Two local nurses have been charged with multiple felonies after state investigators accused them of prescribing high volumes of controlled substances to multiple patients that resulted in an array of alleged standard of care violations.

Desiree Desjardins, 52, Garrison, and Jennifer Napora, 45, Surrey, are both licensed advanced practice registered nurses (APRN) or nurse practitioners. They were charged as co-defendants on Feb. 16 with four counts of reckless endangerment-extreme indifference, conspiracy to deliver a controlled substance, all Class C felonies, and one count of conspiracy to deliver a controlled substance-schedule II opiate, a Class B felony. The charges arise from an investigation by agents of the North Dakota Bureau of Criminal Investigation assigned to the Attorney General’s Medicaid Fraud Control Unit.

In an affidavit of probable cause filed with the court, investigators laid out and highlighted a series of red flags for alleged drug diversion activity they say occurred between Feb. 10, 2020, and Feb. 10, 2023, at a healthcare clinic owned and operated by Desjardins called Lakeview Health Clinic in Minot where Napora worked as an employee. An audit was performed on medical files for approximately 55 of Desjardins and Napora’s patients, but due to the sheer quantity of notes and documentation contained in each file, investigators ultimately only selected five patient files to be reviewed by a medical expert.

The expert who reviewed the files found that over a three-year period there were 12 standard of care violations, reporting Desjardins and Napora “practiced egregiously below the standard of care on a consistent basis,” which, “put the lives of all five reviewed patients at risk on numerous occasions and in multiple ways.”

The affidavit goes on to outline the various standard of care violations for each patient, accusing the co-defendants of allegedly prescribing high volumes of morphine milligram equivalents (MME) without medical necessity and in some instances for patients with documented histories with addiction and opioid abuse. The pair are accused of writing duplicate prescriptions that allowed patients to fill one prescription through commercial insurance and another through private pay on or near the same date.

In one example cited in the affidavit, investigators found that during a 17-day period in February 2020, Desjardins prescribed, and her patient filled 285 tablets of oxycodone 30 mg tablets, which was followed by a script for an additional 200 additional tablets on Feb. 28. Based on the prescribing pattern, investigators say Desjardins prescribed approximately 2,495 tablets of oxycodone for the patient in 152 days.

Investigators allege that from Feb. 10, 2020, through Dec. 31, 2021, Desjardin and Napora dispensed 22,181 controlled substance pills, tablets or capsules, and 76 fentanyl patches to just five people in less than 23 months. Investigators noted that these totals don’t include controlled substances prescribed to two patients before and after the period in question.

“By grossly overprescribing controlled substances to their patients and by practicing in such an irresponsible manner, Desjardins and Napora were not legitimately prescribing, but delivering controlled substances to patients,” BCI special agent Breanna Leingang concluded in the affidavit, “I believe Desjardins and Napora implicitly conspired to deliver controlled substances to patients while both were employed as medical providers at Lakeview.”

In February and May of 2021, Desjardin and Napora were served with separate cease and desist orders from the North Dakota Board of Nursing (NDBON) instructing them to cease and desist from prescribing controlled substances. The NDBON also issued an Order of Emergency Suspension in November 2021 suspending Desjardin’s APRN license. Desjardin signed a stipulation for settlement with the NDBON on Jan. 26, where she admitted to prescribing a high number of controlled substances amongst other violations.

Desjardin surrendered her registration with the Drug Enforcement Agency on May 3, 2021, which is required for medical providers to prescribe controlled substances to patients. Lakeview closed its doors in December 2021, and Napora opened her own clinic, Beyond Health Care, in the same location in January 2022.

Desjardin and Napora’s preliminary hearing was originally scheduled for May 4, but was canceled and reset for July 21 at 1 p.m. at the Ward County Courthouse before Judge Gary Lee.