As the RCMP investigate the suspected misuse of oxytocin to induce labour in women without their consent at a Moncton hospital, questions are being raised over the drug’s safe handling and storage.
The Horizon Health Network, which operates the Moncton Hospital, has said it fired a registered nurse for allegedly tampering with IV bags in the maternity ward. The nurse is accused of inappropriately administering the labour-inducing drug oxytocin to pregnant women.
Police have confirmed at least two cases, while dozens of other women fear they were also victims.
If police lay charges against the nurse, they could range from "administering a noxious substance" to the much more serious charge of "aggravated assault.â€
That latter charge suggests “maiming, wounding, for example scarring the mother, endangering her life, that can attract a very lengthy jail sentence," according to Toronto criminal lawyer Ari Goldkind.
But how is oxytocin acquired in the first place?
Industry experts say vials of oxytocin are typically provided to a hospital’s maternity unit by its in-house pharmacy.
They could be stored in a cupboard or a medication cart. They could also be kept in an automated cabinet that tracks the number of vials, the person taking them and possibly the patients using it.
According to the Institute for Safe Medication Practices Canada, "oxytocin vials do not have the same controls as with opioids [narcotics] such as regular counts of vials and recording of wastage."
Asked how nurses get the drug at Moncton Hospital, Horizon Health Network told Â鶹´«Ã½ that "the maternal newborn unit has an automated dispensing cart where oxytocin is stored. Oxytocin is also located in the epidural cart."
To ensure safe use and accountability, Canada's hospital pharmacists like former president of Canadian Society of Hospital Pharmacists Patrick Fitch have specific recommendations.
He urged professionals to conduct "a double check [which involves] having one nurse access and prepare and then a second check or verification by another healthcare provider whether a nurse, a physician or pharmacists."