VERMONT - At first glance, the videotape of Elizabeth Beddie seems to show someone performing her typical nursing duties of caring for the sick and dying. The one-time nursing assistant at the Berlin Health and Rehabilitation Center gently rolls her unconscious patient, a 98-year-old woman with chronic dementia and degenerative joint disease, onto her side and removes a duragesic patch from her skin. The patch, which contains 300 milligrams of the powerful painkiller Fentanyl, is designed to soak into the patient's bloodstream over a three-day period.
Then the picture turns ugly. The scratchy, black-and-white police surveillance tape from August 2004 captures Beddie as she punctures a hole in the patch, sticks her finger into it and sucks out the drug to get high. A police videotape recorded two days later shows Beddie stealing drugs from another transdermal patch.
Beddie was later arrested, convicted, sent to prison and stripped of her nursing license. Her case highlights what investigators in the Vermont attorney general's office say is an alarming trend across the state: the theft of drugs from people who are elderly, dying or in severe and chronic pain, often by their own caregivers.
Beddie's case is featured in a new, 36-minute documentary produced by the Vermont attorney general's office. "Drug Diversion in Vermont: When Healing Hands Harm" was directed by Charlotte filmmaker Kenneth Peck and unveiled at a Burlington screening last week. It's a unique collaboration among law enforcement, health-care providers, prosecutors, defense attorneys, offenders and, most importantly, the victims and their families. Its goal is to raise awareness of a disturbing form of patient abuse and exploitation that often goes unnoticed and unreported.
Linda Purdy, an assistant attorney general and director of Vermont's Medicaid Fraud and Residential Abuse Unit, recalls that about five years ago MFRAU began receiving reports of drugs being stolen from hospitals, hospices and nursing homes. Often, the thieves were taking the drugs when their patients needed them most, sometimes only hours before they died.
One of the first cases MFRAU investigated was that of Brendan Murphy, then a 36-year-old employee of a company that delivered home medical equipment. In a 2002 police surveillance video, Murphy is seen entering a patient's home and rummaging through his pill bottles in search of painkillers. According to one of his victim's family members, Murphy would "lurk at the moment of death" waiting for a chance to steal his fix. "Why couldn't he just let us die in peace?" the family member asked at Murphy's trial.
Another one of Murphy's 12 known victims was John Bodoky of Burlington, a now-deceased lung cancer patient. In 2002, Bodoky's wife, Church Street hot-dog vendor Lois Bodoky, agreed to cooperate with law enforcement after she discovered her husband's OxyContin had disappeared; she suspected Murphy of taking it. Thanks in large part to Bodoky's cooperation, Murphy was arrested, convicted, and sent to prison. He died behind bars at age 37 under suspicious circumstances.
Although investigators say it's hard to know how common these crimes have become, between 2002 and 2005 MFRAU investigated 81 such cases in 13 of Vermont's 14 counties. The only county without a reported case - Grand Isle - has no nursing homes or residential treatment facilities.
In a panel discussion following the screening at Burlington's Waterfront Theatre last week, the filmmakers, investigators and health-care providers explained why these crimes so often go unreported. The victims are society's most vulnerable people - usually in severe and chronic pain, unaware of what's going on around them and/or unable to speak for themselves.
Perpetrators' co-workers also can be very slow to pick up on their abuse. Virginia Werneke, an MFRAU investigator, says in every drug-diversion case she's seen, colleagues said they were surprised by the revelation. When Murphy was arrested in 2002, his company was planning to name him "manager of the year."
Three abusers cooperated in the making of the documentary. Susan Pierce, a registered nurse who was convicted of elder abuse and diverting drugs for personal use, says she stole from her patient's morphine pump even though she knew he was only hours from death. "They were right there in my face," Pierce says in the film. "The temptation was too great."
Drug diversion by health-care providers doesn't just harm the patients whose drugs are stolen; the crime costs Medicaid and the insurance industry millions of dollars annually, and providing care under the influence of narcotics is dangerous and sometimes lethal. When Beddie was finally confronted on the job for her crimes, she admits she was "pretty well drugged."
Part of the problem, notes film director Peck, is a natural tendency among health-care providers to see drug abuse as a medical problem rather than a matter for law enforcement. While he was researching the film, Peck discovered that rather than report an abusing co-worker, care providers often cover for one another, convince a problem employee to resign and leave the state, and/or urge the colleague to enter drug rehab.
Peck also found that similar types of drug abuse in the health-care industry - notably, among psychiatrists and other doctors - can be even harder to identify because those professions have greater access to controlled substances; they can write their own prescriptions. The movie doesn't include any cases of drug abuse among physicians.
Even those people who are inclined to see drug abuse as a law-enforcement issue admit there's no silver bullet for stopping these crimes. As Vermont U.S. Attorney Tom Anderson puts it, "It's not a problem we're going to prosecute our way out of."
About 450 copies of "Drug Diversion in Vermont: When Healing Hands Harm" are being distributed free to every hospital, hospice, nursing home, assisted-living facility and law-enforcement agency in the state.