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Podcast Review: “The Retrievals”

A riveting account of the Yale Fertility Clinic drug diversion scandal

Back view of female patient in surgical gown with her hair over her shoulder.

In late 2020, two hundred patients of the Yale Fertility Center received letters from the Department of Justice telling them that they were potential victims in a federal criminal case. They had already received a prior letter from the fertility center’s director, blandly informing them that “an event may have occurred” involving their care.

The event in question was drug diversion. For months, a member of the clinic staff, a nurse that everyone trusted, had been stealing the fentanyl that was supposed to be used for pain relief during procedures. Some patients received heavily diluted fentanyl, while others had only plain saline in their IVs.

This scandal is the subject of “The Retrievals,” an investigative podcast produced by Serial Productions and the New York Times, and hosted and reported by Susan Burton, longtime producer and editor of “This American Life.” The podcast has five one-hour episodes, each covering a different aspect of the case: “The Patients,” “The Nurse,” “The Sentence,” “The Clinic,” and “The Outcomes.”

Talking to the Patients

The first episode interviews eight of the Yale patients, explaining why they were seeking assisted fertility treatment (AFT) and how they came to choose this particular facility. Their situations were varied and sometimes heartbreaking: One patient has a malformed uterus, making it difficult for her to conceive; one had suffered repeated miscarriages; and another wanted to freeze her eggs before beginning chemotherapy for breast cancer.

All of the patients interviewed underwent egg retrieval procedures, where eggs were surgically removed from their ovaries for in vitro fertilization. All found the procedures excruciatingly painful, far worse than the possible mild discomfort they’d been warned about. One patient drove immediately to an ER afterward, sure that something was wrong. Another patient, a neuroscientist, knew immediately that she’d just undergone the procedure completely unanesthetized.

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The patients trusted the doctors and nurses, and were invested in the process, so most continued their treatments and tried not to stress too much about the pain. Some spoke up, often more than once, only to have their concerns dismissed or ignored. Clinic providers attributed the severe pain to anxiety, low pain tolerance, fentanyl intolerance, or just patient uncooperativeness.

For months, no one on staff seemed to consider the possibility that something might be wrong with the clinic’s drug supply — until an anesthesiologist discovered a loose cap on a vial of fentanyl.

A Nurse Confesses

The second episode takes a closer look at nurse Donna Monticone, who confessed in November 2020 to diverting approximately 175 vials of fentanyl, about 75 percent of the clinic’s supply. We learn more about her: why she thinks she did it; how she was caught; and what happened then, including the impact on her friends and family.

Drug diversion is a well-known problem, with opioids the most common drugs stolen. While state and federal law requires facilities to take measures to discourage and detect drug diversion, drug thefts often go unnoticed. The Joint Commission estimates that 10 percent of all healthcare workers (including aides and administrators as well as nurses and other clinical staff) remove drugs meant for someone else.

Because Monticone confessed and pled guilty to tampering with the fentanyl vials, there was no trial, just a sentencing hearing in a nearly empty courtroom in May 2021. Few patients attended the hearing, although many submitted victim impact statements to the court.

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Ironically, despite the pain she caused so many other women seeking to become mothers, the fact that Monticone herself is a mother spared the former nurse from the five-year prison sentence the U.S. attorney asked for. The judge took into account Monticone’s stressful family situation and sentenced her to just four alternating weekends of incarceration — with early release on Sundays to get her children ready for school — plus three months of home confinement and three years of supervised release.

The nurse in me came away wanting more than just one person to be held accountable. Having so much fentanyl stolen over at least five months sounds like a systemic problem. A DEA audit later found numerous discrepancies in the facility’s drug records; in 2022, Yale agreed to pay more than $300,000 to settle federal allegations that the clinic violated its recordkeeping obligations under the Controlled Substances Act. Another civil suit still pending against Yale charges that the clinic stored controlled substances in unlocked rooms, leaving the drugs vulnerable to theft or tampering.

A Must-Listen Drama

Although nurses will be interested in the finer points of this case, since we understand the policies and procedures involved with controlled substances, I kept returning to the patients. It’s hard not to be appalled by their ordeal — not just the lack of proper anesthesia but also the clinic’s dismissive attitude towards their pain.

The podcast doesn’t include any comment from Yale because so much civil litigation is still pending (and may be combined into a class action suit). However, in a video shown to new patients, Yale Fertility Clinic promised that it would consider patients’ technical, physical, and psychological needs. I would venture to say that many patients don’t feel their wellbeing was taken into consideration. They deserve a voice and an acknowledgement.

“The Retrievals” is no ordinary true crime drama. It’s a riveting exposé of a field that’s become big business (assisted reproductive technology now produces more than 75,000 babies a year in the U.S.) and of the struggle women often face in convincing healthcare providers to take their pain seriously.

All five episodes are now available through most popular podcast services, and “The Retrievals” is also offered to paid subscribers through the New York Times app.

CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

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