College of Nurses of Ontario v. Jan Lardie, 2006 ONCNO 81738

PANEL: George Fieber, RN Chairperson

Kendra O’Bryan, RPN Member Rosalie Woods, RPN Member Karen Harder Public Member

Joan King Public Member

BETWEEN:

) MEGAN SHORTREED for

COLLEGE OF NURSES OF ONTARIO ) College of Nurses of Ontario

and - )

) NO REPRESENTATION for

JAN LARDIE ) Jan Lardie

Registration No. IE04903 )

) Heard: November 16, 2006

DECISION AND REASONS

This matter came on for hearing before a panel of the Discipline Committee on November 16, 2006 at the College of Nurses of Ontario (the “College”) at Toronto.

The Allegations

The allegations against Jan Lardie, (the “Member”) as stated in the Notice of Hearing dated October 12, 2006, are as follows:

You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that you contravened a standard or practice of the profession or failed to meet the standards of practice of the profession as follows:

a. while employed at [the Office], you misappropriated a prescription pad from the workplace; and/or

b. you forged a prescription for Percocet dated August 14, 2003 in the name of [Dr. A]; and/or

c. you forged a prescription for Percocet dated December 17, 2003 in the name of [Dr. B]; and/or

d. you forged a prescription for Percocet dated February 13, 2004 in the name of [Dr. B]; and/or

You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(8) of Ontario Regulation 799/93, in that while working as a Registered Practical Nurse at [the Office], you misappropriated property from your workplace as follows:

a. you misappropriated a prescription pad from the workplace; and/or

You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, as follows:

a. while employed at [the Office], you misappropriated a prescription pad from the workplace; and/or

b. you forged a prescription for Percocet dated August 14, 2003 in the name of [Dr. A]; and/or

c. you forged a prescription for Percocet dated December 17, 2003 in the name of [Dr. B]; and/or

d. you forged a prescription for Percocet dated February 13, 2004 in the name of [Dr. B].

Member’s Plea

The Member admitted the allegations set out in paragraphs numbered 1, 2 and 3 in the Notice of Hearing. The panel conducted a plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.

Agreed Statement of Facts

Counsel for the College advised the panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts which provided as follows:

THE MEMBER

The Member

Jan Lardie, (“the Member”) has been a member of the College of Nurses since 1995.
The Member worked at [a hospital] as an RPN in the emergency observation unit for three years ending in 2003. She began working as an RPN at [the Physician’s Office] in approximately May 2001. She worked shifts as an RPN simultaneously at both facilities.
The Member’s employment was terminated at [the Office] in November 2002 due to absenteeism. Her employment was similarly terminated at [the Hospital] in 2003.

THE FACILITY

The Facility

[The Office] is a physician’s office employing 10 registered staff. It is family practice, with a walk-in clinic and a pediatrician. During 2002-2004, the clinic did not operate on weekends.

STOLEN PRESCRIPTION PAD

Stolen Prescription Pad

In or about 2002, while the Member worked at [the Office], she removed a prescription pad from the clinic. The blank prescription pad contained [the Office’s] letterhead, and allowed prescriptions to be written by any of [Drs. A, B or C].

AUGUST 14, 2003 FORGED PRESCRIPTION

August 14, 2003 Forged Prescription

The Member forged a prescription dated August 14, 2003 for “Jan Lardie” for “Percocet 1-2 Tabs, q 4-6 h, PRN, 150” in the name of “[Dr. A]”. Percocet is the generic name for Oxycodone/acetominophen, a narcotic.

On or about August 16, 2003, the Member presented the forged prescription at the [ ] Pharmacy and attempted to obtain 150 Percocet tablets. The pharmacist on duty declined to fill the prescription. Before returning the prescription to the Member, he faxed a copy to [the Office].

August 16, 2003 was a Saturday so the prescription was not reviewed by [the Office] staff until August 18, 2003, the following Monday. [Dr. A] had not worked at the clinic since February 2003 and confirmed that he had not written the prescription. [The] police were contacted but no charges were laid.
On or about August 15, 2003, the Member presented the same or a similar forged prescription at [another pharmacy]. The prescription was filled and the Member received 150 tablets of Percocet.

DECEMBER 17, 2003 FORGED PRESCRIPTION

December 17, 2003 Forged Prescription

The Member forged a prescription dated December 17, 2003 for “Jan Lardie” for “Percocet 1-2 Tabs, PPN [sic], 150” in the name of “Dr. B]”.
On Saturday, December 20, 2003, the Member presented the forged prescription at [ ] Pharmacy [] and obtained 150 Percocet tablets.
On Monday, December 22, 2003, the pharmacist faxed a copy of the prescription to [the Office]. [Dr. B] confirmed that she had not written the prescription and that it was forgery. [The] Police were contacted, and the matter was referred to [another department]. No charges were laid.

FEBRARY 13, 2004 FORGED PRESCRIPTION

February 13, 2004 Forged Prescription

The Member forged a prescription dated February 13, 2004 for “[ ]” for “Percocet 1-2 Tabs, Q6h PRN, 90” in the name of “[Dr. B]”. “[ ]” was the Member’s first married name and the Member admits that “[ ]” is a pseudonym she invented.
On February 23, 2004, the Member presented the forged prescription to the Day Night Pharmacy in [ ] and attempted to obtain 90 Percocet tablets.
The pharmacist did not fill the prescription. The pharmacist faxed a copy of the prescription to [the Office] on February 24, 2004.
[Dr. B] confirmed that the prescription was a forgery and that she did not have a patient named [ ]. [Dr. B] advised [the] Police of the incident but no charges were laid.
The Member also presented the same forged prescription to the [ ] Pharmacy in [ ]. The pharmacist there also declined to fill the prescription and faxed a copy to [the Office].

THE MEMBER’S HEALTH

The Member’s Health

The Member has suffered from [a health condition] for many years. Her family physician, [Dr. D], began prescribing Percocet to [treat her condition] as early as January, 2002.
In addition, the Member has suffered from [another health condition] for many years. [Dr. D] has been prescribing various [ ] medications for the Member since at least January, 2002. [Dr. D] has advised the College that the Member’s [condition] arises primarily out of personal circumstances, including stress [ ].
On March 30, 2003, the Member was involved in an []accident [that exacerbated her health condition], for which [Dr. D] increased her dosage of Percocet. Moreover, [Dr. D] diagnosed and has been treating the Member for [other] symptoms since June, 2004. Dr. [D] has advised the College that the Member experienced [increased difficulties] on occasion since the time of her accident in 2003.
If the Member were to give evidence, she would state that she does not believe that she suffers from a dependence on narcotic pain medication. [Dr. D] confirms this belief and has advised the College that he monitors the Member's use of Percocet and prescribes a monthly dose that she does not exceed. He believes that the Member requires Percocet to manage her [health condition]. [Dr. D] also believes that the Member's [other condition] is adequately managed.
If the Member [were to give evidence, she] admits that she did steal the prescription pad and forged the prescriptions as set out above. [ ].
In addition, the Member would state that the treatment that she has been receiving from her family doctor [has improved her situation]. Consequently, she gave 150 of the Percocet tablets she acquired to [a relative], who had suffered [an] injury and was taking Tylenol 3 for pain. The Tylenol was constipating and she gave him the Percocet so that he would not have this side effect. The Member acknowledges that this was a further act of professional misconduct.
The Member cannot account for the further 150 Percocet tablets she obtained.

ADMISSIONS

Admissions

The Member admits that she committed acts of professional misconduct by stealing a prescription pad from her workplace, forging three or more prescriptions for Percocet, presenting forged prescriptions for Percocet as legitimate on at least five occasions, and obtaining Percocet by forged prescription on at least two occasions.
The Member acknowledges that she committed the acts of professional misconduct set out in allegations 1, 2, and 3 of the Notice of Hearing in that she contravened the standards of practice of the profession, misappropriated property from her workplace, and engaged in conduct or performed an act, relevant to the practice of nursing that, having regard to all of the circumstances would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional.

Decision

The panel considered the Agreed Statement of Facts and finds that the facts support a finding of professional misconduct and, in particular, found that the Member committed an act of professional misconduct as alleged in paragraphs 1, 2 and 3 of the Notice of Hearing in that:

The Member contravened a standard of practice of the profession or failed to meet the standards of practice of the profession as follows:

a. while employed at [the Office], she misappropriated a prescription pad from the workplace;

b. she forged a prescription for Percocet dated August 14, 2003 in the name of [Dr. A];

c. she forged a prescription for Percocet dated December 17, 2003 in the name of [Dr. B]; and

d. she forged a prescription for Percocet dated February 13, 2004 in the name of [Dr. B]; and

The Member misappropriated a prescription pad from her workplace, [the Office]; and
The Member engaged in conduct or performed an act, relevant to the practice of nursing that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, as follows:

a. while employed at [the Office], she misappropriated a prescription pad from the workplace;

b. she forged a prescription for Percocet dated August 14, 2003 in the name of [Dr. A]; and

c. she forged a prescription for Percocet dated December 17, 2003 in the name of [Dr. B]; and she forged a prescription for Percocet dated February 13, 2004 in the name of [Dr. B].

Penalty

Counsel for the College advised the panel that a Joint Submission on Penalty had been agreed upon. The Joint Submission on Penalty provided as follows:

Jan Lardie (“the Member”) and the College of Nurses of Ontario (“the College”) respectfully submit that, in view of the circumstances set out in the Agreed Statement of Facts, the Member’s agreement to enter into the Undertaking attached, and the Member’s admissions of professional misconduct, the Panel of the Discipline Committee (“the Panel”) should make an Order as follows:

Requiring the Member to appear before the panel to be reprimanded within three months from the date this order becomes final;
Directing the Executive Director to suspend the Member’s certificate of registration for a period of three months to commence on the date this order becomes final;
Directing the Executive Director to impose the following terms, conditions and limitation on the Member’s Certificate of Registration for a period of 2 years following the Member’s return to practice:

(a) The Member must ensure that the Director of the Investigations and Hearings Department (the “Director”) is advised in writing of the names and addresses of any nursing employer or employers for whom the Member practices within 14 days from the date the Member commences employment;

(b) The Member must provide any nursing employer or prospective employer with a copy of the panel’s Order with attached Notice of Hearing, Agreed Statement of Fact, and Joint Submission on Penalty, or, if available, a copy of the panel’s decisions and reasons, and must advise the employer or prospective employer of the monitoring conditions set out in subparagraph (c), prior to commencing practice with the employer;

(c) The Member must practice only for nursing employer(s) who agree to advise the Director in writing within 14 days of the date the Member commences employment that the employer:

(i) has received a copy of the documents referred to in (b); and

(ii) agrees to notify the Director immediately upon receipt of any reasonable information that the Member has engaged in any professional misconduct.

The effect of an order by the Discipline Committee in this matter shall be suspended until such time as the Member reinstates her certificate of registration.

Penalty Decision

The panel accepted the Joint Submission as to Penalty, and accordingly orders that:

The Member appear before the panel to be reprimanded within three months from the date this order becomes final;
The Executive Director suspend the Member’s certificate of registration for a period of three months to commence on the date this order becomes final;
The Executive Director impose the following terms, conditions and limitation on the Member’s Certificate of Registration for a period of 2 years following the Member’s return to practice:

(c) The Member must practice only for nursing employer(s) who agree to advise the Director in writing within 14 days of the date the Member commences employment that the employer:

(i) has received a copy of the documents referred to in (b); and

(ii) agrees to notify the Director immediately upon receipt of any reasonable information that the Member has engaged in any professional misconduct.

The effect of the order of the Discipline Committee in this matter shall be suspended until such time as the Member reinstates her certificate of registration.

Reasons for Penalty Decision

The panel concluded that the proposed penalty is reasonable and in the public interest. The Member has co-operated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility for her actions and has avoided unnecessary expense to the College.

In addition, in making this order, the Panel recognizes the undertaking between the College and the Member signed on November 16, 2006 [in which the Member agrees to ongoing monitoring and treatment for health issues].

I, George Fieber, RN, sign this decision and reasons for the decision as Chairperson of this Discipline panel and on behalf of the members of the Discipline panel as listed below:

Chairperson Date

Panel Members:

Kendra O’Bryan, RPN

Rosalie Woods, RPN

Karen Harder, Public Member

Joan King, Public Member

[APPENDIX A]

Appendix A

IN THE MATTER OF A HEARING BEFORE THE

DISCIPLINE COMMITTEE OF THE

COLLEGE OF NURSES OF ONTARIO

BETWEEN

COLLEGE OF NURSES OF ONTARIO

-and-

JAN LARDIE,

RPN # IE – 0490-3

UNDERTAKING

WHEREAS allegations of professional misconduct were referred to the Discipline Committee for consideration;

AND WHEREAS the College has entered into an agreement with me regarding both the facts and the penalty to be sought from the Discipline Committee respecting the allegations of professional misconduct if it received adequate assurances from me respecting certain health issues;

AND WHEREAS I am desirous of providing satisfactory assurances to the College;

I, Jan Lardie, RPN # IE – 0490-3, do hereby undertake and agree as follows:

I will remain under the care of my family physician, Dr. [D], and will visit him on a quarterly basis for the next two years for the purpose of monitoring my [psychological condition] and use of Percocet or any other narcotic.

I will ensure that Dr. [D] is provided with a copy of this Undertaking.

Further, I will ensure that Dr. [D] provides annual reports to the Director of Investigations and Hearings of the College of Nurses of Ontario, in November of 2007 and 2008, confirming my attendance on a quarterly basis and that he continues to monitor my [psychological condition] and use of Percocet or any other narcotic.

Dated this ___ day of November, 2006

Jan Lardie