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Duluth area nurse practitioner pleads guilty to selling pain pills

Jill Renee Karkoska

A former Essentia Health System nurse practitioner accused of prescribing more than 11,000 pain pills to people who were not her patients pleaded guilty Wednesday to first-degree sale of a controlled substance.

Jill Renee Karkoska, 27, of Gilbert entered the plea in State District Court in Duluth. In admitting to her crime, Karkoska said that she was chemically dependent on pain pills. She said she wrote the prescriptions for people and in return they would give her some of the pills. Legally, the exchange constituted a sale.

The crime is punishable by a guideline sentence of 7 years, 2 months in prison, but because Karkoska has no prior criminal record and has sought treatment, the St. Louis County Attorney's Office offered her a five-year probationary sentence for her guilty plea.

Judge Mark Munger directed an Arrowhead Regional Corrections probation officer to investigate Karkoska's background before sentencing in March.

Assistant St. Louis County Attorney Rebekka Stumme prosecuted the case.

"Ms. Karkoska's actions as a trusted medical provider were appalling," Stumme said after the plea hearing. "While the state certainly took that issue into consideration in the plea agreement for her case, we also considered the fact that Ms. Karkoska does not have any convictions on her record and has taken steps to attempt to address her addiction without court involvement. The state strives to treat individuals with similar backgrounds and charges in substantially the same manner. The state's offer in this case reflects that attempt for fairness. We will seek significant probationary conditions to ensure Ms. Karkoska's continued sobriety and law-abiding behavior."

Stumme told Munger that her office will seek a "significant amount" of local jail time as part of Karkoska's probationary sentence. Karkoska must surrender her nursing license, her Drug Enforcement Administration license and complete a chemical dependency evaluation.

Karkoska's defense attorney, Eric Nelson of Minneapolis, also represented Amy Senser, the wife of former Minnesota Viking Joe Senser, in her highly publicized hit-and-run case. After the hearing, Nelson said he and his client were declining comment.

Christopher Lee Dian, 29, of St. Paul is charged with one count of aiding and abetting the sale of a controlled substance for his involvement in the case. Dian is identified in the criminal complaints as being engaged to Karkoska and sharing a son with her. Investigators with the Lake Superior Drug and Violent Crime Task Force said Dian received more than 2,000 pain pills from Karkoska between Oct. 28, 2010, and June 17, 2011. Dian's case hasn't been resolved. He's scheduled to be in court next Wednesday.

An Essentia spokeswoman said that Karkoska worked for the health system for about nine months before leaving last July.

According to the criminal complaint charging Karkoska:

On June 6, 2011, a Target pharmacist called law enforcement to report a suspicious prescription presented by a customer. The customer had gone to Target on June 1 of last year with a prescription for 180 Percocet pain pills, less than a month after having a prescription for 120 Percocet pills filled there. A member of Target pharmacy telephoned Karkoska, who said she authorized the early fill, but the store employee told investigators it was suspicious and contrary to common practice.

A Lake Superior Drug and Gang Task Force investigator was provided prescriptions that Karkoska had allegedly written for the same customer for pain pills at Sam's Club, Shopko and Walgreens. There were no records at Essentia of that customer ever seeing Karkoska.

Investigators met with Karkoska's supervisors at Essentia on June 28, 2011. It was learned that as a hospitalist, Karkoska would see only patients admitted to the hospital, but she had been writing prescriptions while she was on maternity leave and not working.

Investigators then interviewed Karkoska at her home. She was asked why she was writing prescriptions for nonpatients.

"They were in pain and asked me to," the complaint alleges that she said. She acknowledged that she should not have been writing the prescriptions, the complaint said. When asked why she had been prescribing so many pills, she said: "I don't know if whoever I bring them to sells them or takes them all."

A woman who told investigators she had been a friend of Karkoska's since growing up together on the Iron Range said she had not been feeling well and was not sleeping. She said Karkoska never saw her in a hospital setting but provided prescriptions that she could fill for Lortab. She said she also picked up pills at Karkoska's residence.

The woman said she eventually learned that her insurance provider was being billed for prescriptions at Cub Foods and Walgreens without her permission. Investigators viewed surveillance video tapes from the dates that prescriptions were picked up and identified Karkoska as the person who picked up the pills at Cub Foods and Walgreens.

A woman told investigators that Karkoska would provide a prescription and the woman would fill it and then return half of the pain pills to Karkoska as a payment.

A man told investigators that he had gone to school with Karkoska. He injured his knee in March 2011 and Karkoska prescribed him Percocet for pain with the understanding that he would give a portion of each prescription to her.