By Sarah Volpenheim / Grand Forks Herald
A Crookston nurse's license was suspended after administrators at the Villa St. Vincent nursing home in Crookston discovered he was peeling pain patches from residents' backs, affixing them to his tongue and sticking them back onto residents an hour later, according to a Minnesota Department of Health investigative report.
Local and state officials launched an investigation into allegations that a nurse was pilfering pain pills after a medication aide at the nursing home noticed that several Lorcet tablets, which contain hydrocodone, were missing in May.
The Minnesota Department of Health investigation found that the nurse, David Matthew Perala, more likely than not exploited Villa St. Vincent residents when he stole pain medication from 10 residents.
The agency's report cites video footage of Perala taking hydrocodone tablets from a medication cart at the Crookston nursing home and placing them in his shirt pocket.
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Perala reportedly admitted to taking narcotic pain medication from seven residents, according to the agency's report. He also reportedly admitted to peeling fentanyl patches off of three residents with severe cognitive deficits and sticking them on his tongue for about an hour three or four times per week for at least a year, the report says.
Fentanyl patches are used to treat severe, long-term or chronic pain. Fentanyl is considered highly addictive and is about 80 times more potent than morphine and hundreds of times more powerful than heroin, according to Centers for Disease Control and Prevention.
Crookston police found Perala in possession of 18 pills, including tramadol, hydrocodone and Tylenol #3 -- a combination of acetaminophen and codeine -- and he tested positive for opiates and oxycodone, according to the health department's report. Perala reportedly said he stole the medication to treat his knee pain, according to a Minnesota Board of Nursing order suspending Perala's nursing license.
Perala, who was employed with the Villa since 2002, was fired on May 30, a day after the nursing home reported the allegations to police.
Perala was reportedly in inpatient treatment when a Board of Nursing panel met in July to review the status of his license. His license was suspended in October.
He may apply to reinstate his license in October 2015, but will have to be enrolled in a chemical dependency rehabilitation program and have abstained from mood-altering substances for a year before applying, according to the Board of Nursing document.
No criminal charges have yet been filed against Perala. Crookston police forwarded their investigation to the Polk County Attorney's Office six months ago, Crookston Police Chief Paul Biermaier said. While the county attorney has not pressed charges, he has not declined to file them either, Biermaier said.
Polk County Attorney Greg Widseth did not return an email requesting comment by press time.
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Though the health department's report found the Villa "had policies and procedures in place to govern the handling and control of narcotic medications," it also found that the Villa was not meeting all federal and state regulations. Inspectors wrote that the Villa violated regulations by not properly keeping track of schedule III drugs, including Lorcet and Tylenol #3.
In July, health inspectors noted staff kept proper track of when schedule II narcotics arrived from the pharmacy and counted schedule II narcotics at the end of every shift. However, the inspectors found there was no system for tracking schedule III narcotics, according to the health department's report.
Federal regulations require nursing homes to have a system of documenting all controlled drugs delivered to the facility and given to the residents.
Inspectors returned in August, and though staff kept tabs on when and how many schedule III narcotics arrived at the nursing home from the pharmacy, they did not keep track of when medication was given to individual residents nor did they take a daily count of schedule III narcotics, according to the report.
Villa St. Vincent Administrator Judy Hulst said the nursing home has "strengthened" its existing policies and procedures relating to scheduled, or government regulated, medications and has trained all staff on the new protocol.
"All of us at Villa St. Vincent are saddened by this alleged incident," she said in an email.
