ALJDEC - Licensing

23A-2022040513-NUR · State Board of Nursing · 2024-01-17

IN THE OFFICE OF ADMINISTRATIVE HEARINGS

IN THE MATTER OF THE REGISTERED NURSE LICENSE NO. RN216214

ISSUED TO:

TIFFANY GWYN TERRAZAS,

A.K.A.: TIFFANY GWYN DANISON,

RESPONDENT

No. 23A-[number redacted]-NUR

ADMINISTRATIVE LAW JUDGE DECISION

HEARING: December 6, 2023 with the record held open until January 3, 2024 for the purposes of receiving a transcript.

APPEARANCES: Respondent Tiffany Gwyn Terrazas appeared with her counsel Bretton Barber via Google Meet. The Arizona State Board of Nursing (“Board”) was represented by Assistant Attorney General Deborah Abbey who appeared via Google Meet.

ADMINISTRATIVE LAW JUDGE: Adam D. Stone

EXHIBITS ADMITTED INTO EVIDENCE: Board exhibits 1-18 were admitted.

_____________________________________________________________________

FINDINGS OF FACT

The Board has the authority to regulate and control the practice of nursing in the State of Arizona, pursuant to A.R.S. §§ 32-1606, 1663, and 1664. The Board also has the authority to determine whether licensees have committed unprofessional conduct, thereby furnishing cause for discipline under the Nurse Practice Act, A.R.S. §§ 32-1601 through 1667.

Respondent holds Board-issued registered nurse license number RN216214.

On April 21, 2022, Respondent self-reported that she was charged for driving under the influence on April 12, 2022.

Because of the self-report, the Board initiated an investigation.

Based upon the investigation, the Board issued a Complaint and Notice of Hearing on September 29, 2023, setting a hearing on December 6, 2023, before the Office of Administrative Hearings, an independent State agency. The Complaint alleged that Respondent violated the Nurse Practice Act, A.R.S. §§ 32-1601 to -1669 and Arizona Administrative Code (“A.A.C.”) Rules 4-19-101 to -815.

At hearing, the Board presented the testimony of Bonnie Richter and Phillip Lett, Ph.D., and offered eighteen exhibits. Respondent testified on her own behalf.

Bonnie Richter testimony

Ms. Richter was the Senior Investigator for the Board and conducted an investigation in this matter.

Ms. Richter testified that during the course of her investigation she found the following:

On April 13, 2018, in case number CM2018000211, a Complaint was filed charging Respondent with Disorderly Conduct and Assault with Intent or Knowingly Cause Injury to Other in Apache Junction Municipal Court, Arizona. Respondent failed to report this charge to the Board within 10 days as required by statute and rule. The case was dismissed based on the victim refused to cooperate with prosecution.

On or about September 21, 2021, Respondent was arrested under suspicion of driving while under the influence. On December 17, 2021, Respondent was later charged with DUI, DUI with BAC .08 or more; DUI Extreme BAC .15 -.19, and DUI Extreme with BAC .20 or more in Apache Junction Municipal Court, Arizona. On April 12, 2022, Respondent was convicted, pursuant to a guilty plea of Extreme DUI with BAC .15 - .19, a misdemeanor.

On or about December 18, 2021, Respondent submitted her RN license renewal application. Question #6 stated,

“Since your last renewal, have you been involved in any criminal offense not previously reported to the Arizona State Board of Nursing, including those pending appeal? (You may only exclude minor traffic violations, but must report all DUI charges/convictions)” Have you:” and the options included, “been arrested or have any pending criminal charges,” “been cited or charged with any violation of the law?”

Ms. Richter testified that Respondent answered “No” to each item in question #6. Further, Ms. Richter testified that Respondent failed to report that she had been arrested on September 23, 2021 for DUI, or that she had been cited or that she had pending charges for that DUI, in case number TR20210000566. Respondent also failed to disclose her arrest, and charges in 2018 for assault and disorderly conduct in case number CM2018000211.

Respondent was employed by Banner Baywood from September 2018 until February 5, 2020, when she was involuntarily terminated. During her employment she was absent numerous times.

Respondent was then employed with Arizona General Hospital from March 2020 through September 3, 2021, as she resigned after receiving a performance evaluation which was less than favorable.

From October 2021 to the present, Respondent has been employed with Hospice of the Valley, and has had no complaints or disciplinary actions and only received positive comments on her September 2022 evaluation.

Further, Ms. Richter testified that she interviewed Respondent on December 14, 2022, and that Respondent informed her, that the reason for the non-disclosure was that Respondent was not aware she needed to disclose arrests. Respondent also disclosed to Ms. Richter that she had not consumed alcohol since October 2021.

In addition, Ms. Richter testified that she requested that Respondent take PEth test to determine biomarkers for alcohol. Ms. Richter testified that levels exceeding 20 was indicative of moderate to heavy alcohol consumption, and Respondent’s level was 60.

Next, Mr. Richter compiled her report for the Board meeting in January 2023. The Board requested that Respondent undergo a comprehensive psychological evaluation, and the same was performed by Phillip Lett. Ms. Richter compiled the findings in an updated report, and presented the same to the Board. Next, Ms. Richter testified that the Board met in March 2023, and recommended that Respondent be placed on a 36 month suspension with monitoring.

Ms. Richter also testified that there was no evidence that during Respondent’s employment that there was any harm done to patients.

Finally, Ms. Richter testified that the Board had concerns that Respondent appeared to have alcohol abuse disorder which could jeopardize her ability to practice nursing. Thus, the Board now recommended that Respondent’s license be revoked.

Phillip Lett, Ph.D.’s testimony.

Dr. Lett was a Clinical Psychologist who assessed Respondent at the request of the Board. Dr. Lett met with Respondent on February 9, 2023, and testified as to his conclusions.

Dr. Lett testified that his purpose was to evaluate Respondent’s ability to practice nursing. Dr. Lett testified that he believed that Respondent had the ability to function safely if she abstained from alcohol/substance use and entered an intensive outpatient therapy program.

Respondent’s testimony.

Respondent testified that she believed she only had to report convictions and not merely arrests, as was prove that she disclosed the DUI conviction within 10 days of the same occurring.

As to her employment history, Respondent testified that she acknowledged the absences, but that most were because of illness and that she worked the night shift and could not regulate her sleep. Because of this she, thought it would be better for the patients if she did not come to work sleep deprived.

Further, regarding her departure from Arizona General Hospital, Respondent testified that she resigned because she was not fully recovered from an abdominal procedure.

Respondent also testified that she has had no corrective actions or bad reviews with her new employer.

Regarding the PEth test results, Respondent testified that she consumed alcohol about a week after the interview with Ms. Richter, but before the test.

In addition, Respondent testified that but for the fines/fees, she complied with all of the court’s orders and once again had an unrestricted driver’s license.

Respondent testified that she was not an alcoholic, and her attorney argued that her nursing license should not be revoked.

CONCLUSIONS OF LAW

The Notice of Hearing that the Board mailed to Respondent at her address of record was reasonable, and Respondent is deemed to have received notice of the hearing. See A.R.S. § 41-1092.04; A.R.S. § 41-1061(A).

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

The Board bears the burden of proof and must establish cause to penalize Respondent’s registered nurse’s license by a preponderance of the evidence. See A.R.S. § 41-1092.07(G)(2); A.A.C. R2-19-119(A) and (B)(1); see also Vazzano v. Superior Court, 74 Ariz. 369, 372, 249 P.2d 837 (1952).

“A preponderance of the evidence is such proof as convinces the trier of fact that the contention is more probably true than not.” Morris K. Udall, Arizona Law of Evidence § 5 (1960). 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.” Black’s Law Dictionary 1120 (8th ed. 2004).

The Board established by a preponderance of the evidence that Respondent engaged in unprofessional conduct as alleged in the Complaint and Notice of Hearing having violated the Nurse Practice Act, A.R.S. §§ 32-1601 to -1669 and Arizona Administrative Code (“A.A.C.”) Rules 4-19-101 to -815. Specifically, Appellant’s acts met the definitions of A.R.S. § 32-1601(27)(a), (d), (g), and (j); A.A.C. R4-19-403(17), (20), and (28); and A.R.S.§32-3208 (A),(B), and (D).

As such, the Board established cause to impose a disciplinary sanction against Respondent’s license under A.R.S. § 32-1663(D).

RECOMMENDED ORDER

Based on the foregoing, the Administrative Law Judge recommends that the Board place Respondent Tiffany Gwyn Terrazas Registered Nurse License number 216214 on probation for a period of thirty-six months, subject to the following minimum conditions:

Respondent undergo a Relapse Prevention Evaluation in 12 months following the Board’s decision.

Respondent must attend a Nurse Recovery Group as authorized by the Board.

Respondent must attend Alcoholics Anonymous with a sponsor at least three times per week.

Respondent must undergo drug testing twice per month for the first 18 months and once per month for the second 18 months.

Respondent must undergo PEth testing at least 4 times per year.

Respondent must also submit performance evaluations/self-reports monthly for the first 12 months and quarterly thereafter.

Pursuant to A.R.S. § 41-1092.08(I), the licensee may accept the Administrative Law Judge Decision by advising the Office of Administrative Hearings in writing not more than ten (10) days after receiving the decision. If the licensee accepts the Administrative Law Judge Decision, the decision shall be certified as the final decision by the Office of Administrative Hearings.

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.

Done this day, January 17, 2024.

/s/ Adam D. Stone

Administrative Law Judge

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

Joey Ridenour, RN, MN, Executive Director

State Board of Nursing

Deborah Abbey

[email redacted]

Bretton H. Barber, Esq.

[email redacted]

By: OAH Staff