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Local medic punished for discrepancies, violations regarding medications

By Sharyn  L. Decker
Lewis County Sirens news reporter

A Lewis County paramedic’s credential has been suspended indefinitely for forging forms related to controlled substances and for administering unauthorized doses of morphine to patients.

Marla Fleming-Nixon worked for Lewis County Medic One and also as a volunteer medical coordinator for the Napavine area fire district.

Her credential expired in April of last year. Nixon was fired from Medic One a few months before that and resigned from Lewis County Fire District 5 at the same time.

Grant Wiltbank, executive director of Medic One, a shared ambulance service formerly known as South Lewis County EMS, said his internal investigation was limited to discrepancies in documentation.

“Probably the strictest policies we have are dealing with controlled substances,” Wiltbank said, adding that it wouldn’t cost a person their job if it only happened once.

The investigation that followed, conducted on behalf of the state’s manager of emergency medical services, resulted in a statement of alleged charges issued last September.

Nixon chose to forego a hearing on the matter and signed an agreed order two weeks ago acknowledging she committed unprofessional conduct, according to documents filed with the state Department of Health.

The resolution of the case was reported publicly by the Department of Health yesterday.

The facts Nixon agreed were true are as follows:

Between October and November 2011, on about eight occasions, she administered 20 mg or more of morphine sulfate to patients without medical control authorization. Protocols allow a paramedic to give as much as 10 mg without additional permission.

Between February and August of the same year, Nixon falsified the the required witnesses’ signature when she completed a patient controlled medications documentation form which includes a section noting amounts disposed of. That happened about four times, according to the documents.

Wiltbank described the disposal or waste of controlled medications issue explaining, for example, a standard vial holds 10 mg and if a patient is given less than that, a medic must get rid of the excess in front of a witness.

The conduct was found to cause no or minimal patient harm, according to the state documents.

Fire District 5 Chief Eric Linn said Nixon worked with his district for about two years and he had no reason to think she did anything unsatisfactory.

“I was very surprised, she’s a good medic, she worked very hard,” Linn said.

As the medical services officer, Nixon supervised and taught EMTs, and was responsible for quality assurance and ordering supplies, he said.

Paramedics employed by Lewis County Medic One respond jointly with fire districts in south and central Lewis County.

Wiltbank, who didn’t have personnel records in front of him this afternoon, said he thought Nixon worked for Medic One for three, perhaps four or even five years.

He called it an unfortunate situation, and said there was no animosity on his part.

“This is a very big deal,” Wiltbank said. “This was the first time we had to deal with a situation like this.”

Attempts to reach Nixon for comment were unsuccessful. A phone number listed for her in Winlock has been disconnected.

The documents state that if she seeks to reinstate her paramedic credential, she would be placed on probation for at least two years with monitoring to ensure public safety. She also would be required to complete a number of classes beforehand, as well as pay a fine of $500.

Nixon first became licensed to practice as a paramedic in Washington in 1995.