CONCORD – U.S. Attorney Jane E. Young announces today that Cheshire Medical Center (CMC) in Keene will pay $2 million to resolve allegations that it violated the Controlled Substances Act (CSA) by failing to keep accurate records of controlled substances, including opioids.

“Cheshire Medical Center’s failure to fulfill its obligations under the Controlled Substance Act enabled the theft of prescription narcotics – including powerful opioids such as fentanyl, which led to a shockingly high percentage of drugs missing from CMS’s inventory. The failures uncovered warranted a multi-million-dollar penalty and a stringent corrective action plan,” said U.S. Attorney Jane Young. “This is one of the largest settlements of drug diversion claims against a hospital in the country.”

“The DEA is committed to ensuring that all registrants are in compliance with the required regulations, which are enforceable through the Controlled Substances Act,” said Special Agent in Charge Brian D. Boyle.  “Failure to do so increases the potential for diversion and jeopardizes public health and public safety.  DEA pledges to work with our law enforcement and regulatory partners to ensure these rules and regulations are followed.”

The CSA deters the illegal distribution, possession, dispensing, and improper use of controlled substances, all of which have contributed to the opioid epidemic. The CSA requires the accurate inventorying, tracking and recordkeeping of each controlled substances to prevent misuse.

The Drug Enforcement Administration (DEA) began an investigation of CMC after a nurse had stolen twenty-three intravenous bags of fentanyl solution from an automatic medication dispensing machine. CMC initially disclosed this theft to the DEA in February 2022. CMC later reported that an additional six hundred thirty-four bags of fentanyl were unaccounted for. The nurse that allegedly stole these drugs died on March 3, 2022. In April 2022, DEA investigators conducted audits of eight controlled substances at CMC’s inpatient pharmacy, which included audits of fentanyl 2ml vial; fentanyl 50 ml vial; fentanyl 50 ml IV bag; midazolam 2ml vial; lorazepam 1ml vial; hydromorphone 4mg tablet; hydromorphone 1 ml vial; and morphine sulfate 1ml vial.

This audit revealed an additional 17,961 missing controlled substance units and various related recordkeeping deficiencies on the part of CMC, such as failing to maintain accurate purchase and dispensation records. The audit also revealed that, among other things, CMC failed to regularly review reports to look for possible diversion, to have sufficient structures in place to alert it to the greatly increased purchasing of controlled substances from one month to the other, and to enforce various controlled substance security policies. 

The settlement resolved the allegations that CMC violated the recordkeeping requirements of the CSA and its regulations.  As part of the settlement, in addition to the improvements voluntarily undertaken by CMC before and after the DEA investigation, CMC has agreed to additional security and recordkeeping measures.

The Drug Enforcement Administration led the investigation leading to the settlement agreement. The case was handled by Assistant U.S. Attorney Raphael Katz.