtaining, attempting to obtain or renewing a license or a certificate”).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code section 4-19-403(1) by engaging a pattern of failing to meet the minimum standards of acceptable nursing practice, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) (conduct that is, or might be, harmful or dangerous to the health of a patient or the public) and (27)(j)(violation of a statute or rule).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code sections 4-19-403(7), (8), and (20) by making false and inaccurate entries in LR’s records when she reported administering oxycodone to LR, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) and (27)(j).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code section 4-19-403(9) by failing to follow Good Samaritan Society’s policy regarding wasting medication, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) and (27)(j).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code section 4-19-403(16) by removing narcotics without proper authorization when she represented that she was doing so to waste those narcotics, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) and (27)(j).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code section 4-19-403(17) by engaging in a pattern of using or being under the influence of drugs to the extent that her judgment might be impaired and her nursing practice detrimentally affected, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) and (27)(j).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code section 4-19-403(18) by obtaining and using narcotics without a valid prescription, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) and (27)(j).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code section 4-19-403(20) by failing to respond to the Board’s requests for information during its investigation, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) and (27)(j).

The preponderance of the evidence shows that Ms. Haug violated Ariz. Admin. Code section 4-19-403(28) by failing to report to the Board that she had been charged with driving under the influence, which is unprofessional conduct under Ariz. Rev. Stat. sections 32-1601(27)(d) and (27)(j), and 32-3208(A) and (D).

The Board also alleges that Ms. Haug violated Ariz. Admin. Code section 4-19-403(31)(practicing in any other manner that gives the Board reasonable cause to believe the health of a patient or the public may be harmed), but has not proven this allegation because all of the factual allegations have been proven to be violations of other statutes or rules.

The preponderance of the evidence shows that it was appropriate for the Board to have summarily suspended Ms. Haug’s license.

Because Ms. Haug has committed unprofessional conduct, the Board has authority to discipline her registered nurse license. Ariz. Rev. Stat. §§ 32-1663 and 32-1664.

Considering the facts and circumstances of this matter, including Ms. Haug’s failure to appear at the hearing, it is recommended that Ms. Haug’s registered nurse license number RN198187 be revoked.

RECOMMENDED ORDER

IT IS ORDERED that Megan Elizabeth Haug’s registered nurse license number RN198187 is revoked.

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.

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-137160-45720000Done this day, December 7, 2021.

/s/ Thomas Shedden

Thomas Shedden

Administrative Law Judge

Transmitted electronically to:

Joey Ridenour, RN, MN, Executive Director

State Board of Nursing

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001

-137160-45720000