The ethical and lawful prescription of medications is a fundamental responsibility of healthcare practitioners, ensuring patient safety and well-being. In situations where healthcare practitioners, such as RNs, face allegations of improper prescribing practices and lack of adherence to established protocols, seeking legal guidance becomes imperative. A nurse attorney can offer vital support by navigating the legal complexities surrounding such incidents. They play an important role in advocating for the nurse’s rights throughout investigations and legal proceedings, ensuring fair treatment and effective representation.
At the time of the initial incident, she was employed as a Family Nurse Practitioner RN at a medical facility in Laredo, Texas, and had been in that position for seven (7) months.
On or about November 15, 2021, through April 17, 2022, while employed as a Family Nurse Practitioner at a medical facility in Laredo, Texas, the RN prescribed NP Thyroid 60 mg of to a patient, who had normal thyroid levels and did not have a diagnosis of hypothyroidism. RN documented in the patient’s medical record that the patient is being treated off-label with thyroid hormone and assigned a diagnosis of euthyroid syndrome. Additionally, RN provided medical aspects of care to the patient without written protocols or practice guidelines for diagnosing or treating sick euthyroid syndrome, or written protocols regarding the use and dosing of thyroid replacement medication. Subsequently, the patient reported anxiety symptoms and palpitations after increasing the dosage of the medication up to 120 mg. The patient was then assessed by endocrinology physicians who instructed her to stop thyroid medication. RN’s conduct exposed the patient to a potential risk of harm from the adverse effects of unnecessary hormone dosing.
Without asking for guidance from a nurse license attorney, the RN stated that based on the patient’s lab results and the patient’s reported symptoms of fatigue and mental fog, she was started on NP Thyroid 60 mg. RN stated that while the package insert for NP Thyroid indicates the usual starting dose is 30 mg, increases over weeks to a maintenance dose of 60-120 mg is anticipated and RN’s training specific to hormone replacement therapy suggests a starting dose of 60 mg. RN stated that the patient specifically sought hormone replacement therapy and was educated about the use of thyroid hormone supplementation in the absence of hypothyroidism. RN discussed the risks and potential adverse side effects of each of the medications she prescribed to the patient, and specifically advised her that the thyroid hormone use would be off-label, to relieve her symptoms of hormone deficiency. RN stated that at her second visit, the patient reported she had more energy, did not have any jitteriness, palpitations, or other adverse reactions to the NP thyroid. RN stated that she increased the doses in response to the patient’s reported improvement in symptoms. At her last visit with the RN on April 17, 2022, with confirmation that the patient was not experiencing adverse effects of the medication, the NP Thyroid was increased to 120 mg. However, the patient was instructed to discontinue the medication approximately one month later when she complained of unexplained throat pain (the instruction was given even though throat pain is not associated with any medication prescribed by the RN). During the time the patient was under RN’s care, she never complained of anxiety or palpitations. RN further stated that despite the instruction to discontinue the medication, not only by RN in response to the complaint of throat pain but also by subsequently seen endocrinologists, the patient continued to take NP Thyroid and sought additional prescriptions for thyroid medication from multiple providers. RN stated that endocrinology records from subsequent providers reflect that the patient’s multiple and varied complaints were unrelated to her thyroid. RN stated that she utilizes her clinical judgment, collaboration with her supervising physician, and the recommendations about which she was educated and trained as part of the organization’s certification process.
Because of the above incident, the RN was summoned by the Texas Board of Nursing to defend her side, but the RN failed to hire a nurse attorney. Before moving past an initial accusation, a nurse defense attorney could have helped her draft responses to the inquiries that precede disciplinary hearings and other regulatory actions. As a result, the Texas Board of Nursing then placed her RN license under disciplinary action.
Hire a Nurse Defense Attorney Today To Protect Your License!
If you also received a letter from the Texas Board of Nursing regarding a case or complaint filed against you, you should hire a nurse attorney immediately before it’s too late. Texas Nurse Attorney Yong J. An is one of those dedicated nurse attorneys who is always ready to defend your license without compromising your livelihood. Contact the Law Office of Yong J. An 24/7 through text or call at (832) 428-5679 for a free consultation regarding any allegations from the Texas BON.