Charleston nurse fined $500 after woman dies following outpatient surgery

CHARLESTON, SC (WCSC) - An early-November order issued by the South Carolina nursing board shows a nurse who worked at the Charleston Surgery Center in North Charleston was fined $500 after a patient died five days after an outpatient surgery in 2012.

Laura Bilancione was caring for a 63-year-old woman who had a knee arthroscopy after the procedure on April 18, 2012. The patient reported a 10 out of 10 on the pain scale, so Bilancone followed a post-operation order sheet which included 0.2 milligrams of Dilaudid which could be given again every five minutes up to four milligrams of the drug. Dilaudid is an opioid used to treat severe pain.

Over a 26 minute span from 9:02 to 9:28 a.m., she gave the patient four milligrams of Dilaudid, the order stated. She also gave the patient one 5 milligram percocet 14 minutes later at 9:42 a.m. after which the patient said her pain went down to a 3 of 10, the order stated. The patient was discharged from the facility 18 minutes later at 10 a.m.

That same afternoon, the woman’s husband called 911 when she wouldn’t wake up while she was sleeping and the woman was taken to MUSC and died five days later. The cause of death was ruled an accident and due to probable mixed drug toxicity with fentanyl, promethazine, hydromorphone, oxycodone and midazolam, according to the order, which cited a forensic autopsy of the woman.

The case was reviewed more than two years later in October 2014. The review found that Bilancione gave higher doses of Dilaudid than the doctor’s order specified and gave the patient a percocet without an order. She was still employed by Charleston Surgery Center for another six months after the woman’s death until she resigned and took a position with another provider, the order stated.

Bilancone claimed in the order she had been a licensed nurse in South Carolina for 11 years at the time of the woman’s death and panicked when the patient told her that the pain level was at a 10 of 10. Bilancone also stated the woman appeared fine when she was discharged and was able to dress herself and have a conversation before leaving the center.

Along with the $500 fine, Bilancone was publicly reprimanded, must complete two nursing board approved education courses in the next six months and must appear before the state nursing board again if she wants her license reinstated. The board initially heard the case in May 2018.

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