List of Florida Nursing Schools Issuing Phony Diplomas in Operation Nightingale Increases to 19

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A recent announcement by the Washington State Nursing Care Quality Assurance Commission (NCQAC), now known as the Washington State Board of Nursing, has listed 19 Florida schools that it states are or were involved in the fraudulent scheme investigated by the Federal Bureau of Investigation (FBI) as “Operation Nightingale.”


What Are the Names of the 19 Phony Florida Nursing Schools?

The 19 schools that NCQAC states were involved in taking nursing students’ money and issuing fake transcripts are:

Carleen Health Institute
Carleen Home Health School II
Ideal Professional Institute, Inc.
Jay College of Health LLC
Med-Life Institute – West Palm Beach
Med-Life Institute of South Florida
Med-Life Institute School of Nursing
Palm Beach School of Nursing
Quisqueya Health Care Academy
Quisqueya School of Nursing
Sacred Heart International Institute Inc.
Siena College of Health
Siena College of Health II LLC
Siena Education Center LLC
Sigma College
Sigma Institute of Health Careers
Sunshine Academy
Techni-Pro Institute
The Enfimye Institute

Some of the “newer” names on the list are owned and operated by some of the same fraudsters involved in the original “Gang of Six.” For example, Jay College of Health, LLC, was owned or operated by the notorious Johanah Napolean, who has been indicted and has been forced to forfeit millions of dollars in ill-gotten gains to the federal government. In reality, we believe there are many more than this.

How Many Have Been Caught and Convicted to Date?

For a list of the individuals who have been involved in the scam and who have been convicted through September 28, 2023, click here.

How Many More Phony Florida Nursing Schools Are There?  Plenty!

We receive calls several times a week from nursing students who have attended “nursing schools” in Florida who state that heir tuition and fees have been taken and they have completed all courses and activities the school required to obtain a diploma but:

a.  The school will not give them their diploma or transcripts or
b.  The school is requiring them to pay more and take more courses than promised or
c.  The school will not approve them to take the NCLEX examination to get a license or
d.  The school and its owners have disappeared, and they can’t get a transcript to transfer.

Why Is All of This Fraud Occurring in Florida?

Why does all of this fraud seem to be occurring in Florida?  It probably is not all of the fraud, only most of the fraud.  We have also heard about phony nursing schools doing business in other states.  But the vast majority of it seems to be in Florida.

Could this be because Florida prides itself in sheltering criminals and con men?  Probably.

Is this because Florida regulatory agencies do not bother to monitor and regulate the schools they approve as they are supposed to.  Most definitely.

Is this because Florida allows the use of shell companies and corporations to routinely defraud people so that the owners can disappear with their money without any consequences?  You know it!

Why do you think the industries of Medicare fraud, Medicaid fraud, and healthcare fraud in general are doing so well here in Florida?

Why doesn’t Florida do something about it?  Because we would lose all of that stolen income that helps support the rich and powerful here, that’s why.

Florida’s history of cons, scams, and fraud goes way back to the real estate salespeople selling Florida swamp land to out-of-state yokels who then moved here only to find the property they purchased was underwater, literally.  And with Cuba only a boat ride away and many friendly Caribbean and South American countries only a direct plane flight away, suitcases full of cash can be spirited out of the country with little trouble.

Are you the victim of a phony nursing school not on the list?

Are you the victim of a phony nursing school not on the list?  Don’t call us; we can’t do anything about these criminals doing this.

Instead, you might consider calling the FBI and the National Council of State Boards of Nursing (NCSBN), which is working hand-in-hand with the FBI and the various state nursing boards on these matters.  The NCSBN can get the word out quickly to the states involved.  Tell them you have been victimized by another school that should be part of “Operation Nightingale” and want to file a complaint.

The telephone number for the NCSBN is (312) 525-3600 or (888) 435-8242and ask for the Nursing Regulation Division, Nursing Education Section, or send an e-mail to [email protected] or send a written letter explaining the problem to:

National Council of State Boards of Nursing
Attn: Nurisng Regulation Division, Education Section
111 E. Wacker Drive, Suite 2900
Chicago, IL 60601.

The FBI’s main hotline for reporting possible criminal activity is (800) 225-5324, file a complaint or tip at https://tips.fbi.gov/home. Alternatively, and perhaps better, you can contact the Miami FBI Office, which is the one handling the Operation Nightingale investigation:

FBI Miami Dade Field Office
2030 S.W. 145th Avenue
Miramar, FL 33027
miami.fbi.gov
Phone: (754) 703-2000.

To see the Washington State NCQAC press release naming the 19 schools above, click here.

To see the original Department of Justice Press Release on Operation Nightingale, click here.

Click here to read one of our prior blogs on Operation Nightingale to learn even more.


Contact Health Law Attorneys Experienced in Investigations Against Nurses and Nursing Students.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students, and ARNPs in Department of Health (DOH) investigations, licensure defense representation, investigation representation, Department of Health investigations, DOJ investigations, Board of Nursing investigations, formal and informal administrative hearings, emergency suspension orders, emergency restriction orders and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.


Current Open Positions with The Health Law Firm.
The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030. View a list of open positions here.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.

By |2023-11-13T14:29:41-05:00November 13, 2023|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone:  (407) 331-6620 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-05-23T13:24:18-04:00October 23, 2023|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone:  (407) 331-6620 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-05-23T13:22:51-04:00September 21, 2023|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Florida Nursing Students Sue College For Deceptive NCLEX Scheme

Author Headshot, smiling in dark blue suit with red tie in front of a light tan backgroundBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 2, 2022, four nursing students from HCI College (formerly Health Career Institute) in Florida filed a federal class action lawsuit against the school. The students claim the school conducted a “malicious scheme” to block 95% of students from graduating and taking the National Council Licensure Examination (NCLEX). The lawsuit also accuses the nursing school of misrepresenting its accreditation status and NCLEX passage rates.

Critical Details Of The Lawsuit.

The class action, brought by four named plaintiffs, was filed in Federal Court in West Palm Beach. The plaintiffs are demanding to have their loans canceled, and payments refunded and are seeking an injunction to allow all students to take the NCLEX exam.

The suit claims that HCI College misrepresented its accreditation status and lied about its NCLEX pass rates. It also states that it deliberately attempted to prevent students from graduating and taking the NCLEX by unfairly dropping them from the program or forcing them to pay to retake classes that HCI argued were non-transferrable. According to the filing, the school is accused of only graduating students who showed the highest likelihood of passing the NCLEX, thus fraudulently inflating the program’s pass rates.

A History of Alleged Questionable Conduct.

In 2018 and 2019, HCI was put on probation by the Florida Board of Nursing for having NCLEX pass rates below state standards for nursing programs. When they failed to obtain accreditation, the Florida BON terminated the nursing program on August 7, 2019.

Rather than attempt to improve the nursing program and apply for reinstatement, the school allegedly created a “new” program and obtained a different state identification number. They used the same curriculum and same instructors as before, but the “new” program allowed the poor pass rates of prior graduates to be wiped clean.

Then, the college was able to use the guise of this “new” program to mislead students and hide their termination status, lack of accreditation, and the dismal NCLEX pass rates of the “old” program.

The bottom line: creating a “new” program would theoretically buy the college five more years to meet BON accreditation requirements. Despite this, HCI continued to charge students approximately $50,000 in tuition and fees to complete their unfortunately subpar ASN program. Click here to view the plaintiff’s class action and learn more about this case.

HCI College disputes these claims and alleges a disgruntled former faculty member initiated the suit. You can read a statement issued on their website on the status of their Florida accreditation and the fake nursing diploma scheme here.

Key Takeaways From This Case.

This lawsuit and the recent fake nursing diploma scams in Florida highlight the adverse effects of insufficient regulation and oversight in Florida’s nursing education programs. Many nurses and nursing students contact our law firm for legal representation who are in very similar situations to the ones who brought the class action suit.

One must remember that Florida is a hotbed of fraud. Florida laws have always been slanted toward protecting fraudsters and con men. Perhaps the members of the Florida Legislature seem to have the attitude of “There but for fate go I.” Who knows? Corporate laws that allow the creation of shell corporations and companies and allow their owners to remain anonymous abound in Florida. It has always, in recent memory, been known as a “debtor’s haven” where people who owe others money could flee in order to avoid being held civilly liable for their debts.

 

Don’t Wait! Contact Health Law Attorneys Experienced in Investigations Against Nurses and Nursing Students.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students, Advanced Practice Registered Nurses (APRNs), CRNA’s and other health professionals in Department of Health (DOH) investigations, license defense hearings, Department of Justice (DOJ) investigations, board of nursing investigations, formal and informal administrative hearings, emergency suspension orders, emergency restriction orders, appeals and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Roberts, Ayla. “4 Nursing Students Sue Florida College For Alleged NCLEX Scheme.” Nurse.org. (January 23, 2023). Web.

Bean, McKenzie. “Students sue Florida nursing school, alleging they were blocked from NCLEX.” Becker’s Hospital Review. (February 3, 2023). Web.

“4 Nursing Students Sue Their School Over Deceptive Scheme.” Nurse News Today. (February 13, 2023). Web.

Press Release. “Nursing Students Sue Florida For-Profit School, HCI College, for Deceitful Scheme to Block Students From Taking Licensing Exam and Trap Them in Debt.” The Project on Predatory Student Lending. (February 3, 2023). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.

By |2023-08-11T12:44:30-04:00September 5, 2023|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone:  (407) 331-6620 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-05-23T13:21:08-04:00August 23, 2023|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Nursing Students Sue Florida School For Deceptive NCLEX Scheme

Author Headshot, smiling in dark blue suit with red tie in front of a light tan backgroundBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 2, 2022, four nursing students from HCI College (formerly Health Career Institute) in Florida filed a federal class action lawsuit against the school. The students claim the school conducted a “malicious scheme” to block 95% of students from graduating and taking the National Council Licensure Examination (NCLEX). The lawsuit also accuses the nursing school of misrepresenting its accreditation status and NCLEX passage rates.

Critical Details Of The Lawsuit.

The class action, brought by four named plaintiffs, was filed in Federal Court in West Palm Beach. The plaintiffs are demanding to have their loans canceled, and payments refunded and are seeking an injunction to allow all students to take the NCLEX exam.

The suit claims that HCI College misrepresented its accreditation status and lied about its NCLEX pass rates. It also states that it deliberately attempted to prevent students from graduating and taking the NCLEX by unfairly dropping them from the program or forcing them to pay to retake classes that HCI argued were non-transferrable. According to the filing, the school is accused of only graduating students who showed the highest likelihood of passing the NCLEX, thus fraudulently inflating the program’s pass rates.

A History of Alleged Questionable Conduct.

In 2018 and 2019, HCI was put on probation by the Florida Board of Nursing for having NCLEX pass rates below state standards for nursing programs. When they failed to obtain accreditation, the Florida BON terminated the nursing program on August 7, 2019.

Rather than attempt to improve the nursing program and apply for reinstatement, the school allegedly created a “new” program and obtained a different state identification number. They used the same curriculum and same instructors as before, but the “new” program allowed the poor pass rates of prior graduates to be wiped clean.

Then, the college was able to use the guise of this “new” program to mislead students and hide their termination status, lack of accreditation, and the dismal NCLEX pass rates of the “old” program.

The bottom line: creating a “new” program would theoretically buy the college five more years to meet BON accreditation requirements. Despite this, HCI continued to charge students approximately $50,000 in tuition and fees to complete their unfortunately subpar ASN program. Click here to view the plaintiff’s class action and learn more about this case.

HCI College disputes these claims and alleges a disgruntled former faculty member initiated the suit. You can read a statement issued on their website on the status of their Florida accreditation and the fake nursing diploma scheme here.

Key Takeaways From This Case.

This lawsuit and the recent fake nursing diploma scams in Florida highlight the adverse effects of insufficient regulation and oversight in Florida’s nursing education programs. Many nurses and nursing students contact our law firm for legal representation who are in very similar situations to the ones who brought the class action suit.

One must remember that Florida is a hotbed of fraud. Florida laws have always been slanted toward protecting fraudsters and con men. Perhaps the members of the Florida Legislature seem to have the attitude of “There but for fate go I.” Who knows? Corporate laws that allow the creation of shell corporations and companies and allow their owners to remain anonymous abound in Florida. It has always, in recent memory, been known as a “debtor’s haven” where people who owe others money could flee in order to avoid being held civilly liable for their debts.

 

Don’t Wait! Contact Health Law Attorneys Experienced in Investigations Against Nurses and Nursing Students.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students, Advanced Practice Registered Nurses (APRNs), CRNA’s and other health professionals in Department of Health (DOH) investigations, license defense hearings, Department of Justice (DOJ) investigations, board of nursing investigations, formal and informal administrative hearings, emergency suspension orders, emergency restriction orders, appeals and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Roberts, Ayla. “4 Nursing Students Sue Florida College For Alleged NCLEX Scheme.” Nurse.org. (January 23, 2023). Web.

Bean, McKenzie. “Students sue Florida nursing school, alleging they were blocked from NCLEX.” Becker’s Hospital Review. (February 3, 2023). Web.

“4 Nursing Students Sue Their School Over Deceptive Scheme.” Nurse News Today. (February 13, 2023). Web.

Press Release. “Nursing Students Sue Florida For-Profit School, HCI College, for Deceitful Scheme to Block Students From Taking Licensing Exam and Trap Them in Debt.” The Project on Predatory Student Lending. (February 3, 2023). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.

By |2023-08-11T12:41:56-04:00August 11, 2023|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

States Take Action to Stop Nurses From Certain Schools From Caring For Patients

Author Headshot in dark grey suit and red tie with arms folded smiling in front of dark backgroundBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In late February 2023, multiple states began taking action against licensed practical nurses (LPNs) and registered nurses (RNs) because of the FBI’s “Operation Nightingale.” This is also being pushed by the National Council of State Boards of Nursing (NCBSN). “Operation Nightingale” is a federal investigation into a wire fraud scheme in which a number of now-closed Florida nursing schools allegedly sold phony nursing diplomas and transcripts from 2016 to 2022, which they then used to apply for and receive nursing licenses.

As a result of this, state nurse licensing officials are scrambling to stop nurses with fraudulent academic credentials from caring for patients. Thousands of notices of investigation from various states have gone out to nurses who indicated on their original licensing applications that they had graduated from one of these Florida Schools. What is really disheartening, however, is the fact that many of the schools involved were fully accredited schools of nursing. What is even more disheartening is that many nurses actually attended courses at these schools and did clinical rotations at these schools, earning their degrees honestly. Even these are receiving notices that they are now under investigation.

According to prosecutors, about 7,600 students paid an average of $15,000 for bogus diplomas. In addition, around 2,400 people passed a licensing exam to obtain jobs as registered nurses and licensed practical nurses in multiple states. It is not entirely clear how many of the roughly 2,400 nurses with credentials from the identified schools are currently employed, or where, officials said.

If you are a nurse who receives one of these notices of investigation from the Florida Department of Health (DOH) or any state board and you have insurance from CM&F Group, Nursing Service Organization (NSO), CPH & Associates, or one of the other professional liability insurance companies, your insurance company may cover your legal defense expenses. Call your insurance company or call us.

Are Honest Nurses Getting Caught Up In the Investigation? Yes, they are!

Attorneys for several nurses in New York and Georgia argue that nurses who legitimately earned diplomas are getting caught up in the investigation. “There are obviously people who bought transcripts who are fraudulent and should not be practicing nursing under any circumstances,” said Atlanta attorney Hannah Williams. “But there are also people who went to those schools legitimately and did nothing wrong. And they are somehow being lumped together with the fraudulent nurses.” The Health Law Firm’s president, George F. Indest III, in Orlando, Florida, also confirmed what Ms. Williams stated.

Additionally, New York’s Office of the Professions posted on the New York Education Department’s website that it expects some of the 903 licensees who attended the schools [who are now licensed in New York] “did attend required hours and clinical and are properly licensed.” As a result, those individuals are now being asked to have a qualified nursing program submit verification.

The Big Question: Have They Been Successful at Finding Any Nurses With False Credentials?

So far, the Washington State Nursing Care Quality Assurance Commission rescinded the nursing licenses of 17 people and denied license applications for four others. The Delaware Board of Nursing annulled 26 licenses. As well as the Georgia Board of Nursing asked 22 nurses to surrender their licenses voluntarily. Licensing officials in Texas filed administrative charges against 23 nurses, but they can continue working while their disciplinary cases are pending.

A spokesperson for the U.S. Veterans Administration (VA) said that it removed 89 nurses “from patient care” nationwide in 2022 immediately after being notified by federal officials of the potential problem. Still, the agency has not found any instances of harm done to patients.

In Florida, there are literally thousands of nurses who are being notified that they are under investigation related to this situation. Many have been practicing nursing for five years or more.

To learn even more, read my prior blog here.

In addition, you can stay on top of the Operation Nightingale investigation by checking for updates on our Articles and Documents section on our website.

What You Should Do If You Receive a Notice of Investigation or a Call from an Investigator.

If you receive any contact from any investigator, here is what you should do:

1. DO NOT TALK TO THE INVESTIGATOR OR MAKE ANY STATEMENT. Tell the investigator you must speak with your attorney first.

2. Contact your professional liability insurance company to see if you have coverage for this matter.

3. Contact an experienced health law attorney, immediately. DON’T WAIT! The attorney will be able to lead you through this process.

4. DO NOT TALK TO THE INVESTIGATOR OR MAKE ANY STATEMENT. Your attorney can do all the communicating from this point on.

Contact Health Law Attorneys Experienced in Investigations Against Nurses and Nursing Students.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students, Advanced Practice Registered Nurses (APRNs), CRNA’s and other health professionals in Department of Health (DOH) investigations, license defense hearings, Department of Justice (DOJ) investigations, board of nursing investigations, formal and informal administrative hearings, emergency suspension orders, emergency restriction orders, appeals and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Hill, Michael. “States move to crack down on nurses with bogus diplomas.” Associated Press. (March 1, 2023). Web.

Whitford, Emma. “How Thousands Of Nurses Got Licensed With Fake Degrees.” Forbes. (February 21, 2023). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.

Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the second in the series. Remember to read Part 2 and Part 3 of this blog series! Part 2 deals with substances that may cause a false positive for cocaine. Part 3 deals with Marijuana and THC Imposter Substances.


Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.
The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstasy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests. Remember to read Part 2 and Part 3 of this blog series! Part 2 deals with substances that may cause a false positive for cocaine. Part 3 deals with Marijuana and THC Imposter Substances.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.
To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone:  (407) 331-6620 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-08-16T21:59:10-04:00July 18, 2023|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Medications and Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone:  (407) 331-6620 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-05-23T11:57:20-04:00June 23, 2023|Categories: Massage Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Medications and Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone:  (407) 331-6620 Toll-Free: (888) 331-6620.

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