IN THE CARE OF A CRIMINAL

A Tribune investigation finds gaps in the regulatory system that keeps nurses convicted of crimes ranging from child abuse to assault out of our hospitals

lparrilla@thetribunenews.comOctober 11, 2008 

Stained in bloody scrubs and drenched in the stench of fresh antiseptic, Bonnie Lynam pushed through the operating room doors of a Santa Maria hospital ready to head home.

The 30-year veteran nurse left feeling camaraderie with other nurses in the tight-knit operating room team at Marian Medical Center.

But that warm feeling disappeared when she returned home on June 19, 1995.

Sitting in her scrubs at the kitchen table, still on call, she wondered why her husband wasn’t home. Then the phone rang, and a woman on the other end said he was in San Luis Obispo lying on an emergency room table in a hospital, fighting for his life.

And an off-duty nurse had put him there.

Lynam raced to the hospital where Tom Lynam lay bruised and swollen, kept alive only by life-support machines.

Diana Kutz had slammed her black Nissan 300ZX into his Lincoln Town Car. Wearing only a swimsuit, Kutz staggered around Highway 101 in San Luis Obispo with more than three times the legal limit of alcohol in her body and a gash above her left eye, slurring words and reeking of alcohol, according to a police report.

“She nearly killed him right then,” said Lynam, reliving the image of her husband on life-support. “He was on oxygen the rest of his life. “I can’t imagine a nurse would go out and do that when we’re supposed to go out there and save lives.”

Tom died three years later from a heart attack. Today, Bonnie Lynam lives in Arroyo Grande and is still a nurse. Kutz, meanwhile, is illustrative of a little-known problem statewide that allows nurses to remain on the job with criminal records unknown to regulators.

A history of trouble

The wreck was Kutz’s fourth criminal offense in San Luis Obispo County. Yet she was still practicing in nursing homes and hospitals, still tending to patients, still had her nursing license.

Nurses across the state convicted of crimes such as child abuse, assault with a deadly weapon, drunken driving, battery and other charges leave jail cells and return to work without nursing board regulators finding out because of a flawed system, a Tribune investigation has found.

The loophole exists because about 41 percent of registered nurses in the state are not fingerprinted, according to figures provided by the state Board of Registered Nursing. Fingerprints trigger an alert to regulators that one of their nurses is sitting in jail.

State regulators say they don’t have the staff or authority to fix the problem.

Some top nursing officials don’t see these errant nurses as a problem, saying that they don’t have statistics showing a high number of nurses slipping through the system.

“I don’t have that information to say it’s a problem,” said Ruth Ann Terry, executive officer of the state Board of Registered Nursing. “We often get reports of arrests. … They’re not consistent, but we do get notified of a lot of folks.”

Fingerprinting thousands of nurses may overburden already overworked investigators, Terry added. On average, 30 nurses a month are disciplined by the registered nursing board, which could mean probation up to license revocation, and about 14 nurses a month are reprimanded by the vocational nursing bureau, according to their Web sites.

Regulators say a small pool of nurses poses a threat to the public, but consumer-rights advocates insist that people deserve protection from dangerous nurses regardless of the number.

Consumer-rights advocates blame regulators for not protecting the public. And hospitals rely on state agencies to keep dangerous criminals out of their nursing ranks.

Many in the nursing community aren’t even aware of the loophole in the system.

In Kutz’s case, regulators ultimately learned of some of her convictions, years later, when she abandoned patients at work. She surrendered her license.

There is a relation between on- and off-the-job behavior, nursing experts argue, and criminal offenses committed off-duty could signal that a nurse will carry that behavior into the workplace.

“I think we have enough research articles about human behavior that it’s fairly easy to make the conclusion that what happens outside of work can also impact what happens inside work,” said Louise Timmer, president of the American Nurses Association of California. “Any nurse who is under the influence of anything, drugs or alcohol, if that person comes from outside that work setting to the work setting, they’re putting their patients in jeopardy.”

Where the problem lies

The state licensing system is designed to monitor nurses’ criminal records based on their fingerprints. When people are booked into jail, their fingerprints automatically go to the state Department of Justice. DOJ computers search for matches between fresh prints and those collected from nurses when they were licensed.

A “hit” generates an electronic notification to one of two state nursing agencies — the Board of Registered Nursing or the Bureau of Vocational Nursing and Psychiatric Technicians — telling regulators that one of their nurses is sitting in jail.

But Kutz, along with about 146,000 of approximately 349,000 registered nurses in the state, weren’t fingerprinted when they were licensed, according to figures provided by the Board of Registered Nursing.

San Luis Obispo County alone has about 1,500 registered nurses who are not fingerprinted; larger counties such as Los Angeles have about 28,500.

Registered nursing officials began fingerprinting nurses in 1990. In 1997, a state law was passed that required fingerprinting, but it was not retroactive,and left thousands not fingerprinted. Vocational nursing regulators started the practice sometime before 1979, until ceasing it in 1981, then resuming it when the state law passed; about 17,000, or 16 percent, of the state’s vocational nurses are not in the criminal background system.

When one of those nurses who has not been fingerprinted is booked into jail, regulators are not alerted by the DOJ because it does not have the data on hand.

Take Kutz’s case. When police jailed the then-40-year-old nurse for crashing into Tom Lynam, it was her fourth criminal offense in San Luis Obispo County and the fourth to escape the attention of regulators, according to a state nursing board investigator.

Kutz was driving on a suspended license and had been sentenced to jail two months earlier for a DUI conviction with more than three times the legal limit of alcohol in her blood, court records showed. Two years before that, police caught her drunk in public twice, and a judge sentenced her to a year of probation along with alcohol recovery classes.

After she sobered up following the wreck that injured Tom Lynam, she was released from county jail, and she returned to work.

Ten days later, Kutz was back behind bars finishing jail time for the earlier DUI, according to sheriff’s officials. Several months later she was in jail serving a year sentence for injuring Tom Lynam.

Kutz’s history reflects a system “where the public is totally unprotected,” said a state consumer affairs investigator who asked not to be identified because he is not authorized to talk to the media. “We have people that you and I wouldn’t want around anybody that we loved — nurses who are drug abusers with a record are administering medicine.”

Nurses should be held to a high standard because of the public trust placed in them, stressed Dr. Sidney M. Wolfe, director of the national nonprofit public interest organization Health Research Group at Public Citizen, based in Washington, D.C.

“People that are involved in taking care of patients need to be squeaky clean, whether it’s nurses or doctors,” Wolfe said. “Anything that allows holes in a safety net … those are serious public health risks. “… Nurses have more hours of contact with a patient in a hospital than physicians do, and the potential for doing harm is significant.”

Even one nurse with a dangerous criminal record allowed to treat patients is too many, said former state nursing regulator Tricia Hunter.

“Our license is worthless if it doesn’t protect the public,” said Hunter, the executive director for the American Nurses Association of California. “That’s the only reason we’re licensed.”

Kutz’s past

It was only after Kutz abandoned five patients at Sierra Vista Regional Medical Center in San Luis Obispo in 2005 that regulators started paying attention to her.

She was shaking and had been crying when she told a supervisor she had to leave and could not care for the patients, then walked out, according to a nursing board complaint.

Sierra Vista contacted the temporary employment agency that had placed Kutz at the hospital, and the agency then reported her to regulators.

Kutz told nursing board officials that she could no longer care for patients safely and that her conduct warranted discipline, according to a board report.

Only then did board officials start investigating Kutz’s criminal record and learn about the felony DUI with serious injury conviction in 1995 for injuring Tom Lynam; the DUI four months earlier; and the charge of being drunk in public two years earlier. A second drunk-in-public arrest was dropped in exchange for a guilty plea in the earlier drunk-in-public conviction.

Kutz, who lives in Pismo Beach, declined repeated requests to be interviewed for this story.

As a result of the Sierra Vista incident, Kutz surrendered her license this year after three decades of working as a nurse. Board officials ordered her to undergo a psychiatric examination.

That provides some consolation to nurses such as Lynam. After years of harboring anger against Kutz for severely injuring her husband, Lynam found enough peace, with the help of her priest, to forgive.

Nurses “have other people’s lives in their hands,” Lynam said. “Nurses are nurses because they care for people and they want to care for people, and they want to render medical help. They don’t want to kill people. They don’t want to drive around drunk.”

MORE FROM THIS SERIES:

• How nurses slip through the system

• Nipomo nurse’s drug problem preceded assault on her husband

• Abuse, threats mark Hanford nurse’s history

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