In the following case, an RN signed a contract to participate in a pain medication program administered by a clinic. The clinic required him to submit to random drug testing to document the proper use of the medication and compliance with the program.
The contract stated that if the nurse violated any of the provisions, including illegal drug use, his treatment would be terminated immediately.
RN tests positive
The clinic administered an oral drug test to the RN and collected the sample. The clinic sent the sample to the laboratory. At the RN’s next scheduled appointment, a nurse practitioner informed him that he was dismissed from the program because he tested positive for cocaine.
He told the nurse practitioner (NP) that the result must be a “false positive,” but the NP wouldn't defer to his explanation.
The RN then contacted the laboratory and informed one of the employees that he had received a false-positive result for his specimen. The laboratory retested the specimen with the same result — positive for cocaine.
Claims in the lawsuit
The RN, representing himself, filed a lawsuit against the clinic and the laboratory alleging that his constitutional rights were violated because he was excluded from the program without the right to contest or appeal the specimen result.
Both the clinic and the laboratory filed a Motion to Dismiss the complaint for failure to state a cause of action — in other words, the plaintiff hadn't met the legal requirements for a lawsuit.
The RN filed an amended complaint which, among other counts, claimed that the lab results were inaccurate and both defendants were negligent in failing to retest the sample.
Plus, the RN wasn’t given the opportunity to prove that the result was a false positive. The RN also claimed the defendants violated his 4th, 5th, and 14th Amendment rights under the U.S. Constitution by excluding him from the program without the chance to contest the laboratory results.
Once again, both defendants filed Motions to Dismiss the RN’s complaint for failure to state a cause of action. A hearing was held on the motions, which the RN didn’t attend.
The court granted the motions “with prejudice,” meaning the decision was final, and the RN couldn’t file any future complaints.
The RN filed a Motion to Vacate the court’s order, which was denied. He also filed a Motion to Reconsider, alleging he didn’t attend the Zoom hearing because of technical difficulties. At a hearing, the court informed the RN that the decision to dismiss his complaint was due to its merits and not his failure to attend the hearing.
The RN filed an appeal of the lower court’s decisions. The appellate court held that the trial court didn’t err in dismissing the RN’s complaint and that its dismissal wasn’t an abuse of the court’s discretion.
The importance of legal representation
First of all, this case supports the need for legal representation. The RN represented himself, which was not a wise decision.
His arguments supporting his claims weren’t based on the law. Rather, he presented non-legal positions, including violations of amendments to the Constitution, which weren’t applicable and couldn’t be upheld. Had he sought counsel, an attorney would’ve identified the flaws in his theories.
Secondly, his clinic contract didn’t give the RN the right to challenge a positive drug screen. It clearly stated that a positive screen would result in an immediate dismissal from the program. The right to appeal wasn’t included in the contract.
Had he asked an attorney to review the contract before signing it, the attorney could’ve informed the RN that he couldn’t challenge the decision or the laboratory’s results — absent a basis in the law such as negligence or a breach of contract.
The RN’s request for a second drug screen of the sample resulted in the same positive outcome which — absent factual challenges regarding how the specimen was handled and tested — failed to support the assertions in his claim.
I don’t know why the RN entered into the agreement with the clinic. Was his physician concerned about his underlying condition and the effect of the prescribed drug on the RN’s pain? Was the physician concerned about an accidental overdose or that the RN could misuse the pain medication?
Whatever the reason, such oversight is important. However not adhering to the terms of the contract can result in not only a dismissal from treatment but also the inability to continue receiving the pain medication.
If you need to participate in a program regulating pain medication use, have the contract reviewed by an attorney. This way you’re clear about your responsibilities and what you can expect from the program.
You can review a sample contract of a prescription drug monitoring program here.
If you’re faced with a true false-positive drug screen while in a prescription drug monitoring program, contact your attorney immediately so that you can assert legally sound challenges to that result.
If you’re a nurse practitioner and have a client to whom you prescribe pain medication, provide your client with the contract you require as part of your pain medication protocol treatment and suggest they have it reviewed by an attorney.
