Nurse Pleads Guilty to Swapping Saline for Fentanyl Used in Fertility Procedures

Donavyn Coffey

March 04, 2021

Donna Monticone, a 49-year-old nurse at the Yale Reproductive Endocrinology and Infertility clinic in Orange, Connecticut, pleaded guilty to tampering with fentanyl intended for fertility patients.

As part of her job at the fertility clinic, Monticone ordered and inventoried a variety of narcotics, including fentanyl, which were used by physicians to anesthetize patients during outpatient procedures, according to the US attorney's office.

In June 2020 Monticone began stealing fentanyl for her own use from secure storage areas, a statement from the US attorney's office reported. After withdrawing the narcotic, she injected saline into the vials so that the drugs wouldn't appear to be missing. Monticone admitted to using fentanyl at the clinic and eventually taking vials home with her where she would refill the vials with saline before returning them to the clinic and placing them with the stock used for surgical procedures.

An investigation revealed that "approximately 75% of the fentanyl given to patients at the Yale REI clinic from June to October 2020 was adulterated with saline," the US attorney's office said in a statement. "Some of the vials contained diluted fentanyl, while others contained no drug at all and contained just saline." Monticone admitted that she knew the vials of fentanyl she replaced would be used in surgical procedures and cause serious pain and injury to the patients.

Attorney Josh Koskoff is now working with 20 women who were patients at the clinic. These women were at Yale for procedures such as egg extraction and IUD placement. "But I don't think that likely covers the full extent of the procedures affected," Koskoff told Medscape Medical News. One of Koskoff's client's, who happens to be a physician, told CBS news that the egg harvesting procedure she underwent at the Yale-affiliated clinic was so painful, "I couldn't tolerate it."

"I've heard from over 20 people. Many of them had this experience that was much more painful than they thought or had been told the procedure would be," Koskoff said. Many of the women felt they were to blame for their experience, that their pain tolerance wasn't normal. But now, "they feel incredibly abused," he said.

Koskoff also said the majority of the patients he's working with are angry with Yale rather than the nurse.

"Fertility treatment is very profitable for the hospitals and patients have a choice. These women chose Yale," he said. "Because it was Yale, they thought they'd have the highest degree of care and comfort, and instead what they got was clearly a system designed like an accident waiting to happen." Many of the women have also described raising concerns about their procedures and initially being dismissed by Yale only to receive a defensive letter months later recounting Monticone's tampering, according to Koskoff.

"Yale has informed patients that there is no reason to believe that the nurse's action harmed their health or the outcome of their treatment. The Fertility Center routinely uses a combination of pain medications during procedures and modifies the medications if there are signs of discomfort," Karen Peart, director of media relations at Yale said in a statement. Yale said after a review of its management of controlled substances that it is making changes in "procedures, recordkeeping, and physical storage that will prevent this type of activity from happening again."

But Koskoff sees this as part of a frightening trend, "One of the things we are seeing in the legal community is devastating instances happening at outpatient clinics that we would never see at hospital. There simply isn't the same redundancy or structure as there would be at a hospital."

Monticone no longer works for the clinic. According to the US attorney's office, she surrendered her nursing license and faces a maximum term of imprisonment of 10 years.

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