Case Title: In re Smith

Citation: 169 Vt. 162, 730 A.2d 605

Docket Number: 

State: vermont

Court: Vermont Supreme Court

Date: 1999-04-09T00:00:00Z

Document:
In re Smith    (97-417); 169 Vt. 162; 730 A.2d 605

[Filed 9-Apr-1999]

       NOTICE:  This opinion is subject to motions for reargument under
  V.R.A.P. 40 as well as formal  revision before publication in the Vermont
  Reports.  Readers are requested to notify the Reporter  of Decisions,
  Vermont Supreme Court, 109 State Street, Montpelier, Vermont 05609-0801 of
  any  errors in order that corrections may be made before this opinion goes
  to press.

                                 No. 97-417

In re Trudy J. Smith	                    Supreme Court

                                            On Appeal from
                                            Washington Superior Court

                                            June Term, 1998

Alan W. Cheever, J.

       William H. Sorrell, Attorney General, and Eve Jacobs-Carnahan,
  Assistant Attorney General, Montpelier, for Appellant.

       Paul Gillies of Tarrant, Marks & Gillies, Montpelier, for Appellee.

PRESENT:  Dooley, Morse, Johnson, and Skoglund JJ., and Cashman, D.J.,
          Specially Assigned

       SKOGLUND, J.  The State appeals the Washington Superior Court's remand
  of the Board  of Nursing's decision to suspend the nursing license of
  appellee, home-health nurse Trudy Smith.  The superior court remanded the
  case, ordering the Board to apply a clear and convincing  standard of
  proof, rather than preponderance of the evidence, and on remand to exclude
  from  consideration hearsay evidence presented by the State in the
  suspension hearing.  We reverse and  reinstate the Board's decision.

       Appellee served as the primary home-health nurse for two elderly
  patients, L. and M, who  accused her of taking some of their prescription
  Percocet, a narcotic drug, during September and  October 1994.  At the time
  of the alleged misappropriations of Percocet, appellee possessed a 
  probationary nursing license from the Board that contained a condition
  requiring her to remain  drug and alcohol-free.  On October 17, 1994, prior
  to L. and M.'s reporting the allegations, the  Board had fully reinstated
  defendant's license.  On October 28, 1994, during a regularly 

 

  scheduled visit from another home-health nurse, who until the spring of
  1994 had been their  primary nurse, M. reported that some of their drugs
  were missing and that they suspected appellee  took them.  The nurse
  immediately called the home-health supervisory nurse to relay the 
  allegations.  The supervising nurse met that same day with the patients to
  discuss the allegations  and then reported appellee to the Board.  As a
  result of the Board's investigation into the  allegations, it charged
  appellee with unprofessional conduct. 

       On December 13 and 14, 1994, the Board held an evidentiary hearing. 
  Neither L. nor M.  testified at the hearing.  Appellee's supervisor and the
  other home-health nurse testified at the  hearing regarding L. and M.'s
  accusations.  The supervising nurse stated that M. said she kept  her
  bottle of Percocet by the telephone, moved it to her sock drawer after she
  noticed some tablets  missing, and then she did not notice any more tablets
  disappearing.  L. reportedly conveyed a  similar set of facts to the
  supervising nurse.  He kept his bottle of Percocet by the kitchen sink, 
  changed the location to a cupboard next to the kitchen sink after he had
  noticed that tablets were  missing, continued to find tablets were missing,
  and then put them in another cupboard in the  kitchen behind boxes of
  pasta, after which  no further tablets disappeared.  The supervising nurse 
  testified that these patients said appellee would make unscheduled visits
  on occasion, either to use  the telephone or to use the bathroom. 
  According to the supervising nurse, both patients said that  on the
  occasions when she used the bathroom she would wash her hands at the
  kitchen sink even  though there was a sink in the bathroom.  She also
  testified to the fact that patient M. was  hospitalized on October 8 and
  returned to home-health care on October 14.  

       The patients' former primary home-health nurse testified concerning
  their physical  ailments and current health status.  According to her, M.'s
  medical condition kept her in the  apartment and, although L. did sometimes
  go out, it would have been difficult for him to make  it to the hearing
  given the cold weather.  The nurse described a home-health visit on October
  18,  1994, in which L. displayed uncharacteristic anger and ranted about
  the home-health nurse  service.  She stated that it seemed to her a
  disproportionate reaction to the scheduling confusion  that had arisen 

 

  that day.  She then related the circumstances in which M. first reported
  her suspicions of appellee  and what M. had specifically said.  Further,
  she testified that M. appeared distressed by making  the report and said
  that M. stated she cared for the appellee and wanted her to get help. 
  Finally,  the nurse testified to the patients' continued emotional distress
  and decline in physical health since  they had reported their suspicions of
  appellee.   

       The State adduced further testimony regarding L. and M.'s allegations
  from the  investigator on the case.  The investigator spoke to L. and M. in
  the presence of the supervising  nurse.  L. reportedly related to him the
  following incident.  L. stated that, to discover who was  taking their
  Percocet, he and M. devised the plan to plant two tablets near the
  telephone in M.'s  bedroom and to check if they were still there each time
  after a visitor left.  While M. was in the  hospital, appellee made an
  unscheduled visit to the apartment.  She used the telephone, and, after 
  she had left, L. found that the two Percocet were gone.  The investigator
  in addition testified to  his review of L. and M.'s pharmacy records,
  confirming M.'s Percocet prescription and clarifying  that what L. had
  sometimes referred to as Percocet was actually a prescription for Propacet, 
  another narcotic drug.

       In his opening statement, appellee's attorney stated that, "evidence
  as it will be presented  to you today lacks a core piece of evidence; that
  is, the presence of L. and M."  He went on to  explain hearsay under the
  rules of evidence and the hearsay rule for administrative proceedings, 
  then stating that the testimony the State presented would test these rules.
  Nonetheless, the  witnesses testified to the facts detailed above without
  objection from appellee to the specific  questions or answers.  In fact,
  during the testimony appellee raised only one objection -- when the  State
  questioned whether M. told the home-health nurse what L.'s feelings were
  about the  disclosure.

       Applying a preponderance of the evidence standard of proof, the Board
  found that the  appellee took two Percocet from L. and M.'s apartment
  during the week of October 8, 1994.  The  Board concluded that: appellee's
  unprofessional conduct was of a character likely to harm the 

 

  public; diversion of the Percocet was a violation of the conditions on
  appellee's license at the time  of the incident; and, based on a review of
  her pharmacy records over the past eight years,   appellee had an active,
  untreated addiction to narcotics.  The Board ordered appellee's license 
  suspended, conditioning reinstatement on fulfillment of certain conditions. 

       Appellee appealed the Board's decision to an appellate officer,
  contending there was  insufficient evidence to support the Board's findings
  and conclusions and attacking the Board's  reliance on hearsay evidence. 
  Without reaching the hearsay issue the appellate officer upheld the 
  Board's conclusion that appellee had an active, untreated addiction to
  narcotics, but reversed the  Board's other conclusions.  By characterizing
  the burden of proof in a "theft" case as requiring  more than evidence of
  nonexclusive opportunity to take the object later found missing, which the 
  Board found the State had not even shown, and by citing to a criminal case
  in support, the  appellate officer appeared to employ the criminal law
  standard of proof:  beyond a reasonable  doubt.  Both parties appealed to
  the superior court.

       Before the superior court, appellee continued to contest the Board's
  conclusions on  sufficiency of the evidence grounds.  That is, appellee
  argued insufficient evidence existed to  uphold the Board's conclusion
  appellee had an active, untreated addiction.  By contrast, the State 
  appealed the appellate officer's use of the criminal law standard of proof,
  arguing that the officer  should have upheld the Board's decision based on
  the standard of proof the Board had applied,  that is, preponderance of the
  evidence.  In addition, the State asked the court to address the  hearsay
  issue.  The State maintained that appellee waived any challenges to
  admissibility by failing  to adequately object to the presentation of the
  hearsay statements at the time the Board heard the  testimony. 

       The superior court rejected both the standard of proof applied by the
  appellate officer and  the standard of proof applied by the Board, holding
  instead that, given the seriousness of the  disciplinary process and the
  potential loss of livelihood, the Board should have applied a clear and 
  convincing evidence standard of proof.  The court therefore remanded the
  case back to the Board 

 

  for a new evidentiary hearing.  At the parties' request and in the interest
  of judicial economy, the  court addressed the question of whether the
  hearsay evidence presented at the first hearing would  be admissible if the
  Board heard the matter again on remand.  The court ruled that on remand the 
  hearsay statements would be inadmissible. 

       The State's appeal to this Court followed.  On appeal, the State
  asserts, as it did before  the superior court, that the Board's decision
  applying the preponderance of evidence standard to  the disciplinary
  hearing should have been upheld.  Further, the State again maintains
  appellee  waived her hearsay objections.  Finally, it continues to argue
  that, employing the preponderance  of evidence standard, sufficient
  evidence existed to support the Board's finding appellee took two  Percocet
  tablets from the patients' apartment during the week of October 8, 1994.

       We first address this Court's jurisdiction to consider the appeal as
  it was not taken from  a final judgment.  See Huddleston v. University of
  Vt., ___ Vt. ___, ___,