Rocky Allen, now age 30, has just entered prison. How he got there, and how he got access to controlled substances, should send a chill through all of us. His sentence will cause his personal 
introspection to be sure, but the larger – and more important issue is the need for the healthcare profession to look much more closely at itself. Rocky Allen was the addicted stranger in the Operating Room.
Mr. Allen, a Surgical Technologist, has been sentenced to 78 months in federal prison plus three years of supervised release. Among the charges against him are tampering with consumer products (pharmaceuticals) and “obtaining a controlled substance by deception.” The deception part strikes me as being much greater than fraud, it has life and death implications.
In a Position of Trust
Allen, who was sentenced on November 7, 2016, was employed at Denver’s Swedish Medical Center. He was found in possession of fentanyl, which is an opioid and a Schedule II narcotic. How he came to possess the controlled substance is frightening.
On January 22, 2016, a surgical team at the hospital was operating on a patient. Naturally, they were pre-occupied with the procedure-at-hand. It was apparently a complex surgery as there were several members of the surgical team present all concerned with playing their roles. As Allen was a Surgical Technologist at the hospital and knew his way around all of the operating rooms, he was not especially noticed as he slipped into the room fully gowned. He looked like he belonged.
It is important to add that he was not assigned to anyone on staff for that particular case.
Allen entered the room and without permission and completely lacking authority, he took a syringe containing fentanyl and replaced it with another syringe containing saline solution. To make matters even worse, he labeled the saline as containing fentanyl.
What tripped him up was that someone in the operating room theater observed him switching the syringes. Long after Allen left the room, and the anesthesiologist was about to use the drug, someone alerted the anesthesiologist as to what they had observed. This immediately raised suspicion, another (real) dose was given, and of course, a report was filed.
Bad Choices and Consequences
It did not take long for the hospital to identify Allen as the technologist who had slipped into the room. On January 22, 2016, Allen voluntarily submitted to a urine screen. He tested positive for fentanyl, norfentanyl (another opioid drug), and marijuana. Allen is an addict.
In addition, the solution in the syringe was verified to be a saline solution. Allen rationalized that the saline was “harmless,” and if fentanyl had been called for, the saline would not (in Allen’s mind) have caused any harm. To say that Allen was reckless is certainly an understatement, but the case becomes even more alarming.
Upon testing his blood as a follow-up in June 2016, it was found that he carries the HIV virus.
Said Acting U.S. Attorney Bob Troyer:
“Allen put hundreds of innocent people at risk and caused them enormous fear and anxiety. His prosecution and sentence should send a chilling message to any medical professional who abuses his or her position of trust: You will go to federal prison for a long time.”
Mr. Troyer’s statement says all the right things, and it needed to be said but it is an ethically tepid response to a major flaw in the system. My first assumption is that Rocky Allen has probably done this before, and gotten away with it quite successfully. He tested positive for fentanyl and handled the labeling of the saline filled syringe so effortlessly, he knew what he was doing.
The only thing that has stopped his continuing fraud was the “accidental” observation of a person assigned to the OR that day who then decided to say something. Had that person looked away, or had that person been an observing intern, nursing student or even resident, Allen might have worked there to this day.
A drug addict wants drugs. Allen needed his drugs and was more than willing to take the risks. He was given a clear message, but what of others and indeed what about the safety and security of patient’s past and present? We can even take it a step further. Suppose Allen was not an addict but out to intentionally harm a specific patient by switching medications? What safeguards are in place to make sure that cannot happen?
Another assumption I will make is that given the thousands of procedures done each day, I would imagine Rocky Allen is not the only addicted “interloper” who has tried, or is trying to access drugs. One wonders how Allen cooked up his scheme. How loose do hospitals “play it” with opioid products?
Ethically, what are hospitals doing to screen and to monitor anyone entering operating rooms? Ethically, what is the screening process applied to all para-professionals? I have not even approached the area of Allen’s HIV status. Why was he permitted in the OR in any case? Are there not disclosure rules?
Yes, Rocky Allen needed to be incarcerated. However, much larger ethical issues are in play that must be addressed on a nationwide basis. Rocky Allen was the addicted stranger in the Operating Room.
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