By Joel Warner
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Two elements stand out about Parker's story: the twisted recklessness of the scam she was pulling, and the inability of her employers to think like a dope fiend and anticipate or prevent the scam.
On Parker's part, the brazenness took many forms. She took fentanyl home, but she also shot up in a hospital bathroom on breaks, figuring it would help her back problems if she had a long OR session ahead, lugging heavy trays around. Yet none of the trained physicians and nurses who worked with her detected signs of intensive opiate use. "I guess you'd say I knew my limit," Parker boasted to the detectives. "I didn't want to make it obvious to everyone that I was using."
The police couldn't understand why she reused the syringes, exposing others to hepatitis C. There was no need, really — clean needles, like the saline she used to replace the fentanyl, were easy enough to come by. Parker had several responses to this. First, she didn't know she had hep C — or, to be more precise, she never bothered to confirm that she did. "If I had known, it would have been different," she said. "I didn't know this was going to happen."
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She also gave a garbled answer about carrying two syringes around with her — one clean, one already used. She didn't keep track of which one was the clean one when she did the swap. It was just the luck of the draw as to who got what. This is junkie logic, but entirely consistent with her complete indifference to the fact that she was depriving surgery patients of their pain medication even if she wasn't infecting them. "I always figured if they were in pain, [the doctors] would give them something to make the pain go away," she explained.
Hospitals are complex systems. As such, they are no match for single-minded addicts intent on getting high. The high-tech, high-security dispensing machines that are supposed to prevent drug diversion come with sophisticated software designed to detect aberrant patterns of use — for example, if an unusual amount of lidocaine seems to be dispensed on Nurse Crackhead's shift. But Ashton Daigle, the Boulder Community Hospital nurse who copped enough fentanyl to treat a few hundred patients, managed to defeat the machine by filling a bogus order for pain medication, canceling it, then "returning" the fentanyl vial to inventory; the machine didn't know that the vial now contained saline and tap water. Parker's game of switching needles on the med tray is even simpler.
Garvin says Rose Medical Center has been reviewing its patient safety and drug security measures in the wake of Parker's arrest. Administrators are considering expanding the use of tamper-resistant syringes; they're also training managers to recognize the sometimes subtle signs that an employee is diverting drugs. It's not out of the question, she admits, that they'll tap other resources when employees are acting suspiciously — such as checking out their Facebook or MySpace pages for references to drug use or a fascination with needles.
"We've lowered our threshold for triggering an investigation," Garvin says. "This was an exceptional case, but we need to better educate everyone who works in the facility regarding the behavior of people who divert. Maybe all of health care needs to think about more education for physicians and staff to better understand that behavior. It's probably more widespread than any of us think."
Near the end of her interview, the detectives asked Parker what the hospital could have done to stop her.
"Be more aware of what you leave lying around," she said. "A lot of times it wouldn't be available. I couldn't get it every shift."
"I DON'T WANT TO FEEL LIKE A NUMBER"
Call her Pam. Call him Justin. They are patients with different outcomes but many of the same questions.
Pam had surgery at Rose in December. The day the news about hepatitis C hit the papers, she called the hospital's hotline. After a long time on hold, she was given a series of conflicting answers about where she could get tested, how long the wait was going to be, when the results would be available.
She had trouble sleeping. She went to one of the labs recommended by Rose and gave them her blood. Then, because she didn't trust that the results would be timely or accurate, she paid for a second test with another lab. She went online and found Parker's MySpace page — the pictures of tattoos, the talk about needles. She kept calling the hospital with more questions and got different answers.
"I called back and asked if Parker was working the day of my surgery," Pam recalls. "They said they couldn't tell me, but they were putting some patient records online. I called back the next day to ask if she'd been tested for HIV. The lady started explaining about HIPPA, and I said I felt I had the absolute right to know. Finally, she asked her supervisor, then told me she was negative."
After a few days, and much sooner than she expected, she got the test result: negative for hepatitis C. A huge relief, yes — but Pam still felt uneasy. Did that mean she definitely was not exposed? Could she have been exposed and it just didn't take? No one could tell her if Parker was working that day, and she couldn't shake the sense that she had been violated somehow.