An Ipswich physician assistant who had a patient die under her care has had her license reinstated.
June Torrence-Heinz, a physician assistant at the Sanford Ipswich Clinic, was given a temporary order conditioned license by the South Dakota Board of Medical and Osteopathic Examiners on May 16.
Under the conditioned license, Torrence-Heinz will be able to practice medicine under two restrictions:
·She will be unable to provide schedule II prescriptions, a category of drugs that have a strong potential for abuse or addiction, but also have medical use, said Kristi Golden, a spokeswoman for the state board of medicine. It includes morphine, opium and cocaine, she said.
·Her practice will be confined to Sanford Ipswich Clinic and Sanford Aberdeen Clinic.
Physician assistants are normally able to prescribe schedule II drugs, Golden said.
"This is putting her on conditioned license," she said. "It's saying, 'You can practice. You've been evaluated, but we still have these concerns, and that's why there are these restrictions that we're putting on it.'
Torrence-Heinz came under investigation after Jeremy Johnsen, a 29-year-old patient under her care at Golden Living Center in Ipswich, died.
In October, Johnsen received a life-threatening dosage of morphine, which was ordered by Torrence-Heinz, according to a report by the board of medicine.
Johnsen had been released from Avera St. Luke's Hospital to Golden Living Center in early September after he was treated for pneumonia, according to the report. Johnsen's primary care provider was Dr. Harvey Hart, a physician at the Sanford Ipswich clinic who supervised Torrence-Heinz, according to the report.
Physician assistants must be supervised by a doctor, as mandated by South Dakota law, according to the board.
Neither Torrence-Heinz nor Hart was an employee of Golden Living Center, but the two were the health care providers chosen by Johnsen's family, said Kelli Luneborg, public relations director for Golden Living Center headquarters in Plano, Texas.
According to the board of medicine report, Torrence-Heinz issued a do not resuscitate order at the request of Johnsen's family and discontinued all of his medications, except insulin and Seroquel, a medication used to treat symptoms of schizophrenia after meeting with the family.
Torrence-Heinz also ordered that Johnsen receive 10 milligrams of morphine intravenously every three to four hours, then three days later, ordered an increase in morphine to 20 milligrams intravenously every two hours, according to the report.
The same day that Torrence-Heinz increased the morphine dosage to 20 milligrams, Johnsen was pronounced dead, the report stated.
A morphine dosage rate of 20 milligrams every two hours threatens the life of a patient and can lead to death, according to the report.
In an interview with the state Department of Criminal Investigation in the report, Torrence-Heinz said she increased the morphine from 10 to 20 milligrams because Johnsen was restless. In the report, she also said she routinely ordered that amount if a patient was having pain.
In the DCI interview in the report, Torrence-Heinz also said Johnsen's mother, Julia Johnsen, said her son had been through enough and that she did not want him to suffer anymore because Johnsen was not getting better.
Julia Johnsen was her son's guardian as well as the director of nursing at Golden Living Center in Ipswich.
The report also indicated the documentation was not adequate for the do not resuscitate order and the change in medication order.