ALJDEC decisions subject to certification as final

23A-2021050406-NUR · State Board of Nursing · 2023-10-04

IN THE OFFICE OF ADMINISTRATIVE HEARINGS

IN THE MATTER OF THE REGISTERED NURSE LICENSE NO. RN197001 AND PRACTICAL NURSE LICENSE NO. LP051268 (Expired 8/1/19) ISSUED TO:

MEGAN RAE YOUNG,

RESPONDENT.

No. 23A-[number redacted]-NUR

ADMINISTRATIVE LAW JUDGE

DECISION

HEARING: August 24, 2023, with the record held open until September 15, 2023, for receipt of the transcript.

APPEARANCES: Charles S. Hover, III, Esq., Assistant Attorney General, represented the Arizona Board of Nursing (Board). Megan Rae Young (Respondent) appeared on her own behalf. Tracy A. Reinke (CCR No. 50823) served as the court reporter for the proceedings.

ADMINISTRATIVE LAW JUDGE: Brian Del Vecchio

FINDINGS OF FACT

At hearing, the Board presented the testimony of Anna Anderson and the Board’s exhibits 1 through 8 were admitted. Board’s exhibits 2, 3, 4, 5, and 8 were confidential and reviewed under seal. Respondent testified on her own behalf, and Ernest Baxter testified on Respondent’s behalf.

Respondent held Board issued Registered Nurse License Number RN197001 and held Practical Nurse License Number LP051268, which expired August 1, 2019, in the State of Arizona.

On May 14, 2021, Respondent was admitted to Valleywise Behavioral Health (VBH) in Phoenix, Arizona, by a Court Ordered Evaluation petitioned by her brother. Per the petition, Respondent had been behaving erratically, losing important items, housing transients, not bathing, hearing voices, and acting delusional and paranoid with mood swings. The petition alleged Respondent was in danger of losing her house and reported suicidal ideations. At the same time, Respondent took in a “runaway child” which she did not report to authorities. Respondent presented as tangential, talkative, perseverative, and lacking insight. Respondent demonstrated flight of ideas, verbosity, and appeared paranoid towards evaluation. Respondent reported she had the police called on her multiple times in the past two months and admitted to having a “community child” living in her home, which the police returned home. Respondent reported she was terminated from her hospice job as a Registered Nurse and had been unable to work since December 2020. Respondent’s mental status was described as disheveled, cooperative, dysphoric, elevated and anxious-moderate, labile affect, paranoid, persecutory delusions, partial insight, and moderately impaired. Respondent was persistently or acutely disabled and qualified for Inpatient Admission. During a Psychiatric Work Evaluation, Respondent reported she was dealing with the death of her father and struggled with chronic mental health problems; she also disclosed a hospitalization from overdose of heroin at the age of 19. Respondent stated she was at St. Luke’s (Behavioral Health) in Tempe “for quite a while” and was also at Banner Thunderbird in January 2021 where she signed herself in voluntarily. Respondent did not feel she needed to be hospitalized or be on medications.

On May 19, 2021, Respondent was evaluated by the VBH medical team and determined to be severely mentally ill.

On May 25, 2021, a complaint was filed with the Board regarding Respondent for her admission to VBH beginning May 14, 2021. Respondent was evaluated for behavior changes, poor personal hygiene, auditory hallucinations, delusions, paranoia, profound memory loss, and insomnia. Respondent was discharged from VBH on May 25, 2021, because Court Ordered Treatment was dismissed.

On June 14, 2021, and July 19, 2021, Board staff mailed an Investigative Questionnaire to Respondent’s address of record with instructions to provide a written description of events in response to the complaint filed with the Board. The mail was not returned to Board offices by USPS.

On July 15, 2021, Respondent called Board staff, confirmed that she received the first Investigative Questionnaire mailed to her, and asked that a second one be sent, which was done after Respondent’s address was confirmed. Respondent failed to provide a written statement to the Board as required by Arizona Nurse Practice Act.

On April 7, 2022, Respondent was admitted to VBH on a Court Ordered Evaluation petitioned by her son, after she was transferred from another facility where her April 6, 2022, lab/test results were positive for methamphetamine and tricyclic antidepressant. According to Respondent’s nursing admission note, she was anxious and focused on discharge. She was disheveled, impulsive, restless and tearful. She was loud and verbose, fidgety, moderately anxious, and irritable. Her affect was labile and she denied suicidal ideation or hallucinations. She was paranoid and her judgment was moderately impaired. She smoked marijuana and tobacco daily and used methamphetamine occasionally. Per petition, Respondent’s son alleged Respondent denied mental illness and demonstrated unstable mood, hysteria, paranoia, suicidal thoughts, sleep deprivation, and self-induced starvation. Respondent had a history of self-medicating with methamphetamines and other drugs; she created an unsafe environment by allowing homeless people, gang members, and others into her home. Respondent was determined to have serious mental illness and was diagnosed with a mental health disorder. She refused prescribed psychiatric medications, however used illicit drugs. She was previously on antidepressants but did not believe she needed to be on any medications. According to the patient intake summary, Respondent had pressured and verbose speech. Respondent stated she lived with members of the Mexican mafia, she was affiliated with the Mexican mafia, and she was previously petitioned on Christmas. She presented as grandiose, pressured, perseverative, and delusional. She was labile, elevated, paranoid and agitated. She was extremely tangential and difficult to redirect. Respondent stated she had approximately 3-4 psychiatric hospitalizations. Respondent consumed alcohol occasionally, used marijuana daily, and had a medical marijuana card. She had used methamphetamines and heroin/opiates. Respondent was not compliant with scheduled medications, and on April 18, 2022, Court Ordered Treatment was granted.

On April 26, 2022, Respondent was discharged as she had maximized her potential benefits of inpatient treatment.

On April 11, 2023, in an interview with Board staff, Respondent stated that between May 2021 and April 2022 she had been admitted to three hospitals with one being self-admitted and two being petitioned.

Also during the April 11, 2023 interview, Respondent stated she had not used methamphetamines since her father’s death in April 2021, however, her April 7, 2022, admission documents to VBH stated her lab results/tests from April 6, 2022 were positive for methamphetamines.

Also during the April 11, 2023 interview, Respondent stated that she had continued outpatient services through VBH for mental health treatment and had been compliant with her medication. Respondent admitted to mental health diagnoses. Board staff contacted VBH records department, which confirmed Respondent’s last visit to VBH was in April 2022 and she had not been seen or treated since.

On May 18, 2023, the Board found that the public health safety and welfare imperatively required emergency action. Consequently, the Board, pursuant to A.R.S. § 41-1092.11(B), summarily suspended Respondent’s Registered Nurse License Number RN197001 and Practical Nurse License Number LP051268 (Expired 8/1/19), pending proceedings for revocation and other action by the Board.

CONCLUSIONS OF LAW

This matter lies within the Board’s jurisdiction pursuant to A.R.S. § 32-1606(B)(10).

The Board bears the burden of proof and must establish cause to penalize Respondent’s licenses by a preponderance of the evidence. “A preponderance of the evidence is such proof as convinces the trier of fact that the contention is more probably true than not.” A preponderance of the evidence is “evidence which is of greater weight or more convincing than evidence which is offered in opposition to it; that is, evidence which as a whole shows that the fact sought to be proved is more probable than not.”

The Board established by a preponderance of the evidence that Respondent engaged in unprofessional conduct, specifically: i) conduct that is or might be harmful to the health of a patient or the public; ii) being mentally incompetent or physically unsafe to a degree that is or might be harmful or dangerous to the health of a patient or the public; and iii) violating a Board statute or rule, as alleged in the Complaint and Notice of Hearing.

In light of the evidence of record and the risk of harm to which patients and the public were and could be exposed 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 licenses under A.R.S. § 32-1606(B)(10) and A.R.S. § 32-1663(D).

RECOMMENDED ORDER

IT IS RECOMMENDED that the Board affirm its order summarily suspending Respondent Megan Rae Young’s Registered Nurse License Number RN197001 and Practical Nurse License Number LP051268.

IT IS FURTHER RECOMMENDED that the Board revoke Respondent Megan Rae Young’s Registered Nurse License Number RN197001 and Practical Nurse License Number LP051268.

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 forty (40) days from the date of that certification.

-54864001

001

-137160-45720000Done this day, October 4, 2023.

/s/ Brian Del Vecchio

Administrative Law Judge

Transmitted by either mail, e-mail, or facsimile to:

Joey Ridenour, RN, MN, Executive Director

State Board of Nursing

Megan Rae Young

232 S. 12th Ave

Phoenix, AZ 85007

[email redacted]

Charles S. Hover, III

Office of the Attorney General

2005 N Central Ave

Phoenix, AZ 85004-1592

[email redacted]

By: OAH Staff