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N.H. Panel Mulls Hospital Drug Tests

Medical Centers May Have to Test Workers Suspected of Drug Use

A legislative committee unanimously recommended Wednesday that the state require all hospitals to test employees if there is “reasonable suspicion” they are under the influence of a controlled drug.

The bill was inspired by the arrest of a medical technician at Exeter Hospital who injected himself with syringes filled with pain medication and returned them filled with saline solution. David Kwiatkowski pleaded guilty earlier this year to tampering with a consumer product and obtaining controlled substances by fraud, and accepted a prison term of 30 to 40 years.

Before he was arrested, however, he allegedly infected dozens of people in several states with hepatitis C and worked in several hospitals across the country while under the influence of the drugs.

As originally written, the bill would have required hospitals and other health care facilities to randomly test every employee for drugs four times each year.

“Random drug testing is meant to be a deterrent, but it’s also the least effective in determining if someone is drug diverting,” said Rep. Tom Sherman, D-Rye, a gastroenterologist at Exeter Hospital.

Sherman sat on a subcommittee that worked this summer to revise the bill.

“Testing for cause, or reasonable suspicion, is the national standard for wording, and is the single most effective method for determining if someone is diverting drugs or working under the influence,” he said.

He pointed to an example from his own work when a hospital employee was tested after raising suspicions.

“You have to have something that is documentable. ... I walked into an endoscopy suite and (the nurse) was eating his lunch. That’s just against all the rules, but it’s not cause to test someone for drug use. When he couldn’t remember the meds that were given to the patient, that becomes reasonable suspicion,” Sherman said.

While there would be no penalty for facilities that don’t adopt the required policy, the policy would be part of the standard that must be met for licensure.

Concord Hospital has had a similar policy in place since 2008, said Robin Moore, vice president of human resources.

She called the bill a “very reasonable and very appropriate response” to the concerns raised by Kwiatkowski’s case.

“We test people any time we have a suspicion. ... If they agree to be tested, that’s a good thing; if they don’t, they are terminated. If they are tested and we have a positive test, if they agree to some sort of treatment, that’s a good thing; if they don’t, they will be terminated,” she said.

The policy, which Moore said was common among hospitals, covers employees and anyone who provides care to patients, including independent contractors supplied by staffing agencies. It relies, however, on other employees to report suspicious behavior, which Moore admitted can be a hurdle.

“Professionals don’t want to turn in one of their co-workers. It’s very difficult to think they may affect someone’s career and their livelihood,” she said.

The hospital holds classes to help staff become comfortable having uncomfortable conversations, Moore said.

“We try to help them understand we have a process that is fair, and if the person participates, they get help. ... We want to help people because addiction is a disease but on the other hand, we cannot have them working here if they are not safe.”