Nurse who gave heart-stopping drugs to patient stripped of license for ‘serious’ misconduct: College

A “grossly incompetent or grossly negligent” Manitoba nurse has been stripped of her license and fined $10,000 after she admitted to incorrectly administering fentanyl and another drug that caused a patient’s heart to stop, a licensing body says.

A decision released Thursday said Nipaben Patel pleaded guilty to four charges at a hearing in November before an investigative panel of the College of Registered Nurses of Manitoba. The fifth charge was withdrawn.

“The professional misconduct admitted by the registrant is serious,” the January 28 decision said.

“The registrar’s failure to understand his obligations, recognize his inexperience and limitations, and to communicate or cooperate demonstrates a stunning lack of judgment.”

Patel demonstrated an “incredibly serious, serious” lack of skill and judgment in November 2024 when he administered fentanyl and The decision states that a patient in Lynn Lake, Maine, was given succinylcholine without obtaining prior consent from a doctor.

The 55-year-old patient suffered respiratory or cardiac arrest.

Practiced in India 13 years ago

The panel said in the judgment that Patel failed to follow guidelines for administering “high alert medications” and did not properly examine the patient.

“They failed to intervene when the patient’s vital signs became unstable and failed to alert other members of the health care team,” the decision said.

The committee asked the college to revoke Patel’s nursing license, reprimand her and impose a $25,000 fine. Patel asked for a 15 to 18-month suspension, with credit given for not having to practice for 12 months already, and to be put through a clinical competency assessment.

An agreed statement of facts said Patel worked as a registered nurse and midwife in India from 2004-10 before getting a job as a health-care assistant in Canada in 2012.

She completed the English Language Proficiency Test in 2017 and became registered as a Licensed Practical Nurse in Manitoba from 2017-23. During some of that time, he worked in long-term care facilities and for an agency in northern communities.

In 2023, she received a license to practice as a registered nurse in New York, then became registered in Ontario and, through a support portal, was able to bypass a clinical competency assessment and register in Manitoba, the college said.

She received her registered nurse license in Manitoba in August 2023 after the National Nursing Assessment Service deemed her experience in India adequate.

In January 2024, she began receiving contract work in Lynn Lake. Before this, Patel had not practiced as a registered nurse since she moved to India 13 years ago.

Failed to inform colleagues

The Lynn Lake patient in his care was admitted to the hospital after being found lying on the floor of his home. Patel was one of two nurses on staff, along with a clinical care assistant and physician.

The doctor determined that the patient needed to be flown to Winnipeg via LifeFlight air ambulance. The doctor said that eventually he needed intubation, but his condition is stable and currently he is getting air through a mask.

Patel misinterpreted the situation and what the doctor said.

He removed fentanyl from a locked cupboard in the medicine room without writing on the drug sign-out sheet what the drug was for, then took the paralysis drug succinylcholine from the refrigerator. He did not properly label any of the syringes and ignored other warnings.

She did not double-check any of the drugs, which is required by Manitoba’s provincial health care body, Shared Health, under safety controls for high-alert drugs.

Patel administered succinylcholine. He watched as the patient’s oxygen levels dropped over the next four minutes, and then administered fentanyl to the patient – ​​all without notifying his colleagues and without a doctor present.

Within six minutes, the patient went into respiratory and cardiac arrest. A Code Blue was called and CPR was begun by a member of the emergency medical team.

The doctor took control of the situation and the patient started breathing again.

Patel falsely believed he had received verbal permission from a physician to administer the drug, but later admitted he did not receive any orders from the doctor or anyone else, the decision said.

After the Code Blue, Patel asked the doctor to fill out a written order stating that he gave her permission to administer succinylcholine and fentanyl. The doctor retroactively refused to do so.

The next day, Patel stepped down.

‘Shocking’ conduct: College

About a week later, the physician filed a complaint which was reviewed as an urgent matter by the CEO and Registrar of the College of Nursing.

Patel’s license was temporarily suspended. An investigation began and found that, in part, Patel had not previously consumed succinylcholine and “did not know what the drug was for.”

The panel ordered that Patel’s license be revoked, and he be reprimanded and fined $10,000.

His misconduct was described as “shocking” and the college said the decision was important to maintain public trust and “keep people safe”.

“The fact remains that the registrant neglected or ignored numerous safety steps that could have resulted in the patient’s death if a paramedic had not been present in the trauma bay,” the decision said.

“If the registrant had been subjected to (a clinical competency assessment) before being approved as a registrant at the college in 2023, these tragic events could have been avoided.”

‘Move with the times’: Premiere

The College of Manitoba – like other regulators – Registration decisions must be respected Made elsewhere in Canada.

In 2022, Audrey Gordon, the Progressive Conservative Minister of Health at the time, issued a directive to the College of Registered Nurses of Manitoba to no longer enforce the “currency of practice” requirement.

Under that requirement, nursing applicants registered to practice in other jurisdictions – known as labor mobility applicants – must show that they have worked a certain number of hours in Canada before being allowed to work in Manitoba. This requirement applies to applicants trained outside of Manitoba.

After the NDP took power in 2024, the college reimposed the requirement. Health Minister Uzoma Asagwara then asked the regulator to remove it, saying it could violate elements of the Canada Free Trade Agreement.

Deb Elias, the college’s CEO and registrar, said last June that some applicants were “Finding a loophole” through the trade agreement, registering elsewhere so they can practice in Manitoba.

Elias said in a statement Thursday that the easing of requirements for labor mobility applicants registered in other Canadian jurisdictions “is at the core of the College’s concerns regarding the continued direction of the Government of Manitoba that the College should not require or set a standard for the currency of practice for labor mobility applicants seeking registration in Manitoba.”

The college is now looking to meet with provincial officials to review that directive.

Premier Wab Kinew said he was ready for the meeting. He also wants colleges to “keep an open mind.”

“Many people outside our government have told him about the need to modernize and move with the times,” Kinew told reporters at an unrelated news conference on Thursday.

“A report like this is certainly difficult, but you can’t ignore the years of people advocating for this particular college to open up more opportunities for nurses to work in our province… to make it easier for nurses around the world and especially from other parts of the country to move up.”