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Multiple Fatalities Alleged as Nurse Swapped Fentanyl with Tap Water

Police are conducting a criminal investigation, in which painkillers were allegedly removed and replaced with tap water, which is not sterile.

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An Oregon Public Broadcasting article highlighted a disturbing set of incidents at Asante Rogue Regional Medical Center (RRMC) in which a nurse is suspected of removing the painkiller fentanyl from patients’ IV bags, replacing it with tap water.

Initially, NBC5 News broke the story on 12/29/23, then reporting that eight to nine patients died at RRMC as a result of the drug diversion and tampering. Tap water, which is not sterile, reportedly led to multiple incidences of pseudomonas infection. Docs on Call host Dr. Robin Miller says the infection is very dangerous to people in poor health, and can “cause sepsis, pneumonia, it could infect all the organs, so it could be a very severe infection.”

The number of people who have died or been impacted has not been officially reported.

Experts discussed the news on LinkedIn. Martin van Trieste is a pharmaceutical industry veteran and author of e-book “Protecting Patients at All Costs: The Drug Watch Dogs.” He lamented that these events are “more common than we want to believe with other healthcare professionals, especially those who are providing anesthesia.” He noted that in most of these cases, sterile saline—widely available in hospitals—is used as the substitute.

David Aguero, director, medication systems and informatics at St. Jude Children's Research Hospital, added, “Tragic. All the more reason for these medications to be delivered via ready-to-administer syringes AND why we should rapidly be developing systems to trace these products through the chain of custody. We can save lives, time, and money with development from the pharma and technology spaces if we do it right.”

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