Before her death at the age of 85, Mary Fitzgerald was prescribed Dilaudid, a pain reliever. And according to the medication logs at Mountain View Center in Rutland, where she was in hospice care, that’s exactly what she was taking.
But when an autopsy was completed after her death, no traces of the drug were found. Instead, there were traces of Haldol and Seroquel, both of which treat mental disorders — and neither of which had been prescribed for her.
This week, the nurse who had provided care for Fitzgerald during the final hours of her life appeared in court, answering to charges of abuse of a vulnerable adult, and obtaining a regulated drug by deceit.
Dermot Hanna, 59, of Rutland, administered more medication than any other nurse at the facility. And although an affidavit shows that he admitted to police that he had diverted Fitzgerald’s drugs for his own use, he ultimately pleaded not guilty to all charges.
When Fitzgerald was first admitted to Mountain View Center last year, it was because of “injuries obtained due to extreme neglect by her family,” according to the affidavit.
But when she got there, things started looking up. She was being treated by Hanna, who had 15 years of experience and a glowing reputation for helping patients manage their pain.
One of Hanna’s supervisors said he was “considered one of the best nurses they had regarding pain management.” The supervisor told police that other nurses often complimented Hanna’s practices, and felt that he managed patients’ pain better than most of his colleagues.
But a complaint filed in August with the state Office of Professional Regulation noted that the center’s narcotics logs showed that Hanna had 28 incidents of medications being dropped or spit out by residents — without any witness to confirm the “accidents.”
The primary drug involved was Ativan, often used to treat epilepsy or anxiety.
Hanna spoke to his bosses at the center about the complaint the day it was made. He said “ya, my only excuse is/was taking shortcuts,” according to the affidavit. Hanna was then suspended, pending the investigation’s outcome.
A few days later, police met with Hanna at the Rutland City Library. He told them that he had dropped some pills, and didn’t get signatures “on quite a few instances.” He explained that the circumstances had just raised some red flags with the administration.
When the officers brought up the case of Mary Fitzgerald, they asked Hanna about the day of her death, when, according to the affidavit, the center’s narcotics log showed that the pain reliever hydromorphone (or brand name Dilaudid) was taken out of the medication cart multiple times, though its administration wasn’t recorded, and it didn’t show up in Fitzgerald’s autopsy results.
Hanna told police that he remembered that day, and Fitzgerald being in significant pain. He said he gave her the medication to make her comfortable, saying since she was in “rough shape,” he was in her room for the majority of the day. Hanna said he was sure he gave her the medication.
The officers then asked Hanna to be honest, asking if he’d taken the hydromorphone for himself or someone else, the affidavit notes.
Hanna admitted he had taken it for himself, according to the affidavit. He said he’d been working longer shifts for the past 18 months or so, and as a result, dealing with ankle pain from an injury he’d gotten 15 years earlier.
He said he had health insurance, but didn’t want to deal with it, finding it easier to just get the medication he needed at work.
When asked if he gave Fitzgerald the Haldol and Seroquel found in her system, he said he couldn’t remember, according to the affidavit. Police asked him if he was addicted to the medication. He said he didn’t think so, noting that it had been 10 days since he’d last taken any.
Hanna told the officers that on the day of Fitzgerald’s death, he’d taken Seroquel from other residents and given it to Fitzgerald, trying to make her comfortable, since he was taking her actual medication.
When police asked again about the Haldol, Hanna maintained that he didn’t remember whether he’d given it to Fitzgerald.
He eventually told police that any time where he didn’t have a witness signing off on “waste” on the narcotics log, he was taking the medication himself. He said he had also taken medication from residents for himself at times where it appeared he had properly documented it, according to the affidavit.
Hanna said he was taking an average of a pill a day. He ultimately admitted that he often took Avitan home in his sock to help him sleep. As for the pills he took at work, Hanna told police he never felt it affecting him, or making him sleepy or groggy, on the job.
When police consulted a doctor, Elizabeth Bundock, about the case, she said the non-prescribed meds, Haldol and Seroquel, were not contributing factors in Fitzgerald’s death. She did say, however, that the lack of prescribed pain medication could have caused “unnecessary pain and suffering” during the days and months before her death. But, morphine and fentanyl found in postmortem testing, Bundock said, would have been sufficient for pain relief during the final hours of her life.
Police ultimately concluded that over the past 18 months, Hanna diverted medication at least 31 times — though if his estimate of once a day is accurate, the number could be far higher. He was released on conditions after his arraignment Monday.
The Attorney General’s Office is prosecuting the alleged crimes. The first charge, abuse of a vulnerable adult, has a maximum penalty of one year in prison and a $1,000 fine. The second, obtaining a regulated drug by deceit, has a maximum penalty of two years and $5,000.
Mountain View officials would not discuss the nursing home’s current relationship with Hanna, who was released on conditions.
Fitzgerald’s daughter, Marie Fitzgerald, and grandson, Christopher Preedom, both of Rutland, had earlier been charged with neglect of a vulnerable adult resulting in serious bodily injury.