CHARLES CITY – Months before Christopher Scott West was found semiconscious in a hospital bathroom with two syringes, officials at Floyd County Medical Center had become suspicious of the nurse anesthetist’s access to opioid medication.
West stepped down after the September 2018 bathroom incident, telling a staff member “it was very easy to have access to the narcotics at (FCMC) and that the autonomy made it easier as well.”
West, who started working for FCMC in 2016, told the staff member he used the short-acting drug propofol because he could get a quick euphoria and “check out” for awhile. He also used other medications he diverted, according to court records released Thursday as he pleaded guilty to product tampering and obtaining a controlled substance by deception that shed light on the scope of his drug theft.
Plea documents alleged West, who had been licensed to practice in other states before landing in Iowa, had ordered additional medication for a laparoscopic surgery patient so he could use the leftovers. That patient had complications from surgery and had to spend extra time in the hospital and undergo painful catheterizations because he wasn’t able to urinate, records state.
Around May 2018, the hospital reviewed West’s obstetrics work and found women in labor had reported the spinal anesthesia he had administered wasn’t controlling pain, and they had to be given general anesthesia.
Records document two women who reported feeling their C-section procedures in 2017 and had to be given general anesthesia. In one, the woman was crying out in pain, and her husband was removed from the operating room. The baby was delivered with a low APGAR score, records state. An APGAR score measures breathing, heart rate, muscle tone, stimulation reflex, and skin color as an indicator of blood circulation, according to the National Institutes of Health.
The problems with his childbirth patients ceased when the hospital’s chief nursing officer brought her concerns to West, according to court records.
Suspicions also arose in August 2018 when a co-worker told officials West frequently wanted her to witness him “waste” — destroy — medication he allegedly had contaminated or broken in accidents.
Records allege West had claimed to have dropped his drug kit, breaking the vials inside.
“Defendant would report that he would drop his anesthesia box but only the sufentanil would break,” records state. In reality, he was using the drugs himself.
Records allege West “dropped” sufentanil ampules more often than any other medical professional at the hospital — 27 vials in eight months, compared to the previous nurse anesthesiologist who had dropped or contaminated five vials in 15 months.
Hospital officials changed procedures so the same staff member wouldn’t always be acting as a witness for West.
West also used his credentials to access opioid medication in Omicells — password-protected vending machine-like distribution systems in the hospital’s operating room and labor and delivery unit. He sometimes accessed the machines on weekends and after hours when there were no surgeries. He allegedly removed fentanyl and sufentanil from drug kits in the machine and made it appear he was getting headphones for patients — another item in the Omnicells — records state.
Upon discovering the breach following the bathroom incident, hospital officials cleared out the machines, and a review found 43 vials and ampules of fentanyl and sufentanil had been opened, glued back together and contained saline.
“The sufentanil ampules were broken at the neck and glued back together. The glue had a purplish-bluish tint. There was a perforated line on the vials with a tamper-proof label with the label then reattached,” records state. Stoppers on other vials had visible needle puncture marks.
After he was caught, West explained to state nursing officials he would “waste” the tampered meds and sometimes ordered other medications for patients to keep them from getting the tampered containers.
West left Floyd County Medical Center on Sept. 7, 2018, after he injected propofol in a hospital bathroom, and a visitor found him on the floor.
His nursing license was suspended in December 2018, and he was indicted by a federal grand jury in March 2019.
The tampering charge carries up to 10 years in prison, and the drug charge is punishable by up to four years in prison. Sentencing will be at a later date, and West remains free until then.