ALJDEC decisions subject to certification as final
24A-202005346-NUR · State Board of Nursing · 2024-12-02
IN THE OFFICE OF ADMINISTRATIVE HEARINGS
IN THE MATTER OF THE REGISTERED NURSE LICENSE NO . RN190830 ISSUED TO:
JEFFREY LEE MILLER,
AKA: Jeff Miller,
RESPONDENT.
No. 24A-[number redacted]-NUR
ADMINISTRATIVE LAW JUDGE DECISION
HEARING: October 9, 2024.
APPEARANCES: Respondent failed to appear. Michelle Bagford and Assistant Attorney General Charles Hover appeared for the Arizona Board of Nursing.
ADMINISTRATIVE LAW JUDGE: Samuel Fox
EXHIBITS ADMITTED INTO EVIDENCE: Arizona Board of Nursing’s Exhibits 1 through 17.
_____________________________________________________________________
FINDINGS OF FACT
The Arizona State Board of Nursing (Board) had 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 had the authority to impose disciplinary sanctions against the holders of nursing licenses for violations of the Nurse Practice Act, A.R.S. §§ 32-1601 to 1667 and Arizona Administrative Code (A.A.C.) R4-19-101 to R4-19-904.
Jeffrey Lee Miller (Respondent) held Board issued practical/registered nurse license number RN190830 in the State of Arizona.
The Board received a complaint from Banner Thunderbird Medical Center in a letter dated May 1, 2020, describing the following incident:
On 4/14/2020, Mr. Miller called in late for his shift and upon arriving an hour late it was noticed he was sweaty, pinpoint pupils, pale, his hands were shaking, and it was noticed there were red sores in his right antecubital area. When being asked questions his answers were short, abrupt, and he was fumbling with his speech. Those observations along with his aggressive behavior led to the suspicion of Mr. Miller being under impaired. A leader observation log for reasonable suspicion drug testing was completed and Mr. Miller was exhibiting four of the behaviors. Mr. Miller was notified of the suspicion for impairment and asked to submit to random drug testing. Mr. Miller refused to submit to drug testing and resigned from his position effective immediately on 4/14/2020.
The Board received a complaint from Parker Adventist Hospital on July 19, 2023, describing the following incident:
Our house supervisor was called by the Parker PD and informed of the following: Parker PD conducted a traffic stop and found 1 Oxycodone and 2 Clonazepam on Jeffrey Lee Miller. They asked where he worked and he told them he was a traveler at Parker Adventist Hospital. Jeffrey claimed the pills were his wife’s. The reason why the officer came into the ED was to see if the pills came from us as Jeffrey told the officer that he was a travel RN here. The pills were in their individual packaging still. We called the Parker PD and they confirmed the report regarding Jeffrey Miller • He was pulled over while driving • He had a gun on him and was arrested on a weapons charge (no details) • There was reasonable suspicion for being on drugs ( no details) • He had drug paraphernalia on him (were not given details) • He had Oxy and Clonazepam on him in individual packages We immediately did a controlled substance access search and confirmed that no medications were removed from our Pyxis by Jeffrey and that no medications were unaccounted for. Jeffrey was only one day off of our orientation. We then interviewed staff who had interacted with Jeffrey and completed a charting audit. Jeffrey was described as "off" and "spacey". His charting was incomplete and his timeliness for medication adminstration was lacking. He was in violation of our documentation policy and medication adminstration policy. We informed his travel contract (AMN) and terminated his contract. He was not drug tested as he was not available.
Several investigators worked on this matter, including the Board’s witness in this matter, Michelle Bagford, RN.
Ms. Bagford testified in support of the facts provided by the Board. Without any contradicting evidence in the record, the Tribunal adopts the following facts as provided in the Board’s Complaint and Notice of Hearing and supported by testimony and records:
1. On April 14, 2020, while on duty working as an RN at Banner Thunderbird Medical Center in Glendale, Arizona, Respondent was noted to have bloodshot eyes, a disheveled appearance, aggressive replies, and exaggerated arm movements. Respondent refused to submit to a for-cause drug screen and was terminated.
2. On or about June 30, 2022, while on assignment from Trustaff Travel Nursing working as an RN at Northwest Medical Center in Tucson, Arizona, Respondent refused to submit to a random drug screen and was terminated.
3. On July 16, 2023, according to Parker (Colorado) Police Department, Case # 2023-003742, at approximately 1:58am, an officer observed Respondent asleep, slumped over in the driver’s seat, of a vehicle in a Walmart parking lot. The officer approached the vehicle and noted the passenger window was cracked and the smell of the odor of marijuana was coming from inside the car. The officer observed several pieces of tin foil, butane, lighters and an unknown object tucked between the legs of the driver of the vehicle and a black handgun in the center console of the car within reach of the driver. Respondent initially denied he had smoked marijuana but after discussing the marijuana dispensary containers, Respondent admitted to smoking marijuana earlier in the night. After a K-9 unit alerted to the presence of illicit narcotics, a probable cause search of the vehicle identified:
• Two loaded firearms
• A short glass pipe with burnt residue under the driver’s seat
• A short glass pipe with burnt residue in one of the dashboard compartments
• A glass pipe inside a cardboard box on the passenger seat
• A folded piece of tin foil containing 1.2 grams of a white crystal-like substance in a dashboard compartment that tested positive for methamphetamine
• A folded piece of tin foil in a lock box on the passenger seat that contained 0.3 grams of a white crystal-like substance that tested positive for methamphetamine
• 2 rubber containers commonly associated with illicit narcotic use, with white residue
• 2 clonazepam tablets in the original packaging in a cardboard box on the passenger seat
• 1 oxycodone tablet in the original packaging in a cardboard box on the passenger seat
Respondent explained to the officer that the car used to belong to his late fiancée and he knew the methamphetamine and Clonazepam tablets belonged to her, but was not aware of the oxycodone. Respondent explained that he forgot about the presence of the drugs but knew the drugs would be methamphetamine because that was his fiancée’s drug of choice. Respondent was charged with 3 misdemeanor counts of 1) Possession of not more than 4 gm Schedule 1 or 2 Drugs of any Quantity of Scheduled III, IV or V, 2) Possession of Drug Paraphernalia, and 3) Prohibited Use of Weapons. Respondent failed to report these charges to the Board within 10 days.
4. On November 16, 2023, Respondent completed a 14-panel hair test through RecoveryTrek that was positive for Fentanyl, Norfentanyl, and Acetyl Fentanyl (Fentanyl metabolites).
5. On December 18, 2023, in a telephone conversation with Board staff, Respondent verbally stated that on or about October 22, 2023, he took approximately 15 Fentanyl pills during a mental health crisis.
6. On January 9, 2024 and February 7, 2024, Respondent completed a comprehensive psychological evaluation with an emphasis in substance use disorder with Dr. Roxanne Hait, a Board-approved psychologist. Dr. Hait diagnosed Respondent with three mental health disorders and an unspecified opioid-related disorder and made treatment recommendations.
7. On April 15, 2024, based upon the facts and circumstances set forth above, the Board found that the public health safety and welfare imperatively required Emergency action. Consequently, the Board ordered, pursuant to A.R.S. § 41-1092.11(B), and effective immediately, that Jeffrey Lee Miller (“Respondent”), the holder of registered nurse license no. RN190830, is SUMMARILY SUSPENDED pending proceedings for revocation and other action by the Board.
On April 24, 2024, the Board found that the public health safety and welfare imperatively required emergency action. Consequently, the Board issued Findings of Public Emergency and Order of Summary Suspension to Respondent.
On May 6, 2024, the Board issued the Complaint and Notice of Hearing, Summary Suspension Expedited Hearing, setting a hearing for June 5, 2024.
On May 30, 2024, Respondent filed a Motion to Continue the hearing, requesting a two-month continuance; the Board did not object and requested a 45 day continuance.
The Tribunal set the matter for a Status Update on July 26, 2024.
On July 24, 2024, the Board submitted a request for hearing on behalf of itself and Respondent. The Board provided dates of availability; Respondent did not.
The matter was set for hearing on October 9, 2024. The Order setting the new hearing date and time was sent to Respondent’s email address of record.
The Office of Administrative Hearings conducted the hearing on October 9, 2024, but Respondent failed to appear at the hearing. Accordingly, Respondent did not enter any evidence into the record.
At the conclusion of the hearing, the Board requested an Order of Revocation due to Respondent’s inability or unwillingness to be regulated. The Board also requested that patient documents be marked confidential, which was granted.
On or about October 30, 2024, Respondent came to the Office of Administrative Hearings and informed the Tribunal that he had not received the notice setting a date for hearing, and he requested a rehearing. The Board objected to a rehearing. The Tribunal received no communications from Respondent between May 30, 2024, when he requested a two-month continuance and five months later, and October 30, 2024.
The Notice, informing Respondent about the hearing date, was sent to the email address from which the Tribunal received the May 30, 2024, Motion to Continue.
CONCLUSIONS OF LAW
This matter lies within the Board’s jurisdiction pursuant to A.R.S. § 32-1606(B)(10).
Respondent was deemed to have received the Complaint and Notice of Hearing by methods reasonably calculated to effect notice.
The Board bears the burden of proof and must establish cause to penalize Respondent’s practical nurse license by a preponderance of the evidence. A preponderance of the evidence is “evidence which is of greater weight or [is] more convincing than evidence which is offered in opposition to it,” showing that a fact is more probably true than not.
In Arizona, when construing statutes, we look first to a statute’s language as the best and most reliable index of its meaning. If the statute’s language is clear and unambiguous, we give effect to that language and apply it without using other means of statutory construction, unless applying the literal language would lead to an absurd result. Words should be given “their natural, obvious, and ordinary meaning,” unless defined by the legislature.
Pursuant to A.R.S. §§ 32-1663 and 32-1664, unprofessional conduct is grounds for disciplinary action.
The preponderance of the evidence established that Respondent’s conduct constituted “unprofessional conduct” as defined in A.R.S. § 32-1601(27):
“Any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public.” A.R.S. § 32-1601(27)(d).
“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.” A.R.S. § 32-1601(27)(e).
“Violating this chapter or a rule that is adopted by the board pursuant to this chapter.” A.R.S. § 32-1601(27)(j).
The preponderance of the evidence established that Respondent’s conduct was “unprofessional conduct” that “is or might be harmful or dangerous to the health of a patient or the public” as defined in A.A.C. R4-19-403.
“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.” A.A.C. R4-19-403(18).
“If a licensee or applicant is charged with a felony or a misdemeanor involving conduct that may affect patient safety, failing to notify the Board in writing, as required under A.R.S. § 32-3208, within 10 days of being charged.” A.A.C. R4-19-403(28).
“Practicing in any other manner that gives the Board reasonable cause to believe the health of a patient or the public may be harmed.” A.A.C. R4-19-403(31).
The preponderance of the evidence established that Respondent’s conduct violated A.R.S. § 32-3208(A) and (D).
The Board established violations of each provision identified in paragraphs 6 and 7 above, by the preponderance of the evidence.
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 license.
RECOMMENDED ORDER
IT IS RECOMMENDED that the Board affirm its order summarily suspending Respondent Jeffrey Lee Miller’s practical/registered nurse license, number RN190830.
IT IS FURTHER RECOMMENDED that the Board revoke Respondent Jeffrey Lee Miller’s practical/registered nurse license, number RN190830.
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, December 2, 2024.
/s/ Samuel Fox
Administrative Law Judge
Transmitted by either mail, e-mail, or facsimile to:
Joey Ridenour, RN, MN, Executive Director
State Board of Nursing
Jeffrey Lee Miller
[email redacted]
Office of the Attorney General
[email redacted]
By: OAH Staff