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The case appears to be related to the treatment of a 17-year-old who died after visiting the center.
Jessica Erin Hart
Saturday, July 20, 2013
State regulators say a nurse at a Roanoke County urgent care facility gave a patient more than twice the recommended dosage of a powerful narcotic in a case that appears to be related to the treatment of a 17-year-old girl who died hours later.
The Virginia Board of Nursing has brought disciplinary charges against Yevonne Powers, a registered nurse at the MedExpress on Williamson Road.
The charges do not directly link the actions of Powers to the girl's death, which was determined to be of natural causes.
On April 4, Jessica Erin Hart of Montvale showed up at the MedExpress with a severe sore throat, her family members have said.
A July 12 notice of charges brought by the Board of Nursing states that on April 4 Powers administered 4 milligrams of Dilaudid to a patient with acute pharyngitis - or a serious sore throat - "despite the medication's known risk of respiratory depression, and in a quantity at least twice the recommended dosage."
Family members have said that Hart became unresponsive a few hours after being given an injection of what they believed was Dilaudid. She died about 3 a.m. the next day after being taken to Carilion Roanoke Memorial Hospital.
The portion of the notice of charges against Powers that was released publicly did not name the patient to whom she gave Dilaudid.
A spokeswoman for the Department of Health Professions, a state agency that includes the Board of Nursing, declined to say Friday if the circumstances described in the notice were related to Hart's visit to the MedExpress.
However, a Roanoke lawyer with knowledge of the case said it appears that the disciplinary charge against Powers is connected to Hart's treatment.
Travis Graham, an attorney who is a friend of the girl's family members and has spoken on their behalf in the past, made his comments after being provided a copy of the notice by The Roanoke Times.
"All I can tell you is that Ms. Powers is the R.N. who provided care to Jessica Hart at MedExpress for acute pharyngitis on April 4, 2013, and that care consisted in part of administering a 4 mg injection of Dilaudid," Graham wrote in an email.
"I must assume the [disciplinary charge] concerns Jessica's case," he wrote.
It was not clear if state regulators believe that the high dose of Dilaudid - an opioid with similar characteristics to morphine - was directly or even indirectly related to Hart's death.
An autopsy completed earlier this month determined that the teen died of natural causes. Roanoke County police, who had been investigating the incident, closed their case following the medical examiner's ruling.
But at the same time police were investigating possible criminal charges, state regulators were looking into whether administrative regulations that govern health care were violated.
A July 12 notice, sent by certified mail to Powers' Goodview home, stated that she is charged with violating rules that pertain to unprofessional conduct, negligent practice or practicing in a way that poses "a danger to the health and welfare of patients or to the public."
A hearing on the charges has been scheduled for Aug. 8 before the Board of Nursing in Henrico. According to the notice, Powers could face a reprimand, fine or probation if there is sufficient evidence to support the charges.
Dr. Victor Starcher, senior vice president of medical affairs for the Morgantown, W.Va.-based MedExpress, said Friday that he was aware that charges had been lodged against Powers. But he declined to comment on the details of the case or her current employment status, citing patient and employee confidentiality concerns.
A call to a Roanoke attorney who represents Powers was not returned.
Meanwhile, Hart's family continues to have questions about her treatment.
Even though the autopsy found that she died from complications from mononucleosis, Graham said earlier this month that the family wants to investigate any circumstances that might have played a contributing role in her death.
Asked if other health professionals have been cited in the case, Department of Health Professions spokeswoman Diane Powers said she "cannot confirm nor deny other actions taken related to the treatment of Patient A" - the only public identity state officials are giving to the person who was under Powers' care.
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