ALJDEC decisions subject to certification as final
23A-2021020334-NUR · State Board of Nursing · 2022-12-02
IN THE OFFICE OF ADMINISTRATIVE HEARINGS
IN THE MATTER OF THE PRIVILEGE TO PRACTICE NURSING UNDER THE NURSE LICENSURE COMPACT IN THE STATE OF ARIZONA ISSUED TO:
TRELESA ANN MORGAN,
(Louisiana) NURSE LICENSE NO. RN145002
RESPONDENT.
No. 23A-[number redacted]-NUR
ADMINISTRATIVE LAW JUDGE DECISION
HEARING: November 09, 2022 at 9:00 AM.
APPEARANCES: Assistant Attorney General Marc Harris, Esq. appeared on behalf of the Arizona State Board of Nursing (“Board”) with Michelle Bagford as a witness. No appearance(s) by or on behalf of Trelesa Morgan (“Respondent”). Robin Jasper (CCR No. 50286) served as the official court reporter for the proceedings. Charles Hover, Sara Steffen, and Michelina Stazzone observed.
ADMINISTRATIVE LAW JUDGE: Jenna Clark.
_____________________________________________________________________
Having heard the evidence and testimony and having considered the record in this matter, the undersigned Administrative Law Judge hereby makes the following Findings of Fact and Conclusions of Law and issues the following Recommended Order to the Executive Director of the Board.
FINDINGS OF FACT
Background and Procedure
Administrative Notice is taken of Respondent’s professional license history, as it appears on Nursys public website, as follows:
Respondent was issued an unencumbered multistate Registered Nurse License No. RN145002 by the State of Louisiana on June 24, 2014. The license is set to expire on January 31, 2023.
On an unknown date, Respondent was granted authorization to practice nursing in the State of Arizona under the Nurse Licensure Compact.
Respondent was issued Registered Nurse License No. RN687474 by the State of Pennsylvania on August 11, 2016. The license expired on October 31, 2017.
Respondent was issued Registered Nurse License No. RN203616 by the State of Arizona on October 24, 2016. The license expired on April 01, 2021.
Respondent was issued Registered Nurse License No. 952776 by the State of Texas on September 06, 2018. The license expired on July 31, 2020.
Respondent was issued unencumbered Registered Nurse License No. 95206308 by the State of California on September 25, 2019. The license is set to expire on August 31, 2023.
On October 13, 2022, the Board issued a Complaint and Notice of Hearing setting the above-captioned matter for hearing at 9:00 a.m. on November 09, 2022. The Notice of Hearing identified the issue as follows:
[T]o determine whether grounds exist to take disciplinary action, including suspension or revocation against Trelesa Ann Morgan, holder of Louisiana registered nurse license number RN145002, privileged to practice as a registered nurse in the State of Arizona under the Nurse Licensure Compact.”
The Board set forth eleven specific factual allegations in the Complaint, and based on those allegations the Board charged Respondent with having committed unprofessional conduct as defined by Ariz. Rev. Stat. §§ 32-1601(27)(d), as more specifically defined by Ariz. Admin. Code R4-19-403(25); 32-1601(27)(e), and 32-1601(27)(j). Violations of the foregoing constitute grounds for discipline under Ariz. Rev. Stat. §§ 32-1663 and 32-1664.
The Board referred the matter to the Office of Administrative Hearings, an independent agency, for an evidentiary hearing on the allegations in the Board’s Complaint.
Hearing Evidence
The Board presented the testimony of Michelle Bagford and submitted Exhibits 1-15. The Complaint was also admitted into the evidentiary record as its own exhibit. The substantive evidence of record is as follows:
On or about February 23, 2021, the Board received a complaint against Respondent’s Registered Nurse License No. RN145002. In pertinent parts, the complaint alleged that Respondent “sent inappropriate texts and emails to several Neurosurgeons demanding money, medical care and private jet flights” and had also “made a death threat to one of the Neurosurgeons” in violation of Ariz. Admin. Code R4-19-403(31) around her time as a travel nurse for Mayo Clinic between May 16, 2017, and April 26, 2018.
As a result, on March 10, 2021, the Board issued a Notice of Complaint letter to Respondent with an attached investigative questionnaire. Respondent was advised to return the questionnaire by April 12, 2021.
Respondent did not return a completed questionnaire to the Board.
None of the Board’s correspondence sent to Respondent via the United States Postal Service was returned as undeliverable.
On July 19, 2022, Respondent submitted a complaint to the Board whereby she alleged “severe abuse” in Arizona and Louisiana, and further alleged that she and her children were “living in a car with no air conditioner.”
On July 21, 2022, Respondent, whilst pretending not to be herself, submitted a second complaint to the Board whereby she alleged unspecified abuse by law enforcement and reiterated her claim of homelessness.
On July 21, 2022, the Board notified Respondent that her case had been reassigned to another investigator. At that time, Respondent was supplied with a new investigative questionnaire and advised to return it by August 12, 2022.
On July 25, 2022, the Board provided Respondent a copy of the 2021 complaint against License No. RN145002, as well as another investigative questionnaire.
On July 26, 2022, the Board subpoenaed Respondent’s employment records from Mayo Clinic. On or about September 02, 2022, Mayo Clinic provided the Board with the documentation it had requested. The records establish that on February 01, 2021, Respondent sent multiple threatening messages to Mayo Clinic physicians demanding money and services.
On July 26, 2022, the Board subpoenaed records from the Phoenix Police Department (“PPD”) regarding Respondent. On or about August 01, 2022, PPD provided the Board with the documentation it had requested. The records establish that police were called to the home of a Mayo Clinic physician on February 02, 2022, after receiving a message from Respondent threatening to “spread his ashes” if he did not give her money.
On July 29, 2022, Respondent, whilst pretending not to be herself, sent tangential correspondence to the Board whereby she alleged, in part, as follows:
It is your job to protect your nurse and not threaten her along with doctors who are committing crimes against a nurse. This message will be copied to the president of the united states because with the complaint that we filed showing Trelesa Morgan needs help and you should not even mention the lies that were reported to you. You should be investigating why the doctors are lying and reporting them to the police for not helping the nurse and trying to set her up.
(All errors in original.)
On or about August 04, 2022, the Board was forwarded an email purportedly authored by Respondent the prior day whereby Respondent accused her ex-husband of trying to kill her and their children and fail to provide for them financially, asking him to write “a large check for the 7 years of child support that you owe.”
On September 22, 2022, the Board voted to summarily suspend Respondent’s privilege to practice in the State of Arizona using Registered Nurse License No. RN145002. As a result, a Findings of Public Emergency and Order of Summary Suspension was issued against Respondent.
On September 22, 2022, Respondent submitted a 7-page tangential email to the Board whereby she made a number of accusations, including but not limited to, “being illegally murdered by the lies and secret cults,” “being murdered by lies of unlawful police, doctors, and judges,” contending that police have stolen her property, and accusing her ex-husband of trying to kill her and their children. Respondent also included a 36 person list of people, both specific and general, who allegedly abused her and committed no less than 28 other transgressions and/or crimes against Respondent between 2019 and 2022. Respondent denied being mentally ill.
On September 28, 2022, Respondent, whilst pretending be US President Joseph Biden, submitted a third complaint to the Board whereby she fabricated an FBI email handle and attempted to order the Board to contact Louisiana authorities to remove her nursing license suspension.
Closing Argument
In closing, the Board argued that the evidence of record established that Respondent is unsafe to practice, a danger to the public, and that her behavior evinced her intent not to submit to the Board’s jurisdiction. The Board asked that its summary suspension be upheld, and that the Tribunal recommend revocation of Respondent’s privilege to practice nursing in the State of Arizona.
CONCLUSION OF LAW
This matter lies within the Board’s jurisdiction under Ariz. Rev. Stat. §§ 32-1606(B)(10), 32-1663, 32-1664, and 41-1092.11(B) to regulate and control the practice of nursing in the State of Arizona. Pursuant to Ariz. Rev. Stat. §§ 32-1601 through 1669 and Ariz. Admin. Code R4-19-101 through 815 the Board has authority to impose disciplinary sanctions for violations of the Nurse Practice Act.
The Complaint and Notice of Hearing that the Board mailed to Respondent at his address of record was reasonable, and Respondent is deemed to have received notice of the hearing. See Ariz. Rev. Stat. §§ 41-1092.04 and 41-1061(A).
The Board bears the burden of proof to establish cause to penalize Respondent’s registered nursing license. Respondent bears the burden to establish affirmative defenses and factors in mitigation of the penalty by the same evidentiary standard.
The Board’s burden is a preponderance of the evidence.
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).
Ariz. Rev. Stat. § 32-1601(26) defines unprofessional conduct in the nursing profession, in pertinent part, as follows:
"Unprofessional conduct" includes the following, whether occurring in this state or elsewhere:
(d) As any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public.
(e) Willfully or repeatedly violating a provision of this chapter or a rule adopted pursuant to this chapter.
* * *
(j) Violating this chapter or a rule that is adopted by the board pursuant to this chapter.
Ariz. Admin. Code R4-19-403 defines unprofessional conduct in the nursing profession, in pertinent part, as follows:
For purposes of A.R.S. § 32-1601(24)(d), any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public includes one or more of the following:
(25) Failing to (a) Furnish in writing a full and complete explanation of a matter reported pursuant to A.R.S. § 32-1664.
Ariz. Rev. Stat. § 32-1663 outlines the Board’s disciplinary authority and process, in pertinent part, as follows:
* * *
(D) If the board finds, after affording an opportunity to request an administrative hearing pursuant to Title 41, Chapter 6, Article 10, that a person who holds a license or certificate issued pursuant to this chapter has committed an act of unprofessional conduct, it may take disciplinary action.
* * *
(F) If the board determines pursuant to an investigation that reasonable grounds exist to discipline a person pursuant to subsection D or E of this section, the board may serve on the licensee or certificate holder a written notice that states:
(1) That the board has sufficient evidence that, if not rebutted or explained, will justify the board in taking disciplinary actions allowed by this chapter.
(2) The nature of the allegations asserted and that cites the specific statutes or rules violated.
Ariz. Rev. Stat. § 32-1664(O) further outlines the Board’s disciplinary authority and process regarding unprofessional conduct, stating that, “If the regulated party is found to have committed an act of unprofessional conduct or to have violated this chapter or a rule adopted pursuant to this chapter, the board may take disciplinary action.”
Here, the Board has sustained its burden of proof.
The Board established by a preponderance of the evidence that Respondent is unsafe to practice nursing and will not submit to the Board’s authority and jurisdiction. Most concerning are Respondent’s erratic and tangential correspondences with the Board, several under obvious pseudonyms, as well as the litany of accusations regarding persons who have harmed Respondent. The record also reflects, that although given multiple opportunities and an extended period of time, Respondent never submitted a completed investigative questionnaire to the Board. In failing to do so, Respondent was not able to avail herself of substantive assistance the Board could have provided.
There is no mitigating evidence in the record for Respondent’s actions, or lack thereof.
Thus, the Board established that Respondent committed unprofessional conduct pursuant to Ariz. Rev. Stat. §§ 32-1601(27)(d), as more specifically defined by Ariz. Admin. Code R4-19-403(25); 32-1601(27)(e), and 32-1601(27)(j).
In light of the risk of potential harm to patients as a result of Respondent’s actions and violations of the Nurse Practice Act, the Board established cause to impose a disciplinary sanction against Respondent’s license under Ariz. Rev. Stat. §§ 32-1663(D) and 32-1664(N).
Because Respondent has committed unprofessional conduct, the Board has authority to revoke her privilege to practice nursing in the State of Arizona under Ariz. Rev. Stat. §§ 32-1663(D) and 32-1664(O).
Considering the facts and circumstances of this matter, it is recommended that Louisiana Registered Nurse License No. RN145002 be revoked.
RECOMMENDED ORDER
Based on the foregoing,
IT IS RECOMMENDED that the Board revoke Trelesa Ann Morgan’s privilege to practice under Louisiana Registered Nursing License No. RN145002.
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, December 05, 2022.
Office of Administrative Hearing
/s/ Jenna Clark
Administrative Law Judge
Transmitted electronically to:
Joey Ridenour, RN, MN, Executive Director
c/o Trina Smith
State Board of Nursing
1740 W. Adams St., Ste. 200
Phoenix, AZ 85007-2607
[email redacted]
Trelesa Ann Morgan, Respondent
2465 Woodmere Blvd.
Harvey, LA 70058
[email redacted]
Marc Harris, Esq., Assistant Attorney General
Office of the Attorney General
2005 N. Central Ave SGD/LES
Phoenix AZ 85004-1592
[email redacted]
By Miranda Alvarez
Legal Secretary