SADIE J. SARABIA v. GARY TROY WRIGHT, CRNA

IN THE DISTRICT COURT IN AND FOR OKLAHOMA COUNTY STATE OF OKLAHOMA SADIE J. SARABIA, PLAINTIFF vs. GARY TROY WRIGHT, CRNA an individual, and JOHN PAUL PERKINS, MD an individual and OKLAHOMA CENTER FOR ORTHOPEDIC & MULTI-SPECIALTY SURGERY, LLC An Oklahoma Domestic Limited Liability Company, DEFENDANTS. Case No. Attorney Lien Claimed Jury Trial Demanded PETITION COMES NOW, Sadie J. Sarabia, an individual, by and through her counsel, Tim Gilpin, Gilpin Law Office, and for her Petition for Relief against Defendants Gary Troy Wright, APRN-CRNA, John Paul Perkins, MD and Oklahoma Center for Orthopedic & Multi-Specialty Surgery offers the following in support of her claims: JURISDICTION, PARTIES & VENUE 1. At all times relevant to the claims alleged herein, Plaintiff, Sadie J. Sarabia ("Sadie"), was a resident of Pottawatomie County, state of Oklahoma; 2. At times relevant to the claims alleged herein, Defendant Gary Troy Wright, CRNA ("Wright") appears to have been licensed; and, practicing in the State of Oklahoma, Oklahoma County, as an APRN-CRNA, acting individually and/or as agent, servant, and/or employee of Oklahoma Center for Orthopedic & Multi-Specialty Surgery; 3. At all times material hereto, Defendant John Paul Perkins, MD ("Perkins") was licensed and practicing in the State of Oklahoma, Oklahoma County, as a Medical Doctor with specialty in anesthesiology, acting individually and/or as agent, servant, and/or employee of Oklahoma Center for Orthopedic & Multi-Specialty Surgery. Further, at all times material hereto, Perkins was acting as Wright's supervisor or supervising anesthesiologist; 4. At all times material hereto, Defendant Oklahoma Center for Orthopedic & Multi-Specialty Surgery ("OCOM") was an Oklahoma limited Liability Company and operated in the State of Oklahoma, Oklahoma County, as an orthopedic and multi-specialty hospital or surgery center, with Defendants Wright and Perkins acting as an agent, servant, and/or employee of OCOM; 5. Jurisdiction is proper in the State of Oklahoma since the events in question took place in Oklahoma; 6. Venue is proper in the Oklahoma County District Court pursuant to 12 O.S. § 139, county in which a defendant resides or may be summoned; and, 12 O.S. § 134, county in which corporate defendant is situated, principle place of business or where the cause of action arose, or some part of it arose, or in a county in which a codefendant may be properly sued; STATEMENT OF FACTS 7. Paragraphs 1 through 6 are incorporated herein by reference; 8. On February 21, 2024, Sadie reported to OCOM for a scheduled surgery that was performed on her right knee, lateral patella retinacular release. (EX “A”); 9. Sadie had requested and received a Nerve Block into her right lower extremity on that same day at OCOM, an injection of medication near the femoral nerve to provide temporary regional anesthesia; 10. The right lower extremity Nerve Block was performed by Wright under the supervision of Perkins at OCOM. (EX “B”); 11. The right lower extremity Nerve Block was done after Sadie was under general anesthesia and performed with negligence and gross negligence such that as a direct result Sadie suffered serious permanent injuries and damages; 12. That as a result of all the Defendants’ negligence and gross negligence Sadie suffered permanent nerve damage including, at least, Femoral and/or peripheral nerve(s) damage, diagnosed as Complex Regional Syndrome Type I and Type II; 13. Upon awakening from general anesthesia to present, Sadie suffers pain and discomfort in her right leg, including but not limited to: constant serious pain with aching, stabbing, burning, cramping, tightness and pulling pain associated with numbness and tingling. Her pain is exacerbated with cold, touch, clothes, shoes and exertion. (EX “C”); 14. As a result of the injuries Sadie has undergone a series of treatments with little to no benefit, including ice, heat, physical therapy, medications, nerve rehabilitation treatments, surgical placement of nerve stimulator (EX D), etc., As a direct result of the Defendants’ negligence and gross negligence, Sadie’s pain and discomfort impact and negatively affect her activities of daily life; 15. Upon information and belief, prior to Sadie’s knee surgery, Wright had a long and publicly documented history of substance abuse in several states (including Oklahoma) license suspension, voluntary surrender and substandard medical anesthesiology care: 11/18/24 – Voluntary Surrender of License – (Oklahoma) Basis for action – 16 Misappropriation of patient property or other property F2 Unable to practice safely by reason of substance use H4 Inappropriate or unauthorized administration of medication or sedation • 2/21/24 Plaintiff’s, Sadie J. Sarabia, Knee Surgery at OCOM 12/13/23 – License Restored or Reinstated, Complete (Oklahoma) 4/11/22 – Voluntary Surrender of License – (Texas) 11/15/21 – Voluntary Surrender of License – (Utah) 8/24/21 – Summary or Emergency Suspension – (Oklahoma) Basis for action – 99 – other- not classified, specify – pending a hearing on the merits of a complaint 2015 – Disciplined in Utah for continued substance abuse 2013 - Disciplined in Utah for continued substance abuse 2004 - Disciplined in Utah for continued substance abuse (Publicly available Board of Nursing records, EX “E”) 16. Further, shortly prior to Sadie’s February 21, 2024, knee surgery Wright’s professional license had only been reinstated from suspension as of December 13, 2023, for offenses including substance abuse. (EX “E”); 17. That upon information and belief, Defendants, OCOM and Perkins, had knowledge of, or with the exercise of reasonable care should have had knowledge of, Wright’s substance abuse issues, substandard patient care, voluntary license surrender, suspension(s), etc., and Defendants OCOM and Perkins acted recklessly with careless disregard, and with gross negligence by allowing and/or not closely supervising Wright in the performance of his duties toward Sadie; 18. Further, upon information and belief, Wrights’ substance abuse problem and substandard patient care had occurred and exhibited itself at OCOM with Defendants’ actual knowledge, or with reasonable care Defendants should have been aware of Wright’s substance abuse and substandard care, both before and shortly following Sadie’s knee surgery. Defendants OCOM and Perkins acted recklessly with careless disregard, and with gross negligence by allowing and/or not closely supervising Wright in the performance of his duties toward Sadie; FIRST CLAIM OF RELIEF MEDICAL NEGLIGENCE 19. Paragraphs 1 through 19 are incorporated herein by reference; 20. Defendants, each of them directly and individually, owed a direct duty of care to Sadie, and a duty of care regarding the acts of their employees, providers and agents; 21. Defendants, each of them individually and directly, breached their duty to Sadie resulting in her permanent nerve damage; and, Defendants OCOM and Perkins acted recklessly and with gross negligence by allowing and/or not closely supervising Wright in the performance of his duties toward Sadie: 22. As a result of the Defendants’ negligence, gross negligence and recklessness directly, individually and/or through the doctrines of respondeat superior and/or agency, Sadie suffered both physical and emotional pain, loss of quality of life, delay in treatment, permanent injuries, significant physical impairment, etc.; 23. As a direct and proximate cause of Defendants’ negligence, concurrent and joint, Sadie has suffered actual damages in excess of Seventy-Five Thousand Dollars ($75,000) in damages; 24. Defendants’, each of them, willful, wanton, and/or reckless care and/or careless disregard and/or failure to supervise Wright, entitles Sadie to punitive damages, in excess of $75,000.00; SECOND CLAIM OF RELIEF RESPONDEAT SUPERIOR/AGENCY 25. Paragraphs 1 through 24 are incorporated herein by reference; 26. Defendants OCOM and Perkins are liable for the actions of their employee, agent, and/or servant Wright, and any and all others with supervisory duties and responsibility for and/or providing care to Sadie, or lack of, as otherwise alleged herein directly and under the doctrine of respondeat superior and/or agency; 27. As a direct and proximate result of the negligence, gross negligence, careless disregard, and/or reckless conduct of Defendants, individually and in conjunction, Sadie has suffered significant physical and emotional pain, loss of quality of life, permanent injuries, significant physical impairment, etc.; 28. As a direct and proximate cause of Defendants’ negligence, concurrent and joint, Sadie has suffered more than Seventy-Five Thousand Dollars ($75,000) in damages; 29. Defendants’ willful, wanton, and/or reckless care and/or careless disregard entitles Sadie, to actual and punitive damages in excess of $75,000.00 from both; THIRD CLAIM OF RELIEF NEGLIGENT HIRING AND RETENTION DEFENDANTS 30. Paragraphs 1 through 29 are incorporated herein by reference; 31. At all times mentioned herein, Defendants OCOM and Perkins were responsible for the hiring and retention of Wright; 32. In the course of management, OCOM and/or Perkins, hired Defendant Wright to work therein; 33. The injuries sustained by Sadie resulted from the negligence of Defendants OCOM and Perkins hiring and retention of Wright; 34. As a result of the negligent hiring and retention of Defendant Wright as alleged above and without any negligence on the part of Sadie, she suffered the injuries alleged herein; 35. Defendants, OCOM and Perkins, willful, wanton, and/or reckless disregard entitled Sadie to actual and punitive damages both in excess of $75,000.00 from both; FOURTH CLAIM OF RELIEF NEGLIGENT SUPERVISION 36. Paragraphs 1 through 35 are incorporated herein by reference; 37. Defendants, OCOM and Perkins, had a duty to supervise and train Wright in a manner to prevent harm to Sadie; 38. Defendants, OCOM and Perkins, failed to accurately supervise and train Wright. 39. As a direct a proximate result of the actions, or inaction, of Defendants, OCOM and Perkins, Sadie incurred injuries; 40. Defendants', OCOM and Perkins, willful, wanton, and/or reckless disregard entitles Sadie to actual and punitive damages in excess of $75,000.00 from both. WHEREFORE, the Plaintiff, Sadie J. Sarabia, respectfully request this Court enter judgment against Defendants, jointly, concurrently and severally, and for an award of compensatory damages in an amount in excess of Seventy-Five Thousand Dollars ($75,000) and punitive damages against the Defendants, individually and in conjunction, to deter such recklessness and gross negligence, and to apprise the public at large that society does not condone such actions in an amount in excess of $75,000.00. Plaintiff further requests this Court grant her any and all pre-judgment and post-judgment interest on any award of judgment at the current statutorily allowed rate until paid. Finally, Plaintiff requests this Court grant her the expenses and attorney fees properly related to this action, along with all other relief this Court deems just and proper. ATTORNEY LIEN CLAIMED JURY TRIAL DEMANDED Respectfully submitted, Tim Gilpin, OBA #1844 GILPIN LAW OFFICE 2727 E. 21st Street, Suite 504 Tulsa, Oklahoma 74114 Tel: (918) 583-8900 Fax: (918) 796-5789 [email protected] Attorney for Plaintiff 2727 E. 21st Street, Suite 504 Tulsa, Oklahoma 74114 Tel: (918) 583-8900 Fax: (918) 796-5789 [email protected] Attorney for Plaintiff VERIFICATION STATE OF OKLAHOMA ) ) ss. COUNTY OF OKLAHOMA ) I, Sadie J. Sarabia, being first duly sworn upon her individual oath, depose and state that she is the Plaintiff in the above Petition, that she has read and understand the contents contained in the foregoing Petition, and further state that the same are true and correct to the best of her knowledge. Sadie J. Sarabia 2/19/2025 Date SUBSCRIBED and sworn to before me this 19 day of February, 2025. KALLI SELLERS Notary Public - State of Oklahoma Commission Number 22014802 My Commission Expires Nov 2, 2026 EXHIBIT "A" Oklahoma Center for Orthopaedic & Multi-Specialty Surgery Patient: SARABIA, SADIE J MRN: 01331566 FIN: OKLA000434910 DOB/Age/Sex: [REDACTED] 34 years Female Admit: 2/21/2024 Disch: 2/21/2024 Admitting: West DO, Derek L Surgical Documentation DOCUMENT TYPE: Operative Report SERVICE DATE/TIME: 2/21/2024 15:15 CST RESULT STATUS: Auth (Verified) PERFORMED INFORMATION: West DO, Derek L (2/21/2024 15:16 CST) SIGNED INFORMATION: West DO, Derek L (2/21/2024 15:16 CST) PREOPERATIVE DIAGNOSIS: Right knee Patellofemoral syndrome POSTOPERATIVE DIAGNOSIS: Right knee Patellofemoral syndrome with lateral tracking patella PROCEDURES: Right knee Arthroscopy Lateral patellar retinacular release SURGEON: Derek West, DO ANESTHESIA: General Gary Wright, CRNA SPECIMENS: None DRAINS: None COMPLICATIONS: None ESTIMATED BLOOD LOSS: Less than 10 cc SPONGE AND NEEDLE COUNTS: Correct DISPOSITION: The patient was transported to the PACU in stable condition. INDICATIONS FOR PROCEDURE: Oklahoma Center for Orthopaedic & Multi-Specialty Surgery Patient: SARABIA, SADIE J MRN: 01331566 FIN: OKLA000434910 DOB/Age/Sex: [REDACTED] 34 years Female Admit: 2/21/2024 Disch: 2/21/2024 Admitting: West DO, Derek L Surgical Documentation SARABIA, SADIE J is a 34 Years Female evaluated through the office for right knee pain. The patient was found on MRI and clinical exam to have a lateral tracking patella and patellofemoral syndrome. The risks and benefits of surgery were discussed. The patient verbalized understanding and provided written consent to the following procedure. OPERATIVE PROCEDURE: The patient was taken to the operating room and transferred to the operating table. A general anesthetic was administered and the airway was secured. All bony prominences were well padded. Preoperative antibiotics were administered. Following that, the right leg was prepped and draped in standard fashion. A surgical pause was performed to identify the correct patient and operative site. Following that, standard medial and lateral portals were established. The scope was inserted and diagnostic exam was performed. The patellofemoral joint revealed no degenerative changes of the articular surface. The patella was noted to track laterally over the lateral femoral condyle by 50%. The scope was transitioned to the medial compartment. This revealed no tear of the meniscus. The articular surface showed no degenerative changes of the articular surface. The intercondylar notch revealed an intact ACL/PCL complex. Attention was then directed to the lateral compartment. This revealed no tear of the lateral meniscus. There were no degenerative changes of the articular surface. Attention was redirected to the lateral patellar retinaculum. A hook cautery was used to perform a lateral release beginning at the inferior border of the vastus lateralis extending distally along the course of the patella. This resulted in improved patellofemoral mechanics with the patella tracking in the trochlear groove. A final look through the knee showed no retained loose bodies or unaddressed pathology. The scope was removed and fluid was drained from the knee. The wounds were copiously irrigated with normal saline. Marcaine 0.5% with epinephrine was used for local anesthesia. 4-0 Monocryl was used to close the incisions. Sterile dressings were applied. A flexion-extension brace was applied 0-20 degrees. The patient was awakened, transferred to the hospital gurney and was transported to the PACU in stable condition. The patient tolerated the procedure well. Electronically Signed By Derek West Date and Time: 02/21/24 15 16 CST EXHIBIT "B" Patient Name: SARABIA, SADIE J Date of Birth: [redacted] MRN: 01331566 FIN: OKLA000434910 * Auth (Verified) * SARABIA, SADIE J MRN: 01331566 OKMOR: 02364956 APTHESIOLOGIST KNEE LATERAL RELEASE 2807W10961 2/21/2004 14.1 Pre Op Checklist: Checklist Complete: Yes to all Medical Director: Anesthetic plan discussed and reviewed with CPNA/AA Anesthetic plan: See pre-op eval for full note MD present for anesthesia induction MD immediately available for all critical points MD available and/or present for emergency MD Monitored during key points of anesthesia MD Participated in regional anesthesia MD Assisted with PACU management 14.2 Patient In Room Anesthesia Start Immediate Pre-Induction Eval Pre-duction assessment: Performed immediately prior to induction Cuff location: Left Patient moved to table: Yes Pre-CO2 Yes 14.2 Position OR/LA Position: Supine Eyes taped: No Eyes taped: Yes Head/Neck: Neutral Positioning Left Arm: < 90 degrees on arm board Left Arm: Neutral Position Right Arm: < 90 degrees on arm board Right Arm: Neutral Position Legs: Neutral Position Body Rolls in place Warming Devices: Warming Blankers Warming Location: Upper Body Induction 14.3 LMA/Mask OR/LA Mask: Adult LMA Size: 4 Difficulty: Easy CO2 Present: Yes All Breath Sounds Present: Yes 14.4 Lower Extr Nerve Block OR/LA Performed By: Wright CPNA Gary For Postop Analgesia As requested by surgeon & patient Time Out Completed: Yes Type/Site Femoral Type/Site Scalp with classic approach Laterality: Right Sterile Protocol: Yes Medications: Bupivacaine w/ epinephrine Medications: Dexmethasone PF Medications: Other: prilocay Needle: 22G Stimplex 4in Nerve Stimulator Used: Yes Ultrasound used: Yes Aspiration: Negative Dose: Single 14.5 Surgery Start 15.1 Transfer OR/LA Transferred to: PACU Report given to: PN Immediate postop vitals signs: Reviewed Care transferred to PACU RN: Yes Note: Transfer form completed identifying info verified Medical history reviewed Anesthesia type/medications reviewed Post op status reviewed: All questions answered EXHIBIT "B" Patent Name: SARABIA SADIE J Date of Birth: [REDACTED] MRN: 01311566 FIN (OKLA:) 20434910 * Auth (Verified) * <table> <tr> <th>First Name</th> <th>Last Name</th> <th>DOB</th> <th>Age</th> <th>Sex</th> <th>Height</th> <th>Weight</th> <th>Race</th> <th>Language</th> <th>Primary Language</th> <th>Secondary Language</th> <th>Other Language</th> <th>Home Phone</th> <th>Work Phone</th> <th>Cell Phone</th> <th>Emergency Contact</th> <th>Emergency Address</th> <th>Emergency Phone</th> <th>Injury Location</th> <th>Time Incurred</th> <th>Time Hospital</th> <th>Time Discharged</th> <th>Hospital</th> <th>Patient ID</th> <th>Doc ID</th> <th>Doc Title</th> <th>Doc Type</th> <th>Doc Subtype</th> <th>Doc Source</th> <th>Doc Format</th> <th>Doc Details</th> <th>Doc Status</th> <th>Doc Date</th> <th>Doc Time</th> <th>Doc Provider</th> <th>Doc Supervisor</th> <th>Doc Signed By</th> <th>Doc Entered</th> <th>Doc Entered By</th> </tr> <tr> <td>SARABIA</td> <td>SADIE J</td> <td>[REDACTED]</td> <td>31 years</td> <td>female</td> <td>5'10"</td> <td>187 lbs</td> <td>white</td> <td>English</td> <td>English</td> <td>English</td> <td>English</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> <td>[REDACTED]</td> </tr> </table> Medications Information <table> <tr> <th colspan="11">Medications</th> </tr> <tr> <th>Patient</th> <th>Medication</th> <th>Dose</th> <th>Rate</th> <th>Unit</th> <th>Route</th> <th>Frequency</th> <th>Timing</th> <th>Instructions</th> <th>Follow-Up</th> <th>Notes</th> </tr> <tr> <td>15 mg</td> <td></td> <td>4 mg</td> <td></td> <td></td> <td></td> <td>15/15</td> <td>IM</td> <td></td> <td></td> <td></td> </tr> </table> <table> <tr> <th colspan="11">Information</th> </tr> <tr> <th>Time</th> <th>Hospital</th> <th>Doc ID</th> <th>Doc Type</th> <th>Doc Subtype</th> <th>Doc Source</th> <th>Doc Format</th> <th>Doc Details</th> <th>Doc Status</th> <th>Doc Date</th> <th>Doc Time</th> </tr> <tr> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> </table> <table> <tr> <th colspan="11">Medications</th> </tr> <tr> <th>Time</th> <th>Hospital</th> <th>Doc ID</th> <th>Doc Type</th> <th>Doc Subtype</th> <th>Doc Source</th> <th>Doc Format</th> <th>Doc Details</th> <th>Doc Status</th> <th>Doc Date</th> <th>Doc Time</th> </tr> <tr> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> </table> Provider Wright CRNA Gail INTRACOLUMNI 14 08-15 14 Supervisor Perkins MEJ John P 14 08-15 14 Signed By Perkins MEJ John P 14 04 06-12:04 Patient Name: SARABIA, SADIE Date of Birth: [REDACTED] Auth (Verified) Klahoma Center for Orthopaedic Multispecialty 8181 South Walker Ave Lawton, OK 73508 OFA Integorp Anesthesia Record Date Printed: 2/27/2014 15:14 Page 1 of 6 SARABIA, SADIE J MRN: 01331566 FIN: OKLA000434910 Ortho/Surg Knee Lateral Release W/patella Age: 24 years Gender: Female Height: 113 cm Weight: 107 kg Other Disorder: patella right knee Surgeon: West Liu, Derek L Anesthesiologist: Perkins MD, John P Type: General ASA: I Actual Procedure: Relief <table> <tr> <th>Name</th> <th>Total</th> <th>Remain</th> <th>1d</th> <th>2d</th> <th>3d</th> <th>4d</th> </tr> <tr> <td>LentaNYL 50 mcg/mL Inj Sol 2 mL iv</td> <td>100 mcg</td> <td></td> <td>100 mcg</td> <td></td> <td></td> <td></td> </tr> <tr> <td>cetAZolin 2 gm/100 mL 5% Dextrose Soln iv</td> <td>2 gm</td> <td></td> <td>2 gm</td> <td></td> <td></td> <td></td> </tr> <tr> <td>penicil 10 mg/mL Emul 20mL (Epineph) iv</td> <td>200 mg</td> <td></td> <td>200 mg</td> <td></td> <td></td> <td></td> </tr> <tr> <td>dexmedetomidine 100 mcg/mL IV Sol 2 mL Nerve Block</td> <td>50 mcg</td> <td></td> <td>50 mcg</td> <td></td> <td></td> <td></td> </tr> <tr> <td>ropivacaine-EPINEPHrine 0.5%/1200,000 PF Inj Sol 30 mL Nerve block</td> <td>200 mg</td> <td></td> <td>200 mg</td> <td></td> <td></td> <td></td> </tr> <tr> <td>dexamethasone 10 mg/mL PF Inj Sol 1 mL Nerve Block</td> <td>10 mg</td> <td></td> <td>10 mg</td> <td></td> <td></td> <td></td> </tr> <tr> <td>ketorolac 30 mg/mL inj Soln 1 mL iv</td> <td>15 mg</td> <td></td> <td>15 mg</td> <td></td> <td></td> <td></td> </tr> <tr> <td>ondansetron 2 mg/mL Inj Sol 2 mL iv</td> <td>4 mg</td> <td></td> <td>4 mg</td> <td></td> <td></td> <td></td> </tr> </table> AN End Tidal CO2: 0 AN Inspired Sevoflurane: 0 AN End Tidal Sevoflurane: 0 AN Continued LVP Fluid: 554.55 mL <table> <tr> <th>Monitor</th> <th>Mean</th> <th>10th</th> <th>84th</th> </tr> <tr> <td>AN Oxygen</td> <td>21%</td> <td>16%</td> <td>27%</td> </tr> <tr> <td>AN O2 Flow Rate L/min</td> <td>0.18</td> <td>0.14</td> <td>0.23</td> </tr> <tr> <td>AN FiO2</td> <td>0.</td> <td>0.</td> <td>0.</td> </tr> <tr> <td>AN Tidal Volume Expired</td> <td>0.</td> <td>0.</td> <td>0.</td> </tr> <tr> <td>AN Air Flow Rate L/min</td> <td>0.</td> <td>0.</td> <td>0.</td> </tr> <tr> <td>AN N2O %</td> <td>0.</td> <td>0.</td> <td>0.</td> </tr> <tr> <td>AN N2O Flow Rate L/min</td> <td>0.</td> <td>0.</td> <td>0.</td> </tr> <tr> <td>AN PIP</td> <td>1.</td> <td>1.</td> <td>1.</td> </tr> <tr> <td>AN PEEP</td> <td>2.</td> <td>0.</td> <td>2.</td> </tr> </table> AN HR - AN SpO2 - AN SBP - AN DBP - AN RR Pt: In: 14:13 Out Amet Start: 14:18 Stop: 15:20 Surge Start: 14:55 Stop EXHIBIT "C" Sarabia, Sadie J Ryan Vincent, MD Physician Specialty Pain Medicine Patient Name: Sadie J Sarabia MRN 203899324 CSN: 30200534002 Patient's PCP: Brandi Kammerer, APRN-CNP Chief Complaint Right leg/knee History Sadie J Sarabia is a 34 y.o. female who present for evaluation of right leg pain. The patient has had this since February following surgery and nerve block. Since onset, the pain has worsened. The pain is located in the right leg and knee. The patient describes the pain as a constant pain with aching, stabbing, burning, cramping, tightness, and pulling pains that is associated with numbness and tingling. The pain is rated as a 9 on a scale of 0-10 today. The patient reports that the pain is exacerbated with cord, touch, clothes shoes, exertion. Alleviating factors include rest and heat, gabapentin. The patient has tried ice, heat, physical therapy, Gabapentin, Lyrical, oral steroids, and nerve treatments to help with the pain however relief has been limited. The pain interferes with basic ADLs, work, and household chores. The patient denies any new onset fever, chills, or bowel and bladder dysfunction, focal/progressive weakness or increased pain with coughing/sneezing. Anticoagulation therapy. None Data Reviewed 1 Epic notes 2 PMP Report—Reviewed Risk Assessment 1. Reviewed Opioid Risk Tool Score. LOW risk 2. History of personal or family substance abuse - Denies Functional Assessment 1. Reviewed Roland-Morris Disability Questionnaire Score: 22/24. PHQ-9 19 Failed Treatments ice, heat, physical therapy, Gabapentin, Lyrical nerve treatments, and oral steroids Allergies No Known Allergies Current Medications Current Outpatient Medications. • cephalaxin (Keflex) 500 MG capsule. Take 1 capsule (500 mg) by mouth 4 (four) times a day for 5 days. Disp: 20 capsule. Rfl: 0 • gabapentin (Neurontin) 300 MG capsule. Take 1 capsule (300 mg) by mouth nightly. Disp: 30 capsule. Rfl: 0 • HYDROcodone-acetaminophen (Norco) 7.5-325 MG per tablet. Take 1 tablet by mouth every 4 (four) hours as needed for moderate pain for up to 7 days. Disp: 42 tablet, Rfl: C • hydroyXYzine Pamoate (Vistaril) 25 MG capsule. Disp: , Rfl: • ibuprofen (Advil,Motrin) 800 MG tablet. Take 1 tablet (800 mg) by mouth 3 (three) times a day.. Disp: 90 tablete. Rfl: 3 • pregabalin (Lyrica) 150 MG capsule. Take 1 capsule (150 mg) by mouth 2 (two) times a day., Disp: 60 capsule. Rfl: 0 • promethazine (Phenergan) 25 MG tablet, Take 1 tablet (25 mg) by mouth every 5 (six) hours as needed for nausea or vomiting for up to 7 days., Disp: 28 tablet. Rfl: C • SUMatriptan (Imitrex) 25 MG table, . Disp. , Rfl: Vitals Vitals: 10/08/24 1445 Height: 175.3 cm (5' 9") Weight: 102 kg (225 lb) Vitals: 10/06/24 1445 Height: 175.3 cm (5' 9") Weight: 102 kg (225 lb) Past Medical, Surgical, Family, Social History and Review of System History reviewed. No pertinent past medical history. Past Surgical History: <table> <tr> <th>Procedure</th> <th>Laterality</th> <th>Date</th> </tr> <tr> <td>KNEE SURGERY<br><i>Right knee arthroscopy with lateral release</i></td> <td>Right</td> <td>02/21/2024</td> </tr> </table> History reviewed. No pertinent family history Review of Systems Constitutional Negative for fever and unexpected weight change. Eyes Negative for visual disturbance. Respiratory: Negative for cough, shortness of breath and wheezing. Cardiovascular: Negative for chest pain and palpitations. Gastrointestinal: Positive for nausea and vomiting. Negative for blood in stool. Genitourinary: Negative for frequency and urgency Musculoskeletal: Positive for myalgias. Negative for arthralgias, back pain, joint swelling and neck pain. Skin: Negative for rash. Neurological: Positive for dizziness, weakness, numbness and headaches. Psychiatric/Behavioral: Positive for dysphoric mood and sleep disturbance. Negative for suicidal ideas. The patient is nervous/anxious. Tobacco Counseling She is not a tobacco user. Objective Vital Signs: Reviewed and Stable General: Well developed, well nourished Psych: Alert and oriented, pleasant, calm, normal mentation HEENT: Head is normocephalic, atraumatic, moist mucous membranes, EOMI Pulmonary: Non-labored and non-dyspneic Gait: Non-antalgic gait. Heel, toe and tandem gait normal. Neck: Full ROM of cervical spine. No tenderness to palpation of the cervical paraspinous muscles Back: No tenderness to palpation of the lumbar paraspinous muscles. No pain on extension and rotation bilaterally of the lumbar spine Straight Leg Raise: Negative Manual Muscle Strength Testing Upper Limbs: Strength: Left upper extremity 5/5 with shoulder abduction elbow flexion / extension wrist extension/flexion, finger abduction. Right upper extremity 5/5 with shoulder abduction, elbow flexion / extension, wrist extension, wrist extension/flexion, finger abduction. Manual Muscle Strength Testing Lower Limbs: Left lower extremity strength 5/5 hip flexion/extansion, knee flexion/extension, dorsiflexion, plantar flexor, EHL extension. Right lower extremity strength 4/5 hip flexion/extansion, knee flexion extension, dorsiflexion, plantar flexion, EHL extension SI: FABERS , Fortins , Yeomans , Gaenslens . Thigh thrust Sensation: Intact to light touch in bilateral C4-T1, and L2-S2 dermatomes. decreased sensation to light touch in RLE Clonus: Negative bilaterally Hoffman's: Negative bilaterally Skin: No rashes, no atrophy. Vascular: No edema. Assessment/Plan 1. Complex regional pain syndrome type 1 of right lower extremity 2. S/P right knee arthroscopy 3. Patellar tracking disorder, right 4. Numbness of right anterior thigh 5. Chronic pain of right knee Sadie J Sarobia is a 34 y.o. female patient with right leg pain most consistent on history and physical with complex regional pain syndrome of the right lower extremity. The patient reports right leg pain and has sensitivity of the right lower extremity on physical exam. MRI of lower extremity reveals moderate disc bulging. At this time, the patient has symptoms consistent with CRPS. The patient has failed conservative treatment with activity modification, physical therapy and NSAID's. I recommend right lumbar sympathetic block to improve the patient's pain and functionality. I will have the patient return to clinic 2 weeks following the procedure for further evaluation and management. 10/14/24 8:29 AM The patient has been encouraged to participate in home exercise program to improve pain mobility and functionality. Action numbers: MD910 and tall and in the presence of Ryan Vincent, MD Ryan Vincent, MD personally certified the services described in this documentation, as scribed in my presence and it is both accurate and complete. This message has been dictated using Dragon and may contain translation inconsistencies. Electronically signed by Ryan Vincent, MD at 10/14/2024 16:33 Office Visit on 10/8/2024 Note shared with patient Additional Documentation Vitals BP 124/82 Pulse 90 Ht 175 cm (5' 9") Wt 102 kg (225 lb) SoO2 97% BM1 33.23 kg/m^2 BSA 2.17 m^2 Flowsheets: Vitals Orders Placed Ambulatory referral to Surgery Schedulers Authorized Other Orders Performed Ambulatory referral to Pain Medicine Closed Medication Changes As of 10/10/2024 4:22 PM None Visit Diagnoses Primary: Complex regional pain syndrome type 1 of right lower extremity G90.521 S/P right knee arthroscopy Z98.830 Patellar tracking disorder, right M22.8x1 Numbness of right anterior thigh R260 Chronic pain of right knee M35.961, G89.29 EXHIBIT "D" EXHIBIT "D" ![Photograph of a person's arm with a catheter or tube inserted]  EXHIBIT "E" Verification Report Primary Source Board of Nursing Report Summary for GARY TROY WRIGHT [NCSBN ID: ] Tuesday, February 11 2025 04:53:34 PM For a more accurate search, select Search by License Number or Search by NCSBN ID above. Partial name searches are accepted For nurses (RNs and LPNs) this report is not sufficient as primary license verification when applying to another board of nursing for licensure. For primary verification to transfer/endorse to another state, use the Nurse License Verification service to request the required verification of licensure. Temporary and Permanent (Post Exam) License(s)/Certificate(s) <table> <tr> <th>Name on License</th> <th>License/Certificate Type</th> <th>License/Certificate Number</th> <th>License Status</th> <th>Original Issue Date</th> <th>Current Expiration Date</th> <th>Compact Status</th> <th>Discipline</th> </tr> <tr> <td>WRIGHT, GARY TROY</td> <td>APRN-CRNA</td> <td>M[REDACTED]</td> <td>Voluntary Surrender</td> <td>07/17/2019</td> <td>11/19/2024</td> <td>N/A</td> <td>YES</td> </tr> </table> Primary Source Board of Nursing Discipline/Final orders Contact the boards of nursing for any questions • Discipline/Final Orders state: OK • Date action was taken: 08/24/2021 Basis for action • Basis for Action: 99 - Other - Not Classified. Specify - Pending a hearing on the merits of a Complaint • Initial Action: 1139 - Summary or Emergency Suspension - • Initial action date: 08/24/2021 • Effective date(s): 08/25/2021 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. o Wright, Gary Troy, APRN-CRNA 07.28.2021 • Revision Action: 1147 - Limitation or Restriction on License • Revision action date: 10/12/2021 • Effective date(s): 10/12/2021 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): • Revision Action: 1297 - Modification of Previous Licensure Action • Revision action date: 09/22/2021 • Effective date(s): 09/28/2021 - 11/28/2021 • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. ○ Wright, Gary Troy, aprn-crna 9.22.21 Primary Source Board of Nursing Discipline/Final orders Contact the boards of nursing for any questions • Discipline/Final Orders state: OK • Date action was taken: 11/02/2021 Basis for action • Basis for Action: 99 - Other - Not Classified, Specify - Part of the attached Order on the APRN for Sept. 22, 2021 • Initial Action: 1147 - Limitation or Restriction on License - • Initial action date: 11/02/2021 • Effective date(s): 11/02/2021 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. ○ Wright, Gary Troy, aprn-crna 9.22.21 • Revision Action: 1280 - License Restored or Reinstated, Complete • Revision action date: 12/13/2023 • Effective date(s): 12/13/2023 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): Primary Source Board of Nursing Discipline/Final orders Contact the boards of nursing for any questions • Discipline/Final Orders state: OK • Date action was taken: 11/18/2024 Basis for action • Basis for Action: 16 - Misappropriation of Patient Property or Other Property • Basis for Action: F2 - Unable to Practice Safely by Reason of Substance Use • Basis for Action: H4 - Inappropriate or Unauthorized Administration of Medication or Sedation • Initial Action: 1145 - Voluntary Surrender of License - • Initial action date: 11/18/2024 • Effective date(s): 11/18/2024 - 11/18/2029 • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. ○ Wright, Gary Troy, RN APRN-CNP 9.25.24 Advanced Practice license/recognition information • Population Focus/Specialty: ○ Focus/Specialty: Certified Registered Nurse Anesthetist Expiration Date: 11/19/2024 • Prescriptive Authority: ○ Prescriptive Authority: NO Expiration Date: 11/19/2024 <table> <tr> <th>Name on License</th> <th>License/Certificate Type</th> <th>License/Certificate Number</th> <th>License Status</th> <th>Original Issue Date</th> <th>Current Expiration Date</th> <th>Compact Status</th> <th>Discipline</th> </tr> <tr> <td>WRIGHT, GARY TROY</td> <td>RN</td> <td>[REDACTED]</td> <td>Voluntary Surrender</td> <td>11/02/2021</td> <td>11/19/2024</td> <td>N/A</td> <td>YES</td> </tr> </table> Primary Source Board of Nursing Discipline/Final orders Contact the boards of nursing for any questions • Discipline/Final Orders state: OK • Date action was taken: 08/24/2021 Basis for action • Basis for Action: 99 - Other - Not Classified. Specify - Pending a hearing on the merits of a Complaint • Initial Action: 1139 - Summary or Emergency Suspension - • Initial action date: 08/24/2021 • Effective date(s): 08/25/2021 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. ○ Wright, Gary Troy, APRN-CRMA 07.28.2021 • Revision Action: 1147 - Limitation or Restriction on License • Revision action date: 10/12/2021 • Effective date(s): 10/12/2021 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): • Revision action date: 09/22/2021 • Effective date(s): 09/28/2021 - 11/28/2021 • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. ○ Wright, Gary Troy, aprn-crna 9.22.21 Primary Source Board of Nursing Discipline/Final orders Contact the boards of nursing for any questions • Discipline/Final Orders state: OK • Date action was taken: 11/02/2021 Basis for action • Basis for Action: 99 - Other - Not Classified. Specify - Part of the attached Order on the APRN for Sept. 22, 2021 • Initial Action: 1147 - Limitation or Restriction on License - • Initial action date: 11/02/2021 • Effective date(s): 11/02/2021 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. ○ Wright, Gary Troy, aprn-crna 9.22.21 • Revision Action: 1280 - License Restored or Reinstated. Complete • Revision action date: 12/13/2023 • Effective date(s): 12/13/2023 - Indefinite/Unspecified • Is license automatically reinstated after the effective date(s): Primary Source Board of Nursing Discipline/Final orders Contact the boards of nursing for any questions • Discipline/Final Orders state: OK • Date action was taken: 11/18/2024 Basis for action • Basis for Action: 16 - Misappropriation of Patient Property or Other Property • Basis for Action: F2 - Unable to Practice Safely by Reason of Substance Use • Basis for Action: H4 - Inappropriate or Unauthorized Administration of Medication or Sedation • Initial Action: 1145 - Voluntary Surrender of License - • Initial action date: 11/18/2024 • Effective date(s): 11/18/2024 - 11/18/2029 • Is license automatically reinstated after the effective date(s): • Official primary source board order(s). Also check with the board of nursing for any subsequent or superseding orders. ○ Wright, Gary Troy, RN APRN-CNP 9.25.24 License type information • RN: Registered Nurse • PN: Practical Nurse (aka Licensed Practical Nurse (LPN), Vocational Nurse (VN), Licensed Vocational Nurse (LVN)) • CNP: Certified Nurse Practitioner • CNS: Clinical Nurse Specialist • CNM: Certified Nurse Midwife • CRNA: Certified Registered Nurse Anesthetist Nurse Licensure Compact (NLC) information • Multistate licensure privilege: Authority to practice as a licensed nurse in a remote state under the current license issued by the individual's home state provided both states are party to the Nurse Licensure Compact and the privilege is not otherwise restricted. • Single state license: A license issued by a state board of nursing that authorizes practice only in the state of issuance. • More information about the Nurse Licensure Compact (NLC) BEFORE THE OKLAHOMA BOARD OF NURSING IN THE MATTER OF GARY TROY WRIGHT, a.p.r.n.-c.r.n.a. LICENSE NO. M[REDACTED] (WITH SOOA) SINGLE-STATE LICENSE (TEMPORARILY SUSPENDED) LICENSE NO. [REDACTED] MULTISTATE REGISTERED NURSE LICENSE (PSOR–UTAH) PRIVILEGE TO PRACTICE (TEMPORARILY SUSPENDED) CONSENT ORDER This matter comes on for hearing before the Oklahoma Board of Nursing on the 22nd day of September, 2021, at the Sheraton Oklahoma City Downtown, 1 N. Broadway Avenue, 2nd Floor Ballroom, Oklahoma City, Oklahoma, for disposition by Consent Order ("Order"), pursuant to 75 O.S. §309.E. Gary Troy Wright, a.p.r.n.-c.r.n.a. ("Respondent") and Respondent's legal counsel, Elizabeth A. Scott, having consented to the following Order being entered herein, the Board hereby makes and enters the following Order. 1. Respondent is Gary Troy Wright, a.p.r.n.-c.r.n.a. 2. Respondent has a multistate privilege to practice registered nursing in the State of Oklahoma, pursuant to a multistate registered nurse license, No. [REDACTED], with his primary state of residence in Utah. Respondent's multistate privilege to practice registered nursing was temporarily suspended by the Board on July 28, 2021. Respondent is licensed by the Oklahoma Board of Nursing ("Board") as an advanced practice registered nurse-certified registered nurse anesthetist with authority to order, select, obtain and administer ("SOOA") legend drugs, Schedules II through V controlled dangerous substances, devices and medical gases, License No. M[REDACTED]. Respondent's advanced practice registered nurse-certified registered nurse anesthetist with authority to order, select, obtain and administer ("SOOA") was temporarily suspended by the Board on July 28, 2021. Respondent is nationally certified to practice as a nurse anesthetist through the National Board of Certification and Recertification for Nurse Anesthetists, Certification No. (expiration date June 30, 2023). The Respondent’s licensing history is attached to the Amended Complaint and incorporated by reference as if fully set forth herein. 3. On June 23, 2021, Lisa Griffitts, R.N., Nurse Investigator filed a Complaint, against Respondent’s advanced practice registered nurse-certified registered nurse anesthetist, citing violations of the Oklahoma Nursing Practice Act and Rules. 4. On July 13, 2021, Respondent’s counsel, Elizabeth A. Scott requested, in the Respondent’s Notice of Appearance submitted to the Board, a continuance of the Hearing as the Respondent is in treatment. Said Notice of Appearance is incorporated by reference as if fully set forth herein. 5. On July 28, 2021, the Board, in an Order of Continuance with Temporary Suspension, granted Respondent’s request for a continuance; however, due to the seriousness of the allegations in the Complaint, temporarily suspended the Respondent’s Oklahoma APRN-CRNA nursing license and his multistate privilege to practice as a registered nurse in the State of Oklahoma pending a hearing. Said Order of Continuance with Temporary Suspension is incorporated by reference as if fully set forth herein. 6. On August 26, 2021, Lisa Griffitts, R.N. Nurse Investigator filed an Amended Complaint, citing the following violations of the Oklahoma Nursing Practice Act and Rules: Respondent fails to adequately care for patients or to conform to the minimum standards of acceptable nursing practice that, in the opinion of the Board, unnecessarily exposes a patient or other person to risk of harm; is intemperate in the use of alcohol or drugs, which use the Board determines endangers or could endanger patients; is guilty of any act that jeopardized a patient’s life, health or safety as defined in the Rules of the Board; violated a rule promulgated by the Board, an Order of the Board, or a state or federal law relating to the practice of registered nursing, advanced practice registered nursing, or a state or federal narcotics or controlled dangerous substance law including, but not limited to prescribing, dispensing or administering opioid drugs in excess of the maximum limits authorized in Section 2-3091 of Title 63 of the Oklahoma Statutes; has had disciplinary actions taken against the individual’s professional license in this or any state, territory or country; and is guilty of unprofessional conduct as defined in the Rules of the Board; specifically, OAC 485:10-11-1.(a)(b)(2)(3)(C)(D)(H)(T)(U)(4)(C)(D) and is in violation of the provisions of the Oklahoma Nursing Practice Act, 59 O.S. §§567.1, et seq., specifically, §§567.3.a.10. and §§567.8.A.1.c.d.g.2.3.B. 3., 4., 7., 8., 9. and 10., with the following particulars, to wit: a. On April 9, 2021 the Texas Board of Nursing in an Agreed Order For Eligibility & Discipline ("TX BON Order") granted the Respondent’s Petition for licensure as an advanced practice registered nurse and prescriptive authority with conditions. The TX BON Order includes the following Findings of Fact, in part: Respondent submitted to the TX BON a Petition requesting licensure in Texas; Respondent holds a multistate registered nurse license in Utah; on February 20, 2013 Respondent was issued a Citation by the Department of Commerce Division Occupational and Professional Licensing State of Utah, requiring the payment of a fine; and Respondent satisfied the terms of the Citation on February 20, 2013. Terms of the TX BON Order include: remedial education courses Texas nursing jurisprudence and ethics, and Sharpening Critical Thinking Skills, to be completed within 1 year of licensure. To date, the Respondent has not complied with the terms of the TX BON Order. The TX BON Order is attached to the Amended Complaint and incorporated by reference as if fully set forth herein. b. On or about September 15, 2020 through May 12, 2021 the Respondent, performed services as an advanced practice registered nurse-certified registered nurse anesthetist ("APRN-CRNA") for Western Oklahoma Anesthesia in Elk City, Oklahoma and was placed on a rotating schedule assuming on-call duties as an APRN-CRNA at Great Plains Regional Medical Center in Elk City, Oklahoma ("Hospital"). On May 11, 2021 the Respondent, while practicing as the APRN-CRNA and providing anesthesia¹ for Patient #1’s Total Left Hip Arthroplasty, was observed by a Hospital Radiology Technician during the surgical procedure, to place an anesthesia circuit hose in the Respondent’s mouth, close his lips around the anesthesia circuit hose and hold the anesthesia circuit hose in his mouth at least 6 times during the approximately 1 hour surgical procedure. Patient #1’s surgical procedure is described in the relevant Hospital medical records attached to the Amended Complaint and incorporated by reference as if fully set forth herein. ¹Patient #1 received spinal and regional anesthesia from the Respondent for the surgical procedure. On May 12, 2021 the Respondent was found at approximately 7:52 p.m. by a Western Oklahoma Anesthesia Anesthesiologist in the Hospital’s Operating Room 1, on the floor with the lights off holding the anesthesia machine circuit in his hand, profusely bleeding from his face and scalp. Upon the Anesthesiologist turning on the Operating Room lights, the Respondent stood and displayed impaired behavior, to include: slurred and slow speech and impaired thought processes. Further, upon standing the Respondent put the anesthesia machine circuit in his mouth and began to inhale. The Anesthesiologist shut off the gases2 to the anesthesia machine and directed the Respondent to sit in a chair. On May 13, 2021, the Respondent resigned in lieu of termination from Western Oklahoma Anesthesia. As more particularly described in an email from the Respondent to Western Oklahoma Anesthesia attached to the Amended Complaint and incorporated by reference as if fully set forth herein. 7. Respondent has requested a referral to the Board’s Peer Assistance Program. 8. Respondent is referred to the Peer Assistance Program of the Oklahoma Board of Nursing with the following terms and conditions 9. Respondent’s single-state license to practice as an advanced practice registered nurse-certified registered nurse anesthetist with authority to order, select, obtain and administer ("SOOA") legend drugs, Schedules II through V controlled dangerous substances, devices and medical gases, and multistate privilege to practice as a registered nurse in the State of Oklahoma remain temporarily suspended as of the date of this Order, which both temporary suspensions shall be set aside provided Respondent provides documentation, satisfactory to the Board, of Respondent’s acceptance into the Peer Assistance Program within ninety (90) days from receipt of this Order. 10. If Respondent’s multistate registered nurse license, License No. [REDACTED], (PSOR Utah) is converted to a single-state license and/or the multistate and/or single-state registered nurse license is removed from an active status by Utah during the pendency of this Order, Respondent shall submit to the Board an application for a single-state registered nurse 2The gas flows consisted of 3.3 liters per minute of Oxygen, 6.6 liters per minute of Nitrous Oxide and the Sevoflurane vaporizer was at 8 and completely empty. license and obtain current licensure in Oklahoma as a single-state registered nurse within thirty (30) days of the Utah action. The status of the Oklahoma single-state registered nurse license, upon issuance, shall be the same status as the Respondent’s Oklahoma APRN-CRNA license. 11. If Respondent is not accepted into the Peer Assistance Program within ninety (90) days of receipt of this Order, or having been accepted is terminated/defaults from the Program for any reason other than successful completion of Respondent’s contract, amended contract(s) and treatment plan, Respondent’s single-state license(s) and/or multistate privilege to practice is hereby revoked for a period of two (2) years from the date of non-acceptance in the Program or the date of the termination/default from the Program. 12. If Respondent fails to submit an initial licensure application and obtain active licensure with a single-state registered nurse license in Oklahoma within thirty (30) days of action taken by Utah as described supra, Respondent’s APRN-CRNA license with SOOA is hereby revoked for a period of two (2) years. 13. Respondent shall submit to the Board the applicable licensure modification fee for the APRN-CRNA license with SOOA within thirty (30) days from receipt of this Order. 14. In the event Respondent’s license(s) and/or multistate privilege to practice is revoked as provided herein, any application to reinstate Respondent’s license(s) shall not be considered by the Board until Respondent presents evidence satisfactory to the Board of compliance with the Board’s Guidelines for Individuals Requesting Reinstatement After Suspension, Surrender or Revocation for Misappropriation or Misuse of Drugs/Alcohol, in effect at the time of this Order. Respondent must also submit evidence of the continued qualifications for practice as set forth in the applicable Statutes and Rules of the Oklahoma Board of Nursing in effect at the time of Respondent’s reinstatement. 15. In the event Respondent’s license(s) and/or multistate privilege to practice is revoked as provided herein, Respondent shall pay an administrative penalty payable to the Oklahoma Board of Nursing in the full amount of One Thousand Dollars ($1,000.00). Partial payments are not accepted. The administrative penalty shall be paid only by certified check and/or money order. Any application to reinstate Respondent’s license after revocation will not be considered until the administrative penalty is paid in full. 16. Upon reinstatement after revocation as described herein of any nursing license(s) and/or multistate privilege to practice, Respondent’s license(s) and/or multistate privilege to practice will be immediately placed in temporary suspension pending admission/readmission to the Peer Assistance Program. Respondent shall provide documentation, satisfactory to the Board, of Respondent’s acceptance into the Peer Assistance Program within sixty (60) days of reinstatement of any nursing license(s). 17. If Respondent is not accepted into the Peer Assistance Program within sixty (60) days of reinstatement after revocation as described herein, or having been accepted is terminated/defaults from the Program for any reason other than successful completion of Respondent’s contract, amended contract(s) and treatment plan, Respondent’s license(s) and/or multistate privilege to practice is hereby revoked for a period of five (5) years from the date of the termination/default from the Peer Assistance Program. 18. Prior to the Respondent’s successful completion of this Order, that any violations of the Oklahoma Nursing Practice Act by the Respondent, except as set forth herein, may require Respondent’s appearance before the Board to Show Cause why Respondent’s license should not be revoked or other such action taken as the Board deems necessary and proper. This does not preclude any action(s) the Peer Assistance Program may take against the Respondent’s license. 19. Respondent shall comply in all respects with the Oklahoma Nursing Practice Act, 59 O.S. Sections 567.1, et seq., the Rules, OAC Title 485 Chapters 1 and 10 and Guidelines relating to nursing education, licensure and practice and this Order. 20. This Order will be sent to Respondent at Respondent’s most recent address of record on file with the Board. If this Order is returned with a notation by the United States Postal Service indicating that it is undeliverable for any reason, and the records of the Board indicate that the Board has not received any change of address since the Order was sent, this Order and any subsequent material relating to the same matter sent to Respondent’s most recent address on file with the Board shall be deemed legally served for all purposes. 21. Respondent fully understands that this Order will in no way preclude additional proceedings by the Board against Respondent for acts or omissions not specifically made a part of this Order. 22. Respondent expressly waives all further procedural steps, and expressly waives all rights to seek judicial review of or to otherwise challenge or contest the validity of this Order with the Board. Respondent’s waiver includes Supplemental Orders to this Consent Order. 23. The parties agree that both parties have participated in the drafting of this Order and that no presumption or construction against any party as the drafter of the Order, shall apply or be applied in the event of a claim of ambiguity of the document or a provision thereof. 24. This Order is executed by the Respondent for the purpose of avoiding further administrative action with respect to this cause. In this regard, Respondent authorizes the Board to review and examine all investigative file materials concerning Respondent prior to or in conjunction with consideration of this Order. Furthermore, should this Order not be accepted by the Board, it is agreed that presentation to and consideration of this Order and other documents and matters by the Board shall not unfairly or illegally prejudice the Board or any of its members from further participation, consideration or resolution of these proceedings. 25. This Order shall become final after anticompetitive review, as applicable, and a determination by the Oklahoma Attorney General that the Order is in compliance with the Board's authority and mission to protect the public health, safety and welfare, and Respondent has been legally served with this Order as set forth in this Order. 26. Upon successful completion by Respondent of Respondent's Contract, Amended Contracts (if applicable), and treatment plan with the Peer Assistance Program, no further Order of the Board shall be deemed necessary. 27. This Order constitutes disciplinary action by the Board and may be used in any subsequent hearings by the Board. In the event other misconduct is reported to the Board, this Order may be used as evidence against Respondent to establish a pattern of behavior and for the purpose of proving additional acts of misconduct. IT IS SO ORDERED. OKLAHOMA BOARD OF NURSING By: [signature] Presiding Board Officer [signature] Respondent [signature] Attorney for Respondent OBA# 12470 BEFORE THE OKLAHOMA BOARD OF NURSING IN THE MATTER OF GARY TROY WRIGHT, R.N., A.P.R.N.-C.R.N.A. LICENSE NO. 205938 SINGLE-STATE LICENSE A.P.R.N.-C.R.N.A. LICENSE NO. M[REDACTED] CONSENT ORDER This matter comes on for hearing before the Oklahoma Board of Nursing on the 25th day of September, 2024, at the Sheraton Oklahoma City Downtown, 1 N. Broadway Avenue, 2nd Floor Ballroom, Oklahoma City, Oklahoma, for disposition by Consent Order ("2024 Consent Order"), pursuant to 75 O.S. §309(E), and Gary Troy Wright, R.N., A.P.R.N.-C.R.N.A. ("Respondent") and Respondent's legal counsel, Elizabeth A. Scott, having consented to the following 2024 Consent Order being entered herein, the Board hereby makes and enters the following 2024 Consent Order. 1. Respondent is Gary Troy Wright, R.N., A.P.R.N.-C.R.N.A. 2. Respondent is licensed to practice registered nursing and as an advanced practice registered nurse-certified registered nurse anesthetist with authority to order, select, obtain, and administer drugs ("SOOA") in the State of Oklahoma and is the holder of single-state licenses, License No. [REDACTED] and [REDACTED] issued by the Oklahoma Board of Nursing ("Board"). 3. On or about September 22, 2021, a Consent Order was entered by the Respondent and the Board, for the Respondent to enter the Board's Peer Assistance Program ("PEER"), for the Respondent's April 9, 2021, Texas Board of Nursing Agreed Order for Eligibility & Discipline; and Respondent's diversion to himself of anesthesia gases during a surgical procedure on or about May 11, 2021 and utilizing anesthesia gases for his personal use with physical injuries on or about May 12, 2021. The Respondent successfully completed PEER on or about December 13, 2023. The 2021 Consent Order and Texas Board of Nursing Agreed Order for Eligibility & Discipline are attached hereto as pages 9-23 and made a part hereof. 4. On or about November 15, 2021, a Surrender Stipulation and Order was entered by the Respondent and the Division of Occupational and Professional Licensing of the Department of Commerce of the State of Utah wherein it states that the Respondent participated in Utah’s Diversion program in 2004 and was subsequently disciplined in Utah for continued substance abuse in 2004, 2013, and 2015. The Surrender Stipulation and Order is attached hereto as pages 24-31 and made a part hereof. 5. On August 22, 2024, Sara Chambers, R.N., Nurse Investigator filed an Amended Complaint against the Respondent’s registered nurse and APRN-CRNA licenses, citing the following violations of the Oklahoma Nursing Practice Act and Board Rules: Respondent is intemperate in the use of alcohol or drugs, which use the Board determines endangers or could endanger patients; is guilty of unprofessional conduct as defined in the rules of the Board, unprofessional conduct is behavior (acts, knowledge, and practices) which fails to conform to the accepted standards of the nursing profession, activities generally prevailing in the State of Oklahoma and which could jeopardize the health and welfare of the people which shall include but not be limited to: appropriating without authority medications, supplies or personal items of the patient or agency; conduct detrimental to the public interest and diversion or attempts to divert drugs or controlled substances. Specifically, OAC 485:10-11-1(a), (b)(3)(D), (b)(3)(H), and (b)(3)(U) and is in violation of the provisions of the Oklahoma Nursing Practice Act, 59 O.S. §§567.1, et seq., specifically, 59 O.S. §567.8(A)(l)(b), (A)(1)(d), (A)(1)(g), (A)(2), (A)(3), (B)(4), and (B)(7), with the following particulars, to wit: a. On or about March 5, 2024, the Respondent, an advanced practice registered nurse-certified registered nurse anesthetist contracted to work at Oklahoma Center for Orthopaedic & Multi-Specialty Surgery in Oklahoma City, Oklahoma ("Hospital"), was found with the lights off at approximately 6:35 A.M. by the Hospital Operating Room ("OR") Director in OR #6 leaning over the anesthesia machine with circuit tubing towards Respondent's face. When the Hospital OR Director turned on the lights in the room, the Respondent stood up and dropped the anesthesia machine circuit tubing. The Respondent had dried blood covering the Respondent's face, hands, circuit tubing and also on the floor in front of the OR Automated Dispensing Unit. When the Hospital OR Director asked the Respondent what happened, the Respondent stared at the Hospital OR Director without response. The Hospital OR Director went to get assistance, and upon returning, the Hospital OR Director turned off the Sevoflurane¹ to the anesthesia machine that was at a level 7. The Respondent was subsequently taken via emergency medical services for medical care. 6. On August 24, 2024, the Respondent received service of the Notice of Hearing before the Board, and the Amended Complaint. 7. Respondent has requested to voluntarily surrender his single-state Oklahoma license to practice registered nursing, License No. [REDACTED] and Oklahoma license as an APRN-CRNA with SOOA, License No. M[REDACTED]. 8. The voluntary surrender of Respondent's single-state license to practice registered nursing and license as an APRN-CRNA with SOOA in the State of Oklahoma are hereby accepted with the following terms and conditions: 9. Any application to reinstate any nursing license(s) and/or any initial licensure application in the State of Oklahoma shall not be considered for the period of five (5) years. ¹ Upon investigation by Hospital Administration, there were six (6) empty bottles of Sevoflurane located in the OR trashcan(s). All of the trashcans in the OR had been emptied at the end of the day on March 4, 2024, which was completed at approximately 2:03 P.M. Sevoflurane is a general anesthetic and is used to put patients to sleep for surgery. 10. Respondent agrees not to work in the State of Oklahoma utilizing any professional licensure until the Respondent has completed the terms of this 2024 Consent Order. 11. Prior to the submission of any reinstatement application and/or any initial licensure application to the Board, Respondent shall submit documentation to the Board of an Evaluation, a three to five day extended evaluation at a facility that specializes in the treatment of healthcare professionals with a substance use problem, completed within sixty (60) days prior to the submission of any reinstatement application and/or any initial licensure application, which complies with this Board’s Evaluation Criteria, in effect at the time of reinstatement. a. Respondent shall provide a copy of this 2024 Consent Order and the Board’s Evaluation Criteria to an appropriate Evaluator who meets the written criteria previously established by the Board. b. Respondent shall sign a written release with the Evaluator(s), Counselor(s), and/or treatment providers that allows the Oklahoma Board of Nursing and any and all Oklahoma Board of Nursing staff, as deemed necessary, to obtain and review the Evaluation and/or treatment records. A copy of the written release shall be provided to the Board. c. Evaluator shall discuss findings and recommendations with Respondent and shall submit the Evaluation on letterhead directly to the Board to include a summary of all assessments completed with tools utilized, diagnosis, prognosis, summary/recommendations and course of treatment if recommended. 12. The Evaluation shall be reviewed by the full Board, for the purpose of further Orders regarding Respondent’s license(s) as may be deemed necessary and proper to include but not limited to: referral to the Board’s Peer Assistance Program, probation/supervised practice up to 2880 worked hours, body fluid testing, counseling, and/or education course(s). 13. Prior to the reinstatement of any nursing license, Respondent shall pay an administrative penalty payable to the Oklahoma Board of Nursing in the full amount of $500.00. Partial payments are not accepted. The administrative penalty shall be paid only by certified check and/or money order. 14. Any application for reinstatement of any nursing license and/or any initial licensure application shall require Respondent’s appearance before the full Board for the consideration of said reinstatement/initial licensure application, including further Orders regarding Respondent’s license(s) to practice nursing as may be deemed necessary and proper. 15. Respondent shall comply in all respects with the Oklahoma Nursing Practice Act, 59 O.S. Sections 567.1, et seq., the Rules, OAC Title 485 Chapters 1 and 10 and Guidelines relating to nursing education, licensure and practice and this 2024 Consent Order. 16. Prior to the Respondent’s successful completion of this 2024 Consent Order, any violations of the Oklahoma Nursing Practice Act by the Respondent, except as set forth herein, may require Respondent’s appearance before the Board to Show Cause why Respondent’s license(s) should not be revoked or other such action taken as the Board deems necessary and proper. 21. This 2024 Consent Order will be sent to Respondent at Respondent’s most recent mailing address of record on file with the Board. If this 2024 Consent Order is returned with a notation by the United States Postal Service indicating that it is undeliverable for any reason, and the records of the Board indicate that the Board has not received any change of mailing address since the 2024 Consent Order was sent, this 2024 Consent Order and any subsequent material relating to the same matter sent to Respondent’s most recent mailing address on file with the Board shall be deemed legally served for all purposes. 22. This 2024 Consent Order shall become final after anticompetitive review, as applicable, and a determination by the Oklahoma Attorney General that the 2024 Consent Order is in compliance with the Board’s authority and mission to protect the public health, safety and welfare, and Respondent has been legally served with this 2024 Consent Order as set forth in this 2024 Consent Order. 23. Upon successful completion of the terms of this 2024 Consent Order and any and all Supplemental Order(s), all encumbrances shall be removed from Respondent’s single-state registered nurse license and license as an APRN-CRNA with SOOA. This space left intentionally blank. 17. Respondent fully understands that this 2024 Consent Order will in no way preclude additional proceedings by the Board against Respondent for acts or omissions not specifically made a part of this 2024 Consent Order. 18. Respondent expressly waives all further procedural steps, and expressly waives all rights to seek judicial review of or to otherwise challenge or contest the validity of this 2024 Consent Order with the Board. 19. The parties agree that both (all) parties have participated in the drafting of this 2024 Consent Order and that no presumption or construction against any party as the drafter of the 2024 Consent Order, shall apply or be applied in the event of a claim of ambiguity of the document or a provision thereof. The parties agree that either party may request, in writing, removal of this 2024 Consent Order from consideration by the Board prior to the full Board’s review and decision of said 2024 Consent Order and the 2024 Consent Order will be removed from consideration by the full Board. 20. This 2024 Consent Order is executed by the Respondent for the purpose of avoiding further administrative action with respect to this cause. In this regard, Respondent authorizes the Board to review and examine all investigative file materials concerning Respondent prior to or in conjunction with consideration of this 2024 Consent Order. Furthermore, should this 2024 Consent Order not be accepted by the Board, it is agreed that presentation to and consideration of this 2024 Consent Order and other documents and matters by the Board shall not unfairly or illegally prejudice the Board or any of its members from further participation, consideration or resolution of these proceedings. 24. This 2024 Consent Order constitutes disciplinary action by the Board and may be used in any subsequent hearings by the Board. In the event other misconduct is reported to the Board, this 2024 Consent Order may be used as evidence against Respondent to show a previous violation(s) of the Oklahoma Nursing Practice Act. IT IS SO ORDERED. OKLAHOMA BOARD OF NURSING By: [signature] Presiding Board Officer [signature] 9-16-24 Respondent [signature] Attorney for Respondent OBA# 12470 VALEIRE M. WILDE (U.S.B. 7345) Assistant Attorney General SEAN D. REYES (U.S.B. 7969) Utah Attorney General Commercial Enforcement Division Heber M. Wells Building Box 140872 Salt Lake City, UT 84114-6741 Telephone: (801) 366-0310 BEFORE THE DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING OF THE DEPARTMENT OF COMMERCE OF THE STATE OF UTAH IN THE MATTER OF THE LICENSE OF GARY TROY WRIGHT UTAH LICENSE #__________ TO PRACTICE AS A REGISTERED NURSE IN THE STATE OF UTAH ) ) SURRENDER STIPULATION AND ORDER CASE NO. DOPL 2021-275 GARY TROY WRIGHT ("Respondent") and the Division of Occupational and Professional Licensing of the Department of Commerce of the State of Utah ("Division") stipulate and agree as follows: 1. Respondent admits the jurisdiction of the Division over Respondent and over the subject matter of this action. 2. Respondent acknowledges that Respondent enters into this Stipulation knowingly and voluntarily. 3. Respondent understands that Respondent has the right to be represented by counsel in this matter and Respondent's signature below signifies that Respondent has either consulted with an attorney or Respondent waives Respondent's right to counsel in this matter. 4. Respondent understands that Respondent is entitled to a hearing before the State of Utah's Board of Nursing ("Board"), or other Division Presiding Officer, at which time Respondent may present evidence on Respondent's own behalf, call witnesses, and confront adverse witnesses. Respondent understands that by signing this document Respondent hereby knowingly and intelligently waives the right to a hearing, the right to call witnesses on Respondent's own behalf, the right to call witnesses, the right to confront adverse witnesses, and any other rights to which Respondent may be entitled in connection with said hearing. Respondent understands that by signing this document Respondent hereby knowingly and intelligently waives the right to all administrative and judicial review as set forth in Utah Code Ann. §§ 63G-4-301 through 63G-4-405, and Utah Administrative Code R151-4-901 through R151-4-907. Respondent and the Division hereby express their intent that this matter be resolved expeditiously through stipulation as contemplated in Utah Code Ann. § 63G-4-102(4). 5. Respondent waives the right to the issuance of a Petition and a Notice of Agency Action in this matter. 6. Respondent understands that this Stipulation and Order, if adopted by the Director of the Division, will be classified as a public document. The Division may release this Stipulation and Order, and will release other information about this disciplinary action against Respondent’s license, to other persons and entities. 7. Respondent neither admits nor denies the following, but agrees that the Division shall make the following findings of fact: a. Respondent was first licensed to practice as a registered nurse in the State of Utah on or about February 3, 1998. b. On May 20, 2021, the Division received a complaint regarding Respondent and a substance use disorder occurring in Oklahoma. c. In 2004, Respondent participated in Utah’s Diversion program. Respondent was subsequently disciplined in Utah for continued substance abuse in 2004, 2013 and 2015. d. On May 12, 2021, Respondent was observed at his place of employment inhaling gas from the anesthesia machine in the dark. Respondent fell on the operating room equipment and injured his head while inhaling the gas. Respondent continued to inhale the gas even after being confronted by a physician. Respondent had the anesthesia machine turned to 3.3 Oxygen, 6.6 Nitrous and the Sevoflurane was set at an 8, 4 times the normal rate. e. Respondent desires to surrender Respondent’s license to practice as a registered nurse in the State of Utah along with all residual rights pertaining to said license. 8. Respondent, while neither admitting nor denying the findings of fact above, agrees that the findings of fact made above constitute unprofessional conduct as defined in Utah Code Ann. § 58-1-501(2)(a), (b), (c) and (f); and Utah Code Ann. § 58-31b-502(e) and (f); and that said conduct justifies disciplinary action against Respondent’s license pursuant to Utah Code Ann. § 58-1- 401(2)(a). Respondent hereby surrenders Respondent’s license to practice as a registered nurse in the State of Utah along with all residual rights pertaining to said license. Respondent agrees that the issuance of the Order in this matter constitutes disciplinary action by the Division pursuant to Utah Administrative Code R156-1-102(7) and Utah Code Ann. § 58-1-401(2)(a). Respondent agrees not to reapply for licensure as any type of nurse in the State of Utah until three years has elapsed from date the Division Director signs this Stipulation and Order. If Respondent reapplies for licensure, Respondent will submit three months of negative drug and alcohol testing results evidencing Respondent is fit to practice along with proof that Respondent has had no further licensing violations in any other jurisdiction where Respondent is licensed to practice. The Division does not guarantee that any future application by Respondent for licensure will be granted. If the Division Director accepts the terms of this Stipulation and Order, Respondent forfeits all rights to practice as a registered nurse in the State of Utah. Respondent understands that Respondent will not receive any refund of license or renewal fees previously paid to the Division. 9. This Stipulation and Order, upon approval by the Director of the Division, shall be the final compromise and settlement of this non-criminal administrative matter. Respondent acknowledges that the Director is not required to accept the terms of this Stipulation and Order and that if the Director does not do so, this Stipulation and the representations contained therein shall be null and void, except that the Division and Respondent waive any claim of bias or prejudgment they might otherwise have with regard to the Director by virtue of his having reviewed this Stipulation, and this waiver shall survive such nullification. 10. This document constitutes the entire agreement between the parties and supersedes and cancels any and all prior negotiations, representations, understandings or agreements between the parties regarding the subject of this Stipulation and Order. There are no verbal agreements that modify, interpret, construe or affect this Stipulation. 11. If Respondent violates any term or condition of this Stipulation and Order, the Division may take action against Respondent, including imposing appropriate sanction, in the manner provided by law. 12. Respondent understands that the disciplinary action taken by the Division in this Stipulation and Order may adversely affect any license that Respondent may possess in another state or any application for licensure Respondent may submit in another state. 13. Respondent understands and agrees that if Respondent has been issued an Order by the Division to pay an administrative penalty or a fine, and Respondent has not paid the administrative penalty or fine in full at the time this Stipulation and Order becomes effective, then Respondent may not reapply for licensure in the State of Utah, in any profession or occupation, until Respondent has paid the administrative penalty or fine in full. Respondent understands and agrees that any application for licensure submitted by Respondent shall be denied for the reason of failure to pay an administrative penalty or fine by the Division until Respondent has paid the administrative penalty or fine in full. The Division may also deny the license for any other lawful reason. Respondent understands and agrees that this surrender of Respondent's license(s) does not extinguish any obligation Respondent has to pay any administrative penalty or fine previously ordered by the Division. 14. Respondent has read each and every paragraph contained in this Stipulation and Order. Respondent understands each and every paragraph contained in this Stipulation and Order. Respondent has no questions about any paragraph or provision contained in this Stipulation and Order: DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING BY JEFF BUSADIN Bureau Manager DATE: November 15, 2021 SEAN D. REYES UTAH ATTORNEY GENERAL BY: VALERIE M. WILDE Counsel for the Division DATE: Nov 15, 2021 RESPONDENT BY: GARY TROY WRIGHT DATE: Nov 5, 2021 ORDER THE ABOVE STIPULATION, in the matter of GARY TROY WRIGHT, is hereby approved by the Division of Occupational and Professional Licensing, and constitutes my Findings of Fact and Conclusions of Law in this matter. The issuance of this Order is disciplinary action pursuant to Utah Administrative Code R156-1-102(7) and Utah Code Ann. § 58-1-401(2). The terms and conditions of the Stipulation are incorporated herein and constitute my final Order in this case. DATED this 15th day of November, 2021. DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING MARK B. STEINAGEL Director Investigator: Victoria Brooks CERTIFICATE OF SERVICE I hereby certify that on the ___15___ day of ___Nov/Nov/, 2021, a true and correct copy of the foregoing SURRENDER STIPULATION AND ORDER has been served on the parties of record in this proceeding by mailing a copy thereof, properly addressed by first class mail with postage prepaid, to the following: and caused a copy to be electronically mailed to: Hal Reiser, Respondent's attorney emailed to: [email protected] Valerie Wilde, Assistant Attorney General ([email protected]) ______________________________ Carol Inglesby Administrative Assistant Division of Occupational and Professional Licensing