Cheshire Medical Center
Outcome
Cheshire Medical Center paid $2 million DEA civil settlement June 2023 — one of the largest hospital drug diversion settlements nationally — for failing to maintain accurate controlled substance records after 21 gallons of fentanyl solution became unaccounted for, including a nurse's theft of 23 IV bags and 634 additional unaccounted bags; DEA audit found 17,961 missing controlled substance units.
Details
Cheshire Medical Center — 21 Gallons of Missing Fentanyl and $2 Million DEA Settlement (2020–2023)
Outcome: Cheshire Medical Center in Keene, New Hampshire, paid $2 million in a civil settlement announced June 22, 2023 — one of the largest hospital drug diversion settlements in the country — to resolve DEA allegations that the hospital failed to maintain accurate controlled substance records after 21 gallons of fentanyl solution became unaccounted for over two years; two former nurses were later indicted in connection with the diversion.
The DEA began investigating Cheshire Medical Center after a nurse stole 23 IV bags of fentanyl solution from a medication dispensing machine. Cheshire subsequently reported that an additional 634 bags of fentanyl were unaccounted for. The federal investigation found that in total, 21 gallons of fentanyl solution — a massive quantity — were lost or unaccounted for at the Keene hospital over a two-year span.
A DEA audit revealed 17,961 missing controlled substance units and various recordkeeping deficiencies. Among the systemic failures documented: the hospital failed to maintain accurate purchase and dispensation records; failed to regularly review reports to identify possible diversion; did not have sufficient structures in place to detect greatly increased purchasing of controlled substances from one month to the next (suggesting no month-over-month spike alerts existed); and failed to enforce various controlled substance security policies.
In addition to the $2 million civil settlement, Cheshire Medical agreed to additional security and recordkeeping measures. Two former nurses were indicted in December 2023 in connection with the diversion. One former nurse pleaded guilty in June 2024. The New Hampshire Board of Pharmacy also reached a separate settlement with the hospital.
Primary Source: DEA Press Release — Cheshire Medical Center to Pay $2 Million to Settle Allegations of Controlled Substances Act Violations (Jun. 22, 2023)
How Crucible Prevents This
DEA found the hospital failed to review reports to detect possible diversion, had no alerts for month-over-month purchasing spikes, and failed to enforce controlled substance security policies — systemic control failures that allowed 21 gallons of fentanyl to go unaccounted for. Crucible's automated controlled substance variance reporting, purchasing spike alerts, and mandatory periodic dispensation-to-purchase reconciliation would have surfaced each of these failures as they occurred.
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