Hospice Patients Alliance: Consumer Advocates

When Narcotics are Diverted, Misused
In Order to Kill a Patient
You can Report the Crime to the
U.S. Drug Enforcement Administration

The United States Department of Justice, Drug Enforcement Administration ("DEA") serves the public through many efforts to fight criminal activity. One specific function of relevance to hospice patients, their families and caregivers is the enforcement of the "Controlled Substances Act" which regulates the use of legal narcotics such as morphine and others used in hospice. The Controlled Substances Act is set forth at Title 21 of the United States Code: 21 USC, subchapter1, starting at part A, Section 801. The DEA states that it is responsible for (among many other responsibilities):

" Enforcement of the provisions of the Controlled Substances Act as they pertain to the manufacture, distribution, and dispensing of legally produced controlled substances. "

The DEA also has the authority for:

"Coordination and cooperation with federal, state and local law enforcement officials on mutual drug enforcement efforts ...."

What is significant for hospice patients and their families is that the DEA does investigate and enforce the provisions of the Controlled Substances Act which regulate the proper and legal use of narcotics such as morphine, fentanyl, methadone, and other opioids for reduction of pain and other appropriate uses, and specifically, violations of the appropriate use of these narcotics especially if the medications are being diverted by a nurse or physician for their own use as well.

You can also file a complaint to the State Board of Nursing if a nurse was involved in administering a fatal dose of narcotic or you have evidence the nurse was using these medications him or herself. It is wise to consult a medical malpractice attorney before filing your complaint to the Board of Medicine and it is also important to get a medical review by an independent physician.

If you find an attorney to bring a legal action, you will need to get a copy of the medical record for an independent medical review. Your attorney can assist you in that, because most hospices will refuse to give you the medical records if something truly terrible happened. But if you are the personal representative of the estate of the deceased, by law, they must send you the records. In that case, you request the records by U.S. certified mail, return receipt requested (so you have proof of the request), keeping copies of everything you send them. If you are not the personal representative of the estate, but are taking legal action, once a legal action is begun, the agency will also have to provide the records.

If you don't have or know of a medical malpractice attorney in your area, you can search for a plaintiffs' attorney by calling the local bar association or looking online for plaintiffs' attorneys. It is very important that you try to find an attorney who files claims as a plaintiffs' attorney to represent you. If you get an attorney who handles medical malpractice, but regularly represents the corporations, you may not get the legal representative you deserve! Hospices have been known to falsify documentation, delete information, send incomplete records, stall and many other tactics that infuriate the families of the victims. A plaintiff's attorney will be able to successfully overcome the obstacles that hospice corporations routinely throw in the way of families seeking the truth (and a full, accurate copy of the medical record).

Taking the step by step approach to achieving justice will help make it more likely that the truly egregious violations of standards of care are noted (some you may miss, not being a physician) and corrected through the government justice departments and local district attorney's office. Having a medical malpractice attorney help you will assure that the complaint to a Board of Medicine or Nursing is written in such a way that the allegations are not capable of being misunderstood or brushed aside. Whether you use an attorney or not to file a complaint to a Board of Medicine or Nursing, such complaints must be concise, to the point, and list specific violations of the standards of care without long narratives.

If you don't want to spend the money on legal assistance, be prepared for nothing to happen...that's just the way the system is set up. Attorneys are needed to successfully achieve justice in the system. Filing a legal action (suing) on your own ("pro se") is not advised unless you have tremendous legal knowledge on your own and have many, many hours on a regular basis to spend on the effort. Even then, filing on your own is usually not successful at all!

While all of these things take time, even months, filing complaints that do not grant you the justice you seek is also futile. Taking the time to do it right, the first time is very much worth the time! Spending many months or even years pursuing justice on your own without an attorney, and then losing your case, is not going to reform the health care system.

We at the Hospice Patients Alliance encourage families who are absolutely convinced and sure that a misuse of narcotics resulted in an undesired euthanasia of their loved one (murder), to carefully question themselves and make sure that they are sure that a misuse of narcotics was what occurred. If you believe that your loved one was actually murdered through the misuse of a narcotic, then you can make a complaint to the Board of Medicine, Nursing, or if diversion of a drug occurred, the DEA.

It is important that when you visit the DEA offices, you should bring your concerns specifically to an agent in the Office of Diversion Control within the DEA. Making phone calls to these offices is not effective in getting action. You need to visit the offices and speak directly with an agent there and learn what you can from them.

We have heard hospice staff, physicians, and managers who complain loudly that involvement of the U.S. DEA can hamper the proper and effective administration of pain medications to help the terminally ill. These hospices complain that they "don't need the DEA watching over their shoulders." What these hospices fail to realize is that physicians, nurses, and others who work in the hospice industry have made it necessary for law enforcement, the DEA, or U.S. attorney to become involved.

Why? Because terminally ill (and other non-terminal) patients who are not yet at the point of dying are being murdered by misguided doctors and nurses who have decided they can commit "euthanasia" without the permission of the patients and their families.

Just because a patient has a terminal illness does not mean that they all wish to die at the hands of a hospice physician or nurse. Patients who are not terminal, but have chronic illnesses, have also been "euthanized" (murdered) by rogue hospice physicians and nurses. Sometimes hospices fraudulently admit non-terminal patients against their will, into their hospices, then collect reimbursement while providing minimal services, and euthanize the non-terminal patients (sometimes with the cooperation and assistance of certain family members). These patients did not come to hospice to be killed, but to receive comfort measures and compassion. Some have not even consented to enroll in hospice but have been railroaded by family members who think it's "merciful" to kill them. Many patients do not want to be euthanized, but actually want to live.The rogue doctors, nurses and their hospices have violated the laws governing the use of these narcotics and have violated the laws governing our citizens.

Doctors and nurses cannot legally murder chronically ill or even terminally ill patients inside or outside the hospice setting. Those rogue hospices, doctors and nurses who kill patients by misusing narcotics have brought a bad reputation to the entire hospice community and have disgraced their hospices. Giving sedatives to stop any protest on the part of the chronically ill or terminally ill patient is the first step. Morphine or another narcotic is given which results in respiratory depression, slowing the breathing down till breathing stops completely and death occurs.

The reason that visiting the DEA and reporting your concerns is an effective means of stopping misuse of narcotics is that each physician has what is called a "DEA number." The DEA number allows a physician to legally prescribe narcotics which are controlled substances regulated by the Controlled Substances Act. The DEA number is like a permit or special license to prescribe narcotics. If a physician is found guilty of misusing a narcotic, not only do they face possible prosecution for a crime (if committed), they also lose their DEA number, thereby preventing them from ever writing orders to use narcotics to euthanize patients again. So, if you wish to stop a rogue physician who has used narcotics to euthanize an unwilling patient, reporting to the DEA is one of the most effective methods.

Consultation with the DEA can help achieve a just and fair investigation of an improper use of narcotics which resulted in the untimely death of a loved one. By achieving a fair and complete investigation of these wrongful deaths, these rogue hospices, doctors and nurses can be stopped from killing any other patients and brought to justice. When rogue hospices, physicians and nurses stop misusing the narcotics involved in treating the terminally ill, then the DEA and U.S. Attorney's office will have no need to investigate.

For your information the U.S. Department of Justice, Drug Enforcement Administration relevant agents can be found online at: Diversion Program. You should ask for the location of the nearest Office of Diversion Control. Make sure to put your complaint in writing and hand a photocopy of your report to the agent you speak with when you visit their offices in person. Do not telephone in your concerns, but you should also send it by U.S. certified mail, return receipt to the same office so you have proof of your complaint that controlled narcotic medications are being misused or diverted. Some nurses collect narcotics from previous patients and have a stash of such medications they use at times. That is illegal.

Speaking directly in person to an agent in the Office of Diversion Control is the most effective manner to first report these concerns.

You can hand the agent your written account of the situation, with all relevant phone numbers, dates, times, names, drugs used, dosages (if you know), along with names of all witnesses, medical or nursing staff who diverted or misused narcotic medications, and other information that is relevant, noted in writing to give to the agent.

Although some DEA agents have not been responsive to family member concerns about misuse of the narcotic medications regulated by the Controlled Substances Act, we must continue to try to have them act to stop these crimes.

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