Background Information on Janice Johnson

Author:

Det. Sgt. Wayne Andrews

Date:June 4, 1998
Pages:12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of
Report
6/4/98

Location 646 Pierce Street Orig Incident Date 12/6/95
Victim Lisa McPherson VI Prosecute Yes No
Investigator Det. Sgt. Wayne Andrews
Previous Status Active
Subject None
Impound Inventory None

The following is background information on Janis Kaye Johnson (AKA Janis Kaye Fitzgerald).

Janis Kaye Smith was born on XXX XX, 1956 in XXXXXXXXXX, California to Helen Joyce Johnson, W/F, age 33, who was born in Texas, and Harold S, W/M, age 31, who was also born in Texas. At the time of her birth, her parents were living at XXXXX XXXXXXX XXX, XXXXXXXXXX, California.

At some point, Janis Kaye Smith got married and became Janis Kaye Volke (no further information on that name or marriage). She was later divorced. On May 5, 1980, she appeared in court in Wayne County, Michigan in front of Probate Judge Frank S. Szymanski and officially had her name changed from Janis Kaye Smith, AKA Janis Kaye Volke, to Janis Kaye Johnson. On July 14, 1981, Janis Kaye Johnson remarried in Michigan and became Janis Kaye Fitzgerald.

As a teenager, Janis Kaye Smith was involved in a serious hang-glider accident and received severe injuries. She later attended the Wayne State University School of Medicine in Detroit, Michigan and graduated with a Doctorate in Medicine on June 8, 1983. She was licensed in Michigan as a medical doctor on September 17, 1984 (License #047930). On July 14, 1981, while a student at Wayne State University, she married a professor there named Michael Joseph Fitzgerald. After graduating, she


Page l of l2

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

served a three-year residency in Anesthesiology at Sinai Hospital in Detroit, Michigan and graduated on August 27, 1986. After graduation, she joined the staff of the Veterans Administration Medical Center in Albuquerque, New Mexico. She remained there from September of 1986 to June of 1987, with privileges to include inhalation anesthesia, I.V. anesthesia, field blocks, pre-operative and post-operative evaluations, and supervision of C.R.N.A. In June of 1987, she applied to the Arizona Board Of Medical Examiners to be licensed as a medical doctor with a specialty in anesthesiology with the intention of going to work for Southern Arizona Anesthesia Services in Tucson, Arizona. On September 4, 1987, Arizona issued License #17132 to Dr. Janis Kaye Fitzgerald. She requested that the license be issued in this name because there was already a doctor licensed as Dr. Janis Kaye Johnson at Southern Arizona Anesthesia Services.

During the time span she worked at Southern Arizona Anesthesia Services in Tucson, Arizona, Dr. Fitzgerald had practicing privileges at the following hospitals:

  1. Tucson Medical Center, 5301 E. Grant Road, P.O. Box 42195, Tucson, Arizona 85733, phone (602) XXX-XXXX
  2. Carondelet St. Joseph's Hospital, X, Arizona 85711, phone (602) XXX-XXXX
  3. Columbia El Dorado Hospital, X, Arizona 857l2, phone (602) XXX-XXXX

Page 2 of l2

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

4) Carondelet St. Mary's Hospital, 1601 W. St. Mazys Road, Tucson, Arizona 85745, phone (602)XXX-XXXX

5) Northwest Hospital, 6200 N. LaCholla Boulevard, Tucson, Arizona 85741, phone (602)XXX-XXXX

6) Sutter Surgical Center, Tucson, Arizona (no further information)

The following are addresses Dr. Janis Kaye Fitzgerald lived at while in Tucson, Arizona:

  1. XXXXX XXXXXXXXXX XX, Tucson, Arizona -(unknown date)
  2. XXXXX XXXXXXXXXX XX, Tucson, Arizona (June 8, 1994)
  3. XXXXX XXXXXXXXXX XX, Tucson, Arizona (1991)

The following information has been obtained from the file on Dr. Janis Kaye Fitzgerald from the Arizona Board Of Medical Examiners in their Investigation #4199:

In October of 1992, while Dr. Janis Kaye Fitzgerald was practicing at the aforementioned hospitals, Northwest Hospital reported discrepancies in six patients she had treated with a drug called Sufenta. These discrepancies were apparently between the medical records and drug sign-out sheets for the following patients: Spinelli, Furlong, Brown, Fields, Barba, and Gomez.


Page 3 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

The following is a brief synopsis of a report written by Sue Hanson, R.N. C.P.H.Q. She was the Director Of Quality Resource Management at Northwest Hospital when Dr. Janis Kaye Fitzgerald practiced there. She did an investigation and wrote a report to Mark Brenzel, the Administrator at Northwest Hospital:

Sue Hanson indicated that a report was received from Fred Jestrab, Pharmacy Director at Northwest Hospital. There were narcotic discrepancies regarding Dr. Fitzgerald and Fred Jestrab asked Sue Hanson whether she had received the report. After checking with Phoebe Coleman, the Surgical Services Manager at Northwest Hos pital, the report was found on November 4, 1992.

The following is a description of the narcotic discrepancy involving Dr. Fitzgerald as reported:

On 10/30/1992, Dr. Fitzgerald approached the R.N. in the Operating Room to sign out narcotics. She requested 15 CCs of Sufenta for a patient named Benny Spinelli. Dr. Fitzgerald advised the R.N. that the Rehab Unit Benny Spinelli was at could not supply Sufenta for his pump. Since Sufenta is a very potent narcotic usually available only in the Operating Room, the R.N. thought this was not an unusual request. The Sufenta was then signed out and given to Dr. Fitzgerald. After the Sufenta was signed out, the R.N. started to complete the charge sheet but could not locate the patient in the computer. She then asked the secretary in the Operating Room to assist her in identifying the charge information. The secretary advised her that she had referred Dr. Fitzgerald to Fred Jestrab on October 29, 1992 regarding the procedure to obtain medication for a non-Northwest Hospital patient. The Operating Room nurse checked with Fred Jestrab on how to properly charge for the medication and Fred Jestrab directed that a report be completed. The patient, Benny


Page 4 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

Spinelli, was not registered or seen at Northwest Hospital on the day in question, October 30, 1992. The medical record for Benny Spinelli was reviewed and there was no record of any visits by Benny Spinelli's between August 20, 1992 and November 10, 1992. On Monday, November 9, 1992, Dr. Mark Rimirez, the Anesthesia Section Chief, contacted Dr. Fitzgerald for an explanation. Dr. Fitzgerald explained that Benny Spinelli was a patient at Sutter Surgical Center but had been seen at Northwest Hospital in the past. Since Sufenta was not available at Sutter, she obtained it at Northwest Hospital and took it to Sutter since Benny Spinelli had been seen at Northwest Hospital in the past. On Tuesday, November 10, 1992, at approximately 0800 hours, Dr. Fitzgerald requested additional Sufenta for Benny Spinelli from the R.N. in charge of the Operating Room. Knowing that this was improper procedure, the R.N. refused to sign the Sufenta out to Dr. Fitzgerald and referred her to Fred Jestrab in the Pharmacy. Dr. Fitzgerald commented to the R.N. that she had gotten into trouble the day before and would therefore have the patient, Benny Spinelli, come into the OP Services Department. Later that day at approximately 1130 hours, Benny Spinelli arrived at the OP Services Department for a refill of his intrathecal pump. The medications, Sufenta and Marcain, were then given to Dr. Fitzgerald, who drew them up into syringes. Once the medications were prepared, Dr. Fitzgerald requested that the R.N. from the OP Services Department come in and assist her with the procedure. It should be noted that, since the review of this incident led to the question about narcotic usage, I performed an audit of all of Dr. Fitzgerald's usage during October of 1992. The controlled substance records for October 1992 identified six patients, including Benny Spinelli. All records were compared with the controlled substance records and conclusions were completed by Sue Hanson, R.N. as follows:


Page 5 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

  1. Dr. Fitzgerald was told to contact Fred Jestrab on October 29, 1992 regarding correct procedures. However, she failed to do so and bypassed procedure.
  2. On October 30, 1992, Dr. Fitzgerald took $360 worth of Sufenta at $24 per CC from the Northwest Hospital.
  3. Dr. Fitzgerald took Sufenta and transported it from the Northwest Hospital across town to another facility.
  4. On November 10, 1992, Dr. Fitzgerald made a second attempt to bypass proper procedures, even after Dr. Ramirez spoke with her.

Records indicated that, on November 17, 1992, Dr. Fitzgerald went to Elizabeth E. Wack, M.D. and requested a prescription for Demoral and Dilaudin to treat a swollen limb from a spider bite. During November 1992, there were five different occasions Dr. Fitzgerald showed problems and discrepancies about the following drugs: Sufenta, Versed, and 4 cc's of liquid cocaine.

On November 20, 1992, Northwest Hospital indicated that they were concerned about Dr. Fitzgerald possibly using Fentanyl. They also indicated that she removed Sufenta from the Operating Room and showed a continual usage of injectable Dalgan for pain.


Page 6 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

On November 30, 1992, two R.N.'s from the Post-Anesthesia Care Unit wrote a letter indicating that, over the past few months, Dr. Fitzgerald started injecting Fentanyl (Sublimaze) in many of her epidural pain block patients. The letter stated the following:

"On Friday, November 27, 1992, I was assisting Dr. Fitzgerald with an epidural injection. For these injections, Dr. Fitzgerald opens the epidural tray. She then draws up two CC's of Fentanyl in a 3 CC syringe and squirts a half to 2 CC's of the medication into a small cup on the epidural tray prior to putting on sterile gloves and doing the procedure. On this date, it appeared to me that, after drawing up the Fentanyl, she placed the syringe in her jacket pocket and took out another filled 3 CC syringe from the opposite pocket and used it when she instilled the medication on the tray. I did not question her at this time. However, she made the comment to me "Oh, I put that syringe in my pocket and I shouldn't do that ... it's a bad habit." She used 1 1/2 CC's of the solution and gave me back the syringe with the remainder for disposal. However, I saved the syringe. I was concerned about what I thought had occurred, so I asked my charge nurse, Sylvia Nelson, to watch Dr. Fitzgerald closely while she was assisting her with the next blocks. Sylvia informed me that it also appeared to her that, with one of the blocks, Dr. Fitzgerald placed the syringe of Fentanyl in one pocket and used a different syringe from another pocket. Sylvia also saved the unused solution and syringe. I expressed my concerns to Dr. Leib, Chief of Anesthesia, at this time. He asked me to keep the syringes until Monday. I locked up the syringes from the blocks, as well as filled syringes from Dr. Poutz, which Dr. Leib had in my file cabinet."

"On Monday, November 30, 1992, there were six blocks for Dr. Fitzgerald on this date. During two of these blocks, Sylvia saw Dr. Fitzgerald place the


Page 7 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

Fentanyl syringes in her pocket. During one of these blocks, I observed Dr. Fitzgerald setting up for the block while another R.N. assisted her. I observed Dr. Fitzgerald draw up the Fentanyl and place the syringe in her pocket. The assisting R.N. had her back to Dr. Fitzgerald at this time. I then observed Dr. Fitzgerald take a different syringe from the opposite pocket and use it for the block. Three syringes with leftover solution were kept and labeled. I again spoke with Dr. Leib regarding my concerns. Dr. Leib and myself met with Dr. Tapia, the Medical Director, and Sherry Collins, Nursing Service, to share my concerns and concerns from other employees in positions regarding this matter and a possible problem. All syringes were given to Dr. Tapia at this time for analysis."

The following is a synopsis of a letter dated November 30, 1992 from Lionel E. Tapia, M.D., who is Director of Medical Affairs at Carondelete St. Mary's Hospital and on the Arizona Board of Medical Examiners. The letter was addressed to Mark Speicher, Associate Director of the Arizona Board of Medical Examiners reference Janis Fitzgerald, M.D.

"This is in followup to our discussion this morning about our suspicion that Dr. Janis Fitzgerald might be an impaired physician. Over the last few weeks, it has been reported that Dr. Fitzgerald has seemed agitated and left for the bathroom. And upon her return, seemed to be remarkably calm. Additionally, several nurses in the Post-Anesthesia Care Unit observed her drawing up Fentanyl, pocketing the filled syringes, and producing a different syringe, from a different pocket and using it's contents for administration to the patient. Of interest is that Dr. Fitzgerald had an indwelling catheter for the administration of long-term antibiotics for a chronic foot infection. This catheter was only just recently removed. We are concerned that Dr. Fitzgerald might be impaired


Page 8 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report XXXXX

because of the anesthetic drug use. We are asking for a speedy investigation so that this matter can be laid to rest or so that the appropriate treatment can begin."

The above letter apparently brought about a further investigation by the Arizona Board of Medical Examiners. The following excerpts were from a fax sent by Mark Speicher, M.D., to Attorney Steven Weiss, who I assume had represented Dr. Janis Fitzgerald.

"Regarding Dr. Yakaitis's letter of December 2, 1992, I cannot share the peer review documents with you but will summarize the concerns we have in them so you can prepare."

Dr. Fitzgerald violated hospital controlled substance policies at Northwest Hospital by obtaining Sufenta for a non-Northwest Hospital patient, Benny Spinelli, after having been told to contact hospital staff regarding correct procedures and failing to do so.

Dr. Fitzgerald took $360 worth of Sufenta.

Dr. Fitzgerald indicated that she gave this Sufenta to a patient in another facility.

On November 10, 1992, Dr. Fitzgerald again attempted to bypass hospital controlled substance policies in the same way.


Page 9 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report XXXXX

There were discrepancies in the six patients treated with Sufenta by Dr. Fitzgerald in October at Northwest Hospital between the medical records and the drugs signed out. The patients were Spinelli, Furlong, Brown, Fields, Barba, and Gomez.

There was apparently further investigation and depositions were taken. Letters were also written back and forth. The following is an excerpt from a letter from Dr. Janis Fitzgerald to Dr. Cerf, one of the doctors on the Arizona Board of Medical Examiners investigating her apparent drug abuse: "I am physically unable to practice medicine at this time and do not expect this to change."

There was apparently an agreement between Dr. Fitzgerald and the Arizona Board of Medical Examiners that she would discontinue practicing clinical medicine at that time and turn in her D.E.A. license number. She was to also undergo random drug testing. It appeared from reading the depositions that Dr. Fitzgerald never admitted to any type of drug use but agreed with the Board of Medical Examiners to turn in her D.E.A. license, not practice medicine, and to go for random drug tests.

The following are the dates of the random drug tests and the drugs that were found through lab analysis to be in her system during those times:

1) February 5, 1993, Hydrocordone was found in her system. She apparently had a prescription for Vicodines


Page 10 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

2) May 13, 1993, Diflunisal, Carbamazepine, and Propoxyphene were found in her system

3) May 17, 1993, Propoxyphene was found in her system

4) February 25, 1993, Hydrocordone was found in her system.

5) March 5, 1993, Carb-1 and Tegradol were found in her system

Dr. Fitzgerald indicated that she was on several prescriptions at the time of the random drug tests. These were Synthroid, Anaprox, and Beconase Nasal Spray.

It should be noted that Dr. Fitzgerald's file indicated she was in tremendous pain at one point. Her foot problem was apparently wrongfully diagnosed at first. However, she was eventually diagnosed as having a Morton's Neuroma in her foot. She indicated that she had also had her back fused in early December of 1992, and that she had a physical at the Mayo Clinic outside of Phoenix on April 5, 1993 by Dr. G. Gonzalez. The physical showed that Dr. Fitzgerald had an unusual amount of medical problems.

The transcript of the hearing that was held on March 16, 1992 at the Arizona Board of Medical Examiners indicated the following on Page 56: "Dr. Fitzgerald said that she was not hesitant In using drugs on people or patients."

In conclusion, it is apparent that Dr. Fitzgerald had some type of medical and/or drug problem in Tucson, Arizona in 1992 and 1993. Records from the Arizona Board


Page 11 of 12

SUPPLEMENT/CONTINUATION

FL0520300/Clearwater Police Department Report No. 95-29158
Offense Death Investigation Date of Report

of Medical Examiners indicated that Dr. Fitzgerald's license was never revoked. The Board, Dr. Fitzgerald's attorney, and Dr. Fitzgerald came up with an agreement that she would not practice clinical medicine any longer and give up her D.E.A. license. She was also asked by the Board to get a qualified doctor to begin treating her and to submit to random drug testing. Dr. Fitzgerald at first agreed to do all of these things, with the idea that she would complete all of the stipulations and get her D.E.A. license back. At some point in time, she began writing letters indicating that she would never practice clinical medicine again and was not interested in getting her D.E.A. license back. The Board finally sent her a notice saying that she would not be able to practice medicine in Arizona again until she re-applied to the Board for a license. As of this date, her file shows that she never re-applied to practice medicine in Arizona.


Ofc.Reporting Det. Sgt. Wayne Andrews/ elg ID No. 603
Case Status Active Date Cleared
Clearance Type
1. Arrest
Adult Juvenile
2. Exceptional
3. Unfounded
4. Other
Exception Type

1. Extradition declined
2. AR of primary offense,
secondary offense,
w/o prosecution


3. Death of Offender
4. V/W refused to cooperate
5. Prosecution declined
6. Juv/No Custody

Ofc. Reviewing Date SAO Info

Page 12 of 12