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Cedar Rapids Nurse Sentenced to Five Years in Federal Prison for Stealing Narcotics from Three Corridor Hospitals

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Department of Justice
U.S. Attorney’s Office
Northern District of Iowa

Friday, January 6, 2023

Replaced Pain Medication with Saline in the Hospitals’ Drug Dispensing Machines

A Cedar Rapids nurse who diverted narcotics to her own use at four major Eastern Iowa health care providers, including three hospitals, in less than two years, was sentenced today to five years in federal prison.  Sarah Jean Moses, age 43, received the prison term after pleading guilty in 2021 and 2022 in three separate federal criminal cases to five felonies, namely, one count of tampering with a consumer product, one count of false statements relating to health care matters, one count of violating the Health Insurance Portability and Accountability Act (HIPAA), one count of obtaining a controlled substance by misrepresentation, fraud, forgery, deception, or subterfuge, and one count of theft of government funds.

In a plea agreement, and at other hearings in the three cases, the evidence showed that, in 2006, the State of Iowa issued a registered nursing license to Moses.  Between 2017 and 2019, Moses acquired various controlled substances from her employers, including opioids such as hydromorphone (also known by the trade name “Dilaudid”), morphine, and oxycodone.  To do so, Moses secretly tampered with the vials of the controlled substances, replacing the pain medication with saline and restocking the tampered-with vials into a secure drug dispensing machine that the hospital’s doctors and nurses used.  To find out which of her employers’ patients were supposed to receive the pain medication, Moses engaged in an illegal practice known as “patient combing,” in which Moses used her access to her employers’ computers to examine private patient records.  Moses also made false and fictitious statements to her employers and in patient records to cover up her scheme.

Specifically, in September 2017, during her first month working in the emergency room of a Cedar Rapids hospital, Moses accessed a secure drug dispensing machine that contained hydromorphone vials.  The hydromorphone was intended for emergency room patients who were suffering pain.  Moses also viewed 7 patient records without lawful authority at the Cedar Rapids hospital.  After the hospital discovered six tampered-with vials in the machine, the hospital terminated Moses’s employment and reported her conduct to the Iowa Board of Nursing (IBON).

In March 2018, during her first month working for a major local home health care company, Moses was assigned to care for an elderly resident of a Marion assisted living facility.  A doctor had prescribed the resident oxycodone for leg pain.  Without the knowledge of her employer, and against the employer’s policies, Moses offered to pick up the resident’s oxycodone from a nearby major grocery store pharmacy chain.  Moses picked up the pain medication from the pharmacy but, instead of delivering the oxycodone to the patient, Moses diverted 56 oxycodone pills to herself and made a false entry in the patient’s medical record.  The home health care company immediately suspended Moses’s employment and reported her conduct to IBON.  Moses never returned to work at the home health care company.  As a result of Moses’s conduct, the pharmacy changed its policy regarding verifying the identity of persons who pick up prescription medications for others.

Between September 2018 and November 2018, Moses worked at an Iowa City hospital.  Moses continued her scheme to tamper and divert controlled substances at the Iowa City hospital and, in doing so, illegally accessed 64 patient files.  Just as she had done at the Cedar Rapids hospital in September 2017, Moses removed the caps from vials of hydromorphone and then carefully punctured the vials with the needles and drew out the hydromorphone. Moses then refilled the vials with saline to make the vials appear as if they still contained hydromorphone. Moses also carefully replaced the caps of the vials to make it appear as if the vials were undisturbed, when, in truth, these consumer products no longer contained their declared values of hydromorphone. In this way, Moses made it appear as if the vials remained new, unopened, and filled with the controlled substance on their respective labels, that is, hydromorphone, when, in, truth, Moses had diverted some or all of the hydromorphone in the vials to herself. Moses then placed the tampered vials back in the dispensing machine.  Moses admitted that she acted with reckless disregard for the risk that another person would be placed in danger of bodily injury and under circumstances manifesting extreme indifference to such risk.  In November 2018, the Iowa City hospital terminated Moses’s employment and reported her to IBON.

Between January and March 2019, Moses worked as a nurse for another hospital in Iowa City.  Moses continued her scheme to tamper and divert at this hospital and, during the entire term of her employment there, stole hydromorphone, morphine, and oxycodone.  Moses illegally accessed 17 patient files at this hospital, which determined Moses was “patient combing.”  In March 2019, this third hospital terminated Moses’s employment.

Moses later found a job working as a paraprofessional for a child.  Between April and August 2020, Moses stole over $6,000 in fraudulent unemployment benefits from the State of Iowa by underreporting her wages from the employment.  The federal government had appropriated the unemployment funds under the CARES Act of 2020 on account of the COVID-19 pandemic.

Moses was detained before her sentencing after a U.S. Magistrate Judge found that she repeatedly violated the terms of her pretrial release conditions.  While on pretrial release, Moses used methamphetamine, failed to participate in drug testing and treatment, and possessed an assault rifle.  Between August and October 2021, while on pretrial release, Moses was caught shoplifting at the same Cedar Rapids big-box department store chain on six separate occasions.  Moses fled from the courthouse in a car after her probation officer informed her there was a warrant outstanding for her arrest for her pretrial release violations.  A deputy U.S. Marshal ultimately gave chase and apprehended Moses not far from the federal courthouse in Cedar Rapids.  Moses has prior convictions in state court for shoplifting and drunk driving.

Moses was sentenced in Cedar Rapids by United States District Court Judge C.J. Williams.  Moses was sentenced to 60 months’ imprisonment.  She was ordered to make over $6,000 in restitution to the State of Iowa. She must also serve a three-year term of supervised release after the prison term.  There is no parole in the federal system.  At the sentencing hearing, Judge Williams observed that Moses’s case was one of the worst cases of narcotics theft by a health care professional he had seen and characterized Moses’s conduct on pretrial release as “abysmal.”

United States Attorney Timothy T. Duax stated, “Sarah Moses’s conduct was egregious.  She placed the patients of three of Eastern Iowa’s major hospitals and a home health care provider at serious risk of harm when she replaced needed pain medications with saline.  Her sentence is well-deserved and hopefully will deter others who would be tempted to steal narcotics from their employers and patients.”

“Patients rely on the knowledge that they will receive FDA-approved medications to manage their conditions,” said Special Agent in Charge Charles L. Grinstead, FDA Office of Criminal Investigations Kansas City Field Office. “When health care professionals tamper with those needed medications, we will pursue and bring them to justice.” 

On May 17, 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to marshal the resources of the Department of Justice in partnership with agencies across government to enhance efforts to combat and prevent pandemic-related fraud.  The Task Force bolsters efforts to investigate and prosecute the most culpable domestic and international criminal actors and assists agencies tasked with administering relief programs to prevent fraud by, among other methods, augmenting and incorporating existing coordination mechanisms, identifying resources and techniques to uncover fraudulent actors and their schemes, and sharing and harnessing information and insights gained from prior enforcement efforts.  For more information on the Department's response to the pandemic, please visit https://www.justice.gov/coronavirus.

Anyone with information about allegations of attempted fraud involving COVID-19 can report it by calling the Department of Justice's National Center for Disaster Fraud (NCDF) Hotline at 866-720-5721 or via the NCDF Web Complaint Form at: https://www.justice.gov/disaster-fraud/ncdf-disaster-complaint-form.

Moses is being held in the United States Marshal’s custody until she can be transported to a federal prison.  The case was prosecuted by Assistant United States Attorneys Timothy L. Vavricek and Jason Norwood, Assistant United States Attorney Clifford Cronk of the U.S. Attorney’s Office for the Southern District of Iowa, and investigated by the Food and Drug Administration, Office of Criminal Investigations, the Iowa Medicaid Fraud Control Unit, and the Department of Health and Human Services, Office of Inspector General

Court file information at https://ecf.iand.uscourts.gov/cgi-bin/login.pl. 

The case file numbers are 21-CR-19, 21-CR-47, and 22-CR-56.

Updated January 9, 2023


USAO - Iowa, Northern

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