A Department of Veterans Affairs audit has discovered rampant irregularities in the handling of narcotics and other controlled substances at La Jolla's V.A. Hospital. According to the report, the VA Inspector General Office's "collaboration in a criminal drug diversion investigation exposed serious problems in CS [controlled substances] management" at the hospital. "Numerous irregular practices related to CS use over a period of at least one year failed to raise suspicions with the charge nurse or supervisor."
Offenses reported by the audit report, released last fall, included a nurse "signing out [controlled substances] without physicians' orders, signing out larger amounts than the physicians ordered, signing out [controlled substances] from other than her assigned unit," and "signing out extremely large amounts of CS to critically ill patients. If these patients had received all the doses, they would have experienced serious breathing and circulatory problems as a result of the drugs' actions."
The investigators found that the nurse in question had been lifting drugs from medication carts other than the one assigned her. "The policy allowed for borrowing only one dose of a narcotic drug if the cart had none of the drug in stock. However, the RN borrowed several doses and even a box full of morphine ampules from another cart." Other unusual activity was noted: "Night-shift staff RNs reported that they frequently observed the RN entering the rooms of patients while the assigned RN was on break. Some of the RNs told us that they had specifically instructed the RN not to give any CS medication to their patient(s) while they were on break, only to return to find that the RN had signed out CS doses to those patients." In addition, "Staff RNs told us that they were suspicious of the RN and 'would not let her relieve me for break.' The shift RNs who were designated as charge nurses told us that they had made the observations mentioned above, but they did not take any action. Fortunately, it does not appear that any patients suffered by the RN's actions."
But to some who claim the hospital has a bigger drug problem, the timing of the release of the audit and the fact that it singled out only one nurse for criticism raises more questions than it answers. According to the audit, the practices in question occurred between June and November 2000, more than four years before the report's public release. The in-house response to the audit's findings -- from Janet M. Jones of the San Diego VA Hospital's Nursing and Patient Care Service -- was dated August 6, 2004: "The Chief, Pharmacy Service, and I are in full concurrence with the recommendations of this report," it said. "The Pharmacy and Nursing oversight group will routinely review the need for staff education with regard to controlled substances and coordinate the provision of such education, as necessary." The audit report says that the investigation "resulted in a recommendation to terminate the responsible registered nurse" but doesn't tell her ultimate fate.
Homeless in the brickyard Ex-San Diego city manager Michael Uberuaga, who some contend played a big role in causing the current financial mess at city hall, has unloaded his house on Edenoaks Street in Scripps Ranch -- for which he paid $456,000 six years ago in November 1998 -- for a cool $1.15 million. No word yet about the current whereabouts of Uberuaga, who got his first city-managing gig at the posh Colorado ski resort of Steamboat Springs in 1983 and was manager of Huntington Beach before being recruited to come to San Diego by then-mayor Susan Golding in 1997. Besides the dicey fiscal situation at city hall, Uberuaga leaves behind him an honorary brick in his name in the pavement of Court Plaza at downtown's taxpayer-financed Padres baseball stadium.