ALJDEC decisions subject to certification as final
22A-2021070500-NUR · State Board of Nursing · 2022-03-17
IN THE OFFICE OF ADMINISTRATIVE HEARINGS
IN THE MATTER OF THE REGISTERED
NURSE LICENSE NO. RN197385
ISSUED TO:
ALTON LAREN MARTIN,
RESPONDENT.
No. 22A-[number redacted]-NUR
ADMINISTRATIVE LAW JUDGE DECISION
HEARING: February 10, 2022; hearing record held open until February 28, 2022.
APPEARANCES: Assistant Attorney General Elizabeth Campbell represented the Arizona State Board of Nursing. Respondent failed to appear.
ADMINISTRATIVE LAW JUDGE: Kay A. Abramsohn
_____________________________________________________________________
FINDINGS OF FACT
1. Alton Laren Martin (“Respondent”) held Board issued Nursing Assistant certification number UCNA100032671 in the State of Arizona; that certification expired in January 2018. Respondent’s Nursing Assistant certification was issued before the statutory change in A.R.S. § 32-1646 effective July 1, 2016.
2. In February 2016, Respondent obtained Registered Nurse license number RN197385; this licensure does not expire until April 2024.
3. In October 2019, the Board received a complaint from Abrazo Arrowhead in Glendale, Arizona, reporting that Respondent had been terminated as a registered nurse following an investigation related to documentation discrepancies and possible diversion of narcotics.
4. In February 2020, Respondent submitted to an evaluation with a Board-approved evaluator who diagnosed Respondent with mental health issues and at risk for a substance use issue. The evaluator made treatment recommendations. 5. On May 29, 2020 the Board and Respondent entered into an Alternative to Discipline (“ATD”) Mental Health Pathway Stipulated Agreement (the “Stipulated Agreement”).
6. From July 2020 to June 21, 2021, Respondent was employed as a registered nurse at Valleywise Health (“Valleywise”) in Phoenix, Arizona. On June 21, 2021, Respondent was counseled by Valleywise for narcotics discrepancies involving Dilaudid, a narcotic drug and controlled substance. On June 21, 2021 at 14:38, Respondent obtained Fentanyl, a narcotic drug and controlled substance, from the Valleywise medication dispensing system through the “override” function under the name of Patient DJ. However, Patient DJ did not have a provider order for Fentanyl. Respondent further documented that he administered the Fentanyl to Patient DJ at 14:43. However, a provider’s order is required for all medication administration.
7. Based on multiple medication discrepancies, Respondent’s employment with Valleywise was terminated on July 26, 2021.
8. Under the Stipulated Agreement (page 4, para. 9), Respondent was required to notify the ATD program within five (5) days of any change in his employer. Respondent failed to notify the ATD program of his termination by Valleywise in violation of the Stipulated Agreement.
9. The Stipulated Agreement required that Respondent enroll in the Board’s approved random drug testing program (Recovery Trek) and remain enrolled while the Stipulated Agreement is in effect. (Stipulated Agreement at 1, para. 3.)
10. Under the Stipulated Agreement, Respondent was required to submit to drug testing with Recovery Trek on the day Board staff requested that he test. (Stipulated Agreement at 1, para. 3(a); Guidelines for Non-Compliance with Drug Testing at 1.)
11. On August 12, 2021, Board staff scheduled a hair/nail drug test for Respondent with Recovery Trek, the Board’s approved drug testing program, and Respondent was instructed to test that day. Respondent missed the test, and it was rescheduled on August 23, 2021. Respondent missed the test again. Board staff rescheduled it for September 13, 2021, which Respondent missed again.
12. Respondent failed to complete the hair/nail test through the Board’s approved drug testing program Recovery Trek. Therefore, Respondent violated the Stipulated Agreement by failing to submit to drug testing with a Board-approved drug testing program when requested to do so by Board staff.
13. Under the Stipulated Agreement (page 4, para. 10(b)), Respondent was required to appear in person for interviews requested by the ATD program staff.
14. On September 15, 2021, Board staff sent Respondent a request to interview. However, Respondent failed to appear for the requested interview in violation of the Stipulated Agreement. Therefore, Respondent violated the Stipulated Agreement by failing to appear for the requested interview.
15. On November 17, 2021, Respondent was discharged from the ATD program for non-compliance with the Stipulated Agreement.
CONCLUSIONS OF LAW
1. The Arizona State Board of Nursing (“Board”) has the authority to regulate and control the practice of nursing in the State of Arizona, pursuant to Arizona Revised Statutes (“A.R.S.”) §§ 32-1606, 32-1663, 32-1664, 41-1092.11(B). The Board also has the authority to impose disciplinary sanctions against the holders of nursing licenses for violations of the Nurse Practice Act, A.R.S. §§ 32-1601through 1667 and Arizona Administrative Code (“A.A.C.”) Rules 4-19-101 to -815.
2. Pursuant to A.R.S. § 32-1664(C), the Board retains jurisdiction to proceed with an investigation or disciplinary proceeding against a regulated party whose license or certificate expired not more than five years before the Board initiates the investigation. Because the Board began its investigation in October 2019 less than five years after Respondent’s Nursing Assistant certification expired in 2018, the Board continues to have jurisdiction over that licensure.
3. The Board bears the burden of persuasion in this matter pursuant to A.R.S. § 41-1092.07(G)(2). The standard of proof on all issues is that of a preponderance of the evidence pursuant to A.A.C. § 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.
Statutes Applicable to Registered Nurses and Licensed Nursing Assistants
4. Unprofessional conduct is defined in A.R.S. § 32-1601(27) and, when it is determined, unprofessional conduct is grounds for disciplinary action pursuant to A.R.S. § 32-1663 and § 32-1664. A.R.S. § 32-1601(27) includes the following:
(d). Any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public. ...
(i). Failing to comply with a stipulated agreement, consent agreement or board order.
(j). Violating a Board statute or rule.
Rules Applicable to Registered Nurses
5. For purposes of A.R.S. § 32-1601(27)(d), Respondent’s conduct while employed at Valleywise regarding the narcotic discrepancies constitutes a conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(12), which is “Assuming patient care responsibilities that the nurse lacks the education to perform, for which the nurse has failed to maintain nursing competence, or that are outside the scope of practice of the nurse.” 6. For purposes of A.R.S. § 32-1601(27)(d), Respondent’s conduct while employed at Valleywise regarding the narcotic discrepancies constitutes a conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(16), which is “Removing, without authorization, a narcotic, drug, controlled substance, supply, equipment, or medical record from any health care facility, school, institution, or other work place location.”
7. For purposes of A.R.S. § 32-1601(27)(d), Respondent’s conduct while employed at Valleywise regarding the narcotic discrepancies constitutes a conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(18), which is “Obtaining, possessing, administering, or using any narcotic, controlled substance, or illegal drug in violation of any federal or state criminal law, or in violation of the policy of any health care facility, school, institution, or other work location at which the nurse practices.”
8. For purposes of A.R.S. § 32-1601(27)(d), Respondent’s conduct while employed at Valleywise regarding the narcotic discrepancies constitutes a conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(31), which is “Practicing in any other manner that gives the Board reasonable cause to believe the health of a patient or the public may be harmed.”
Rules Applicable to Licensed Nursing Assistants
9. For purposes of A.R.S. § 32-1601(27)(d), Respondent’s conduct while employed at Valleywise regarding the narcotic discrepancies constitutes a conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-814(17), which is “Accepting or performing patient or resident care tasks that the licensee lacks the education, competence or legal authority to perform.”
10. For purposes of A.R.S. § 32-1601(27)(d), Respondent’s conduct while employed at Valleywise regarding the narcotic discrepancies constitutes a conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-814(19), which is “Obtaining, possessing, using, or selling any narcotic, controlled substance, or illegal drug in violation of any employer policy or any federal or state law.”
11. For purposes of A.R.S. § 32-1601(27)(d), Respondent’s conduct while employed at Valleywise regarding the narcotic discrepancies constitutes a conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-814(32), which is “Practicing in any other manner that gives the Board reasonable cause to believe the health of a patient or the public may be harmed.”
12. The hearing record demonstrates conduct and circumstances constituting unprofessional conduct pursuant to A.R.S. § 32-1601(27), which is grounds for disciplinary action pursuant to A.R.S. § 32-1663 and § 32-1664. Because Respondent has committed unprofessional conduct, the Board has authority to discipline Respondent’s current Registered Nurse license and expired Nursing Assistant certification. Considering Respondent’s conduct and circumstances involved in this matter, and Respondent’s failure to respond during the Board’s investigation and the failure to appear at the hearing, it is recommended that Respondent’s Registered Nurse license RN197385 and Respondent’s Nursing Assistant certification UCNA100032671 both be revoked.
RECOMMENDED ORDER
IT IS ORDERED that Alton Laren Martin’s Arizona Registered Nurse license RN197385 and Respondent’s Nursing Assistant certification UCNA100032671 are both revoked.
RECOMMENDED this day, March 17, 2022.
/s/ Kay A. Abramsohn
Administrative Law Judge
Transmitted electronically to:
Joey Ridenour, RN, MN, Executive Director
State Board of Nursing