TUPELO – Bureaucratic miscommunications – not diverting controlled substances – are at the heart of the prescription fraud charges leveled against a Ripley nurse practitioner, according to her attorney.
Brenda Shelton, 54, a nurse practitioner at North Mississippi Primary Health Care, was charged with prescription fraud, following an investigation by Mississippi Bureau of Narcotics and the U.S. Drug Enforcement Agency.
Ashland Attorney Tony Farese, who is also a board member for the North Mississippi Primary Health Care, said Shelton had acted in good faith, trusting the guidance she received from a former attorney who assisted her in restoring her nursing license in 2015.
“She mistakenly thought she had a valid DEA number,” Farese said, who noted there are no allegations that medications Shelton prescribed were inappropriate for her patients’ diagnoses or was attempting to divert medications.
As a result of the investigation, long-time Ripley family physician Dr. Dwalia South, a member of the Mississippi State Board of Health, voluntarily surrendered her DEA license to prescribe controlled substances for a year.
In a Wednesday press release, the narcotics bureau accused South of trying to conceal that Shelton had prescribed controlled substances by signing her name on prescriptions that were filled a year earlier.
Farese said South, who served as Shelton’s preceptor, didn’t attempt to conceal anything. She was asked by a Ripley pharmacy to cosign a prescription after the problem with Shelton’s DEA license was discovered. Farese said there is no ongoing investigation involving South.
“Everybody was acting in good faith,” Farese said. “I think Dr. South is a victim of circumstance.”
Hollis Discount Pharmacy is facing civil action in connection with the case, according to the narcotics bureau.
Shelton voluntarily surrendered her nursing license for a year in 2014, in connection with a situation at a different clinic, Farese said.
In October 2015, she went back to the board of nursing and was reinstated with restrictions, Farese said. She was required to take certain classes and had to work under the supervision of a physician as part of the restrictions, Farese said. She was advised that her prescribing privileges were restored, Farese said. Neither she nor her former attorney realized she needed to reapply for her DEA license to prescribe controlled substances.
When she was hired by North Mississippi Primary Health Care, she was upfront with the board about the restrictions on her license, Farese said. During her work at the clinic, she wrote 55 prescriptions for controlled substances over the course of two years. The prescription monitoring system accepted her DEA number as valid.
Shelton, South and the clinic staff cooperated fully with the state and federal investigators. Shelton resigned from the clinic last week after the problems were discovered, Farese said. South is continuing to see patients, and the clinic is making arrangements to ensure patients don’t lose access to needed medications.
“I don’t think Dr. South has been treated fairly, in my personal opinion,” Farese said.
The Mississippi Board of Nursing confirmed Shelton's license was formally restored with restrictions following the October hearing, effective January 2016. Among the restrictions was that she was ineligible to apply for her DEA license to prescribe controlled substances, said Phyllis Johnson, nursing board executive director. As an advanced professional, Shelton should have fully understood the restrictions being placed on her license.
"She has a responsibility herself," Johnson said. "What she did was in error."
When Shelton surrendered her DEA license in 2014, her controlled substances prescribing number should have become invalid, and she should have understood that she would need to apply for a new number as part of an effort to legally regain her controlled substance prescribing privileges, Johnson said.
Following her surrender of the DEA license, Shelton's number should have been invalid in the system. Although the nursing board does not have authority over the DEA licensing process or the state's prescription monitoring program, it does work collaboratively with other agencies, including the pharmacy board, state narcotics bureau and DEA, Johnson said.
"It is something everyone should be concerned about," Johnson said.
The Mississippi Bureau of Narcotics had not responded to Farese’s statements on Thursday evening.
On Wednesday, the narcotics bureau announced cases involving two other Northeast Mississippi health care providers.
Starkville nurse practitioner Amanda Jones, 35, was arrested on allegations of writing prescriptions in the name of a family member for Adderall, a Schedule II controlled substance typically used to treat attention deficit disorder, and filling them at local pharmacies.
She surrendered her license earlier this month, according to the press release.
Dr. William Bell of Tupelo surrendered his DEA license for prescribing controlled pharmaceutical drugs.
Agents said he practicing outside his scope of an emergency room physician and was writing prescriptions for Adderall and Clonazepam, a Schedule IV controlled substance typically used to treat seizures and panic disorder, to family members and acquaintances as well as for his own consumption.
He is not on staff at North Mississippi Medical Center-Tupelo, a hospital spokeswoman confirmed. Bell was previously assigned to the Baptist Memorial Hospital-Booneville emergency department through the physician group that contracts with the hospital; however, he has not seen patients at the hospital for more than a year, a spokesman said.