The case has revealed deficiencies in medicine handling at Førde Central Hospital. An employee at Health Førde has been fined NOK 20,000 in fines for “borrowing” 22 tablets of the pain medication Paralgin forte from a medicine room. The woman later returned the equivalent amount of tablets. But from the same medicine room, several thousand tablets of addictive B preparation have disappeared. Thus, there is a gap of several thousand tablets between the recognized loan and the larger proven waste. – Great stress – For her it has been a great stress to be suspected, says lawyer Lene Knapstad at Eine advokatfirma. Helse Førde confirmed in January this year that a large quantity of tablets had disappeared from a ward at Førde Central Hospital. Paralgin forte and other B preparations are medicines that are used to induce sleep, reduce anxiety or relieve pain. What the medicines have in common is that they affect the central nervous system and can cause an adverse intoxication effect. Recently, a similar case was discussed at Sørlandet hospital. A, B and C preparations A preparations These are medicines that are highly addictive. Examples are morphine and other opiates that act as pain relievers. All A preparations are printed on a separate prescription and you must show identification when the medicine is collected. B preparations These are also drugs that are addictive, but not quite as strong as A preparations. Examples are Valium, Paralgin Forte and sleeping pills. You must also show identification when collecting these medicines. C preparations These are all other medicines that require a prescription to buy. Everything from antidepressants, blood pressure medicines, birth control pills and antibiotics fall under this group. It is allowed to collect medicines for others if it is a question of C preparations. (Source: http://www.lommelegen.no/artikkel/b-og-c-preparater) Already in 2020, the first deviation was reported at the hospital in Førde, then there were three further notices of deviations from employees in 2021. Gradually, an employee at the department came into the spotlight, which led to the police starting an investigation – and the State Administrator in Vestland opened a supervisory case against both the employee and the health care company. So far, there has been no report of the loss of several thousand tablets at Helse Førde. Photo: Oddgeir Sæle Store missing In a preliminary summary, the State Administrator writes that it is a “fact” that “the medicine room during part of the period in which the wastage took place has been easily accessible to unauthorized persons.” In the background, the Norwegian Nurses’ Association (NSF) has also been involved. They were given permission to survey the handling of B preparation at various bedside posts at the hospital, where the answers can be used as part of the inspection case. It is known in several departments that the medicine room doors do not automatically “slam” as they should, but must preferably have an extra “puff”, says the summary from NSF. “It is not always remembered in a hectic weekday, and the door is therefore left open unintentionally, and thus the medicine room can become accessible to unauthorized persons.” There can be as many as 20 people in the medicine room during the course of a day, it says. Everything from nurses, students, professional developers, pharmacists to laundry staff, healthcare workers, doctors and porters. Paralgin forte is one of several types of B preparation that has a pain-relieving effect, but which can also be addictive. Photo: Øyvind Johan Heggstad The woman who has been suspected has also pointed to incidents in connection with the medicine room to which she has reacted, which she has spoken about. “Due to the poor indoor climate, the door to the room was often seen open, and the staff did not always remember to close it when they left the medicine room,” she points out. Department director at Helse Førde, Asle Kjørlaug, says that emergency measures have not yet been introduced in any of the medicine rooms. He points out that the health authority is in the process of a major review of the systems and routines. – I will wait to comment until our own review is finished. Overall, he still thinks the hospital has good routines and good practice. Great burden news has been given access to various parts of the inspection, which have not yet been completed. In a letter to the State Administrator, Helse Førde writes that the waste case has been “a big burden” for the employees in the department. A working environment is depicted where the employees were uncertain and almost started to learn from each other. “Several have also felt insecure at work, both in relation to colleagues and if, for example, one is himself suspected by others”, writes one of the directors. Here it also emerges that officers have reported that the suspect has taken B-preparation from the medicine room, and that the person concerned “over a long time” has been “frequently in the medicine room”. The door log shows that the person concerned has logged into the medicine room several times using their own ID card, and several times outside working hours. “In addition, we have received information from other employees that relevant other times have entered the medicine room while they are there and the door is then open,” writes Helse Førde. A central point from the employer’s side has been to find out what official needs the person concerned has had for visiting the medicine room so often. Denies the debts The employee who has been suspected denies having anything to do with the larger waste, apart from the 22 tablets of Paralgin forte, which she delivered back to the medicine room. Lawyer Lene Knapstad says that documentation has been submitted to the police as to why she visited the room after working hours, and that she has had an official need to be there all along. The woman criticizes herself for “borrowing” 22 tablets, but says she informed colleagues, and that she is also legally able to prescribe tablets from a doctor of the same type. – This is also consistent with other witness statements in the case, says Knapstad. The reason for her borrowing tablets from the medicine room was that, according to the lawyer, she did not have her own tablets with her on some days. The alternative would have been to end the working day and call in sick. Lawyer Lene Knapstad says it has been a difficult time for her client, who at an early stage felt suspicious of the drug waste. Photo: Photographer Reiakvam The woman believes the police have investigated the case in a good and thorough manner, while she criticizes Helse Førde for having tunnel vision and drawing conclusions for which there is no basis. – I must apologize that the person has experienced that it has been like this. From Helse Førde’s side, the goal has always been to treat the case as objectively as possible, says specialist director Asle Kjørlaug. The Norwegian Health Inspectorate is now working on the supervisory case that deals with women. The state administrator has announced that the overall inspection dealing with Helse Førde will be completed around the turn of the year. The employee has now left Helse Førde, in consultation with the employer.
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Several thousand tablets disappeared from the hospital
