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Broward ME Office Accused Of "Gross Mismanagement"

FT. LAUDERDALE (CBSMiami) – Broward County's Medical Examiners Office has been accused of gross mismanagement and employee misconduct by the county's Office of the Inspector General (OIG) for its handling of narcotic medications.

According to an OIG report, "the ME presently cannot determine the whereabouts of at least 3,600 pills, including over 2,100 oxycodone and over 150 hydrocodone, which are classified as controlled substances - many of which by now may have entered into an illicit stream of commerce."

"Our report -- to be clear -- finds gross mismanagement at the highest levels of the ME," said John W. Scott, Broward's Inspector General. "That office failed to comply with professional standards."

"We consider this to be a risk to the public health and safety of Broward County and we don't ever see a way of finding out what happened to them,"Scott said.

During the course of their investigation, OIG inspectors said former ME Legal Investigator Supervisor Linda Krivjanik and the supervisory ME staff, including former Chief Medical Examiner Joshua Perper, failed to ensure medications entrusted to their care were properly secured, cataloged, and destroyed.  The medications were taken from the bodies brought to their office and stored as evidence.

Read The OIG's Broward Medical Examiner Final Report

One of the main problems, according to the OIG report, was a "failure of communication between Dr. Perper and Ms. Krivjanik and, in turn, the investigators she supervised."

Krivnanik reportedly discouraged her staff from participating in staff meetings so that Dr. Perper would not ask her to follow up on any issues discussed.

"For example, in one meeting, Dr. Perper had raised questions regarding evidence handling, and suggested that Ms. Krivjanik implement a system which would require two investigators to be present whenever anyone entered the evidence room. Ms. Krivjanik refused to follow through with Dr. Perper's request, and told one investigator that 'Perper will not remember what he wanted by next week'."

The report also indicates that the staff at the ME failed to adhere to state or office rules. Not only did the ME fail to create adequate policies for handling and disposal of medications, according to OIG investigators, it also failed to train their personnel to follow them.

"All of the investigators interviewed by OIG Special Agents admitted that they received no formal training and, at best, "on the job" training, or "learning by watching others." One investigator stated that although Ms. Krivjanik provided him with a policy and procedure manual, she also told him that "the information written in it is not part of the daily routine you will be doing."

OIG agents say according to the ME manual, the only requirement for storage of seized narcotics is that they be kept in a locked room.

"Nonetheless, the OIG discovered that some investigators never followed even these minimal requirements, never counting medications, much less logging them into the computer system," according to the report. "For example, one investigator merely kept a garbage bag in her office, where she stored medications without logging them. Garbage bags full of medications were also left in the file room, where one investigator said that he often observed that high school and community college students, who were volunteer workers, were left unattended, with unfettered access to the medications."

The report also criticized the department for its failure on multiple occasions to enforce its own rule that staff must witness the incineration of the medications.

"One investigator recalled that in 2011, investigators loaded two vehicles with approximately 20 garbage bags containing medications—which had previously been stored in the file room—for incineration at Memorial Regional Hospital. The investigator stated that after the incinerator staff told them they would have to wait because other material was being burned, Ms. Krivjanik decided that they would not stay to personally witness the incineration."

When an ME official confronted Krivjanik about the claim, she admitted she had falsely claimed to have witnessed the medications incinerated.

"After the matter was reported to Dr. Perper, he directed the investigator supervisor and her assistant to sign a document affirming that they had properly disposed of the medications."

The report concludes that in the age of "pill mills," the failure to account for thousands of pills of controlled substances represents a real public safety concern.  It adds that steps are being taken to correct the problems.

Perper would not comment on the record for our story Monday. However, he said he stands by the information he provided to the Inspector General's Office.

The report includes a letter written from Perper in which he says he "properly instructed" investigators on ways to "handle and release evidence."

In the letter, Perper also cites the "betrayal" of Krivjanic, who "in fact, according to the (Report) repeatedly sabotaged, derided and derailed my instructions for the betterment of the Office."

Dr. Trelka said he takes the problems listed in the report seriously.

"This is very concerning and we've taken the steps necessary to at least secure what we're doing inside this office," he said.

Trelka said the evidence bottles being stored haphazardly and evidence placed improperly in Krivjanik's office will not happen again.

He said new policies are in place to protect evidence. In addition, Broward County hired a outside consultant to review the ME's office from top to bottom. That report is due later this month.

The Broward Sheriff's Office assisted with the investigation, however a spokesperson said Monday that they do not have an ongoing criminal investigation into the matter.

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