Iowa Surgical Center Agrees to Pay $125,000 to Resolve Allegations It Violated the Controlled Substances Act

First Choice Surgical Center, an ambulatory surgical center located in Cedar Rapids, Iowa, has agreed to pay $125,000 to the United States to resolve allegations that it violated civil provisions of the Controlled Substances Act.

First Choice Surgical Center is the surgical center affiliated with Fox Eye Laser & Cosmetic Institute, P.C., a practice performing laser vision correction and cataract surgery. The settlement resolves allegations that First Choice failed to maintain complete and accurate records concerning the controlled substances it purchased and dispensed and failed to provide effective controls and procedures to guard against theft and diversion of controlled substances.

In August 2019, other employees of First Choice discovered that Sabrina Thalblum, a registered nurse at First Choice, had been tampering with vials of fentanyl. The fentanyl was kept at First Choice for patient use during out-patient surgical procedures. A criminal investigation revealed that Thalblum stole the fentanyl for her own use. Thalblum withdrew fentanyl from the vials, reinjected saline into the vials, and returned the vials, which now contained less than declared values of fentanyl, to storage at First Choice.  In January 2021, Thalblum pled guilty in federal court in Cedar Rapids, Iowa, to charges related to the theft and, in January 2022, was sentenced to five years-probation.

A related civil investigation identified at least 130 separate occasions in which the record-keeping requirements of the Controlled Substances Act were allegedly violated by First Choice. The DEA’s investigation found that First Choice employees “batch signed” records indicating they had witnessed the wasting of fentanyl remaining after surgery when it was not First Choice’s practice to ensure those employees had witnessed the wasting. Additionally, First Choice failed to make a timely report to DEA after it learned of the fentanyl theft.

With the passage of the Controlled Substances Act, Congress took steps to create “a closed system” of distribution of controlled substances in which every facet of the handling of the substances – from their manufacture to their consumption by the ultimate user – is subject to intense governmental regulation.  This mission was taken against the backdrop of trying to prevent the diversion and abuse of legitimate controlled substances, while still ensuring that an adequate supply of those substances meet the medical and scientific needs of the United States.           

“This settlement highlights one part of our office’s efforts to battle the opioid crisis,” said Timothy T. Duax, United States Attorney for the Northern District of Iowa. “Healthcare providers must do their part to ensure the safety of our community by maintaining accurate records and safeguarding access to dangerous controlled substances.”

“The DEA works vigilantly to make sure hospitals are enforcing the rules and regulations that ensure patient safety,” DEA Omaha Division Special Agent in Charge Steven T. Bell said. “Lives are unnecessarily put at risk when accuracy and good record keeping habits are brushed aside. These rules are in place for a reason and should provide families with peace of mind that they are receiving the best care possible when they walk in the door of any hospital in the United States.”

The claims asserted against First Choice are allegations only; there was no determination of liability.

The case was handled by Assistant United States Attorney Brandon J. Gray and was investigated by the Drug Enforcement Administration’s Office of Diversion Control.

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