ALJDEC decisions subject to certification as final
24A-2022090170-NUR · State Board of Nursing · 2024-07-16
IN THE OFFICE OF ADMINISTRATIVE HEARINGS
IN THE MATTER OF THE PRACTICAL NURSE LICENSE NO. LP053665 ISSUED TO:
CHRISTINE RENEE DOMINGUE,
AKA: Christine Renee Pollard; Christine R. Ortiz,
RESPONDENT.
No. 24A-[number redacted]-NUR
ADMINISTRATIVE LAW JUDGE DECISION
HEARING: May 1, 2023, with the record held open until June 13, 2024, for receipt of the transcript.
APPEARANCES: Respondent Christine Renee Domingue did not appear. The Arizona State Board of Nursing was represented by Assistant Attorney General Deborah Abbey.
ADMINISTRATIVE LAW JUDGE: Tammy L. Eigenheer
EXHIBITS ADMITTED INTO EVIDENCE: Board’s Exhibits 1 through 18, including subparts.
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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 Christine Renee Domingue holds Board-issued Practical Nurse License No. LP053665.
On or about September 9, 2022, the Board received a complaint (Complaint #1) from Quinny Mazzola, Registered Nurse at Sabino Canyon Rehabilitation and Care Center (Sabino Canyon), that provided as follows:
noted LPN with multiple and several wasted oxycodone tabs, and one missing narcotic medication card of 57 tabs oxycodone. Any second nurse that has signed when C. Dominque wasted narcotics states that signature was forged. can send full investigation
Based on this complaint, the Board opened an investigation.
Respondent submitted a completed Investigative Questionnaire and written statement as to Complaint #1 in which Respondent denied the allegations set forth in the complaint.
On or about March 2, 2023, the Board received a complaint (Complaint #2) from Sarah Beltran, Interim Director of Nursing at Sandstone Estates Rehab Centre (Sandstone Estates), that provided as follows:
Narcotic Diversion LPN Christine Domingue worked night shift (6PM - 6AM) on 2/28/2023. During the narcotic count at handoff, incoming nurse LPN Nanci questioned her about one missing blister-pack card. LPN Chrisine [sic] replied "that card was expired, so supervisor Kathy took it". Supervisor Kathy said she did not take any narcotics from any of the nurses on the day in question. Unit manager, Amber, continued investigation on 3/1/2023. This time LPN Christine said that there were "4 tablets left" and that she went to pop one out but it had "disintegrated". LPN Christine went on to say that she "attempted to get another one" and that one had also "disintegrated". She then claimed that she "removed the other 2 remaining ones and put them in the biohazard container in the cart, and placed the empty card alon gwith [sic] the narcotic count sheet in the medical records file." The medical records filing box was checked and the items were not there. This inspection was conducted immediately after the call with LPN Christine. Facility cameras were reviewed by Administrator Ryan and Unit Manager Amber. Both noted that LPN Christine pulling narcotics from different cards, popping medications into her left hand, pocketing the medications. Unbeknownst to [LPN] Christine, a copy of the narcotic sheets had been made on 2/27/2023 during narcotic audit. The sheet in questions was for Percocet 5/325 and it contained 39 pills, contrary to the 4 pills she claimed was remaining in the blisterpack-card.
Based on this complaint, the Board opened another investigation.
On or about June 19, 2023, Board staff sent Respondent an Investigative Questionnaire to Respondent’s address of record with instructions to complete it and include a written explanation in response to Complaint #2, with a due date of July 3, 2023.
Respondent did not return the completed questionnaire or written statement within 30 days as required.
On or about July 24, 2023, Board staff sent Respondent a second Investigative Questionnaire for Complaint #2 to Respondent’s email address of record.
On or about August 1, 2023, during an email exchange with Respondent, she was informed of the need to complete a second Investigative Questionnaire in response to Complaint #2. Respondent replied that she understood the expectation and indicated that she would complete a written statement regarding Complaint #2.
Respondent did not return the completed questionnaire or written statement.
On or about August 19, 2023, Board staff sent Respondent a third Investigative Questionnaire for Complaint #2 to Respondent’s email address of record.
As of the date of the hearing, Respondent had not returned the completed questionnaire or written statement.
On or about November 13, 2023, when the matter was pending in the Board’s Hearing Department, the Board received a complaint against Respondent from the Director of Nursing at Handmaker Home for the Aging (Handmaker Home) with alleging that, from October 1, 2023 to November 7, 2023, while working as an LPN for Handmaker Home, Respondent diverted 35 to 50 oxycodone pills and falsified patient documentation.
Based on this complaint, the Board opened another investigation.
Sabino Canyon
From August 18, 2022 to August 25, 2022, while working as an LPN at Sabino Canyon, Respondent removed oxycodone-acetaminophen 5mg-325mg tablets as noted below:
On August 18, 2022, Respondent removed one tablet of oxycodone-acetaminophen 7.5mg-325mg for Patient J.S. at 6:30pm. Respondent documented “waste” on the narcotic count sheet. There was no witness signature of the waste on the narcotic count sheet.
On August 25, 2022, Respondent removed one tablet of oxycodone-acetaminophen 7.5mg-325mg at 2:00pm and a second oxycodone-acetaminophen 7.5mg-325mg 1 tablet at 9:30pm for Patient J.S. There was no record of administration, waste, or return of either of these oxycodone-acetaminophen 7.5mg-325mg tablets.
On August 21, 2022, Respondent removed 1 tablet of oxycodone 30mg for Patient R.S. at 10:00am, another tablet on oxycodone 30mg at 10:30am, and a third tablet of oxycodone 30mg at 12:10pm. There was a signature of another nurse verifying the waste of these 3 tablets of oxycodone 30mg. On July 29, 2023, that nurse verbally denied that he wasted any oxycodone with Respondent. Respondent fraudulently signed another nurse’s name on the narcotic count log without contacting that nurse to verify the waste of the oxycodone.
From August 21, 2022 to August 27, 2022, while working at Sabino Canyon, Respondent removed oxycodone 30mg tablets as noted below:
On August 21, 2022, Respondent removed one tablet of oxycodone 30mg for Patient R.S. at 12:30pm and removed a second tablet of oxycodone 30mg at 10:00pm. Respondent did not document that the oxycodone was administered, returned to the medication drawer, or wasted.
On August 25, 2022, according to the narcotic count sheet, Respondent removed 1 tablet of oxycodone 30mg for Patient R.S. at 2:00pm twice and wrote “waste” on the narcotic count sheet twice. There was no witness signature on the narcotic count sheet.
On August 27, 2022, according to the narcotic count sheet, Respondent removed 1 tablet of oxycodone 30mg for Patient R.S. at 8:40pm twice. Respondent documented that Patient R.S. received oxycodone 30mg 1 tablet for a patient level of 8. There was no record of administration, waste, or return of the second tablet of oxycodone.
On August 25, 2022, while working at Sabino Canyon, Respondent removed two tablets of oxycodone 5mg for Patient Y.R. at 5:47pm and 2 tablets of oxycodone 5mg at 7:30pm which she crossed through with a single line on the narcotic count sheet. Respondent decreased the oxycodone 5mg pill count by 2 tablets each time on the narcotic count sheet. Respondent then repeated these two entries a second time, decreasing the pill count by 2 tablets each time, for a total of 8 tablets of oxycodone 5mg. There was no record of administration, waste or return of the eight tablets of oxycodone.
Sandstone Estates
From February 2, 2023, through February 3, 2023, while working as an LPN at Sandstone Estates:
On February 2, 2023, Respondent removed oxycodone 5mg 1 capsule for Patient J.V. at 7:00pm. Respondent did not document that the oxycodone was administered, returned to the medication drawer, or wasted.
On February 2, 2023, Respondent documented removal of oxycodone 5mg 1 capsule for Patient J.V. at 11:00 and then struck through the removal with an annotation that is unintelligible. There was no documentation that the oxycodone was administered, returned to the medication drawer, or wasted.
On February 3, 2023, Respondent documented removal of oxycodone 5mg, 1 capsule for Patient J.V. at 3:00am. There was no record that Respondent administered, returned or wasted the oxycodone.
On February 2, 2023, while working as an LPN at Sandstone Estates, Respondent removed oxycodone tablets as noted below:
On February 2, 2023, Respondent documented removal of oxycodone 10mg 1 tablet at 5:30am and 5:33am. There was no documentation on February 2, 2023 that a second dose of oxycodone 10mg 1 tablet was administered, returned, or wasted.
On February 2, 2023, Respondent removed an oxycodone 10mg 1 tablet for Patient C.V. at 7:00am. There was no record that the dose of oxycodone was administered, returned, or wasted.
On February 2, 2023, Respondent documented removal of oxycodone 10mg 1 tablet for Patient C.V. at 7:00pm and crossed out the entry with an annotation of “vomiting”. Respondent then documented removal of another oxycodone 10mg 1 tablet at 7:00pm. There was no documentation that either dose of oxycodone was administered, returned, or wasted.
On February 2, 2023, Respondent removed an oxycodone 10mg 1 tablet for Patient C.V. at 9:00pm. There was no record that the dose of oxycodone was administered, returned, or wasted.
On February 2, 2023, Respondent documented removal of oxycodone 10mg 1 tablet at 10:00pm. There was no documentation that a second dose of oxycodone 10mg 1 tablet was administered, returned, or wasted.
On February 8, 2023, while working as an LPN at Sandstone Estates, Respondent documented administration of oxycodone 5mg, 2 capsules to Patient J.V. at 9:40pm. There is no documentation that Respondent removed the medication from the narcotic card.
On February 9, 2023, while working as an LPN at Sandstone Estates, Respondent documented administration of oxycodone-acetaminophen 5-325mg, 1 tablet to Patient E.P. at 9:56pm. On February 10, 2023, Respondent documented administration of oxycodone-acetaminophen 5-325mg, 1 tablet to Patient E.P. at 5:50am. However, there was no documentation that Respondent removed the medication from the narcotic card on either occasion.
Handmaker Home
In interviews with Board staff on February 12, 2024, and March 12, 2024, the assistant administrator for Handmaker Home stated that their records indicated that on or around October and November 2023, Respondent forged the names of nurses who were not on duty to facilitate Respondent’s diversion/theft of various forms of oxycodone, e.g., 10 mg tablets, 5 mg tablets, and combination acetaminophen and oxycodone tablets.
Summary Suspension
On or about March 21, 2024, the Board summarily suspended Respondent’s practical nurse license and requested that proceedings be promptly instituted and determined.
On or about March 27, 2024, the Board issued a Complaint and Notice of Hearing, Summary Suspension Expedited Hearing, that alleged violations of A.R.S. § 32-1601(26)(d), (g), (h), and (j) and A.A.C. R4-19-403(9), (16), (18), (25), and (31).
The Notice of Hearing was sent via certified mail to Respondent at her address and email address of record.
Respondent did not appear in person, telephonically, or by video conference at the duly noticed hearing and did not request that the hearing be continued prior to the hearing convening. Although the start of the hearing was delayed 15 minutes to allow Respondent an opportunity to appear, she did not appear, personally or through an attorney, and did not contact the OAH to request that the start of the hearing be further delayed prior to the hearing convening. Consequently, Respondent did not present any evidence to defend her practical nurse license.
CONCLUSIONS OF LAW
The Notices of Hearing that the Board mailed to Respondent at her address and email address of record were reasonable, and Respondent is deemed to have received notice of the hearing.
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 practical nurse license 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 as alleged in the Complaint and Notice of Hearing. As such, the Board established cause to impose a disciplinary sanction against Respondent’s license under A.R.S. § 32-1663(D) and A.R.S. § 32-1664(N).
RECOMMENDED ORDER
Based on the foregoing, the Administrative Law Judge recommends that the Board affirm its order summarily suspending Respondent Christine Renee Domingue’s Practical Nurse License number LP053665.
It is further recommended that the Board revoke Respondent Christine Renee Domingue’s Practical Nurse License number LP053665.
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.
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-137160-45720000Done this day, July 16, 2024.
/s/ Tammy L. Eigenheer
Administrative Law Judge
Transmitted by either mail, e-mail, or facsimile to:
Joey Ridenour, RN, MN, Executive Director
State Board of Nursing
Deborah Abbey
Office of the Attorney General
[email redacted]
Christine Renee Domingue
[email redacted]
By: OAH Staff