Former Iowa City oral surgeon sentenced to 2 years for taking fentanyl meant for patients

DAVENPORT — A former Iowa City oral surgeon was sentenced Wednesday to two years in federal prison for withdrawing fentanyl from vials meant for patients and concealing his crime by adding saline solution to refill the vials.

Andrew Charles Hartwig, 55, formerly with Oral Surgery and Dental Implant Center in Iowa City and Mount Pleasant, pleaded in October to one count of tampering with consumer products in U.S. District Court. Hartwig admitted during a plea hearing to diverting opioids from the office used in dental surgery procedures for his own personal use.

Hartwig would remove fentanyl from single or multidose vials and replace the drug with saline, which caused the fentanyl to be diluted, according to the plea agreement. He would cut the outer plastic wrapper of the box containing the drug vials, swab the plastic tops of the vial with alcohol and withdraw the drug with a sterile needle by puncturing the top of the sealed tubes.

He would replace what he withdrew with a saline solution, rub the plastic cap with an instrument to conceal the needle puncture and close the outer plastic wrapper of the box with clear tape, the plea stated.

On July 3, 2019, the nursing staff first reported their concerns about possible tampering with the outer packaging of the vials to another surgeon in the practice, according to court documents. The box appeared to have opened and resealed with clear tape.

Another nurse told a different surgeon of a similar issue at another office of the practice. The surgeons changed the security code on the drug safe, disabled key access and installed a security camera in one of the practice’s offices, according to the plea.

On July 9, 2019, the fentanyl vials in the opened packaging were more closely examined and pinholes were visible on the vial caps. The next day, all vials were quarantined and the offices stopped administering fentanyl. The surgeons then informed Hartwig about what they found.

That night, Hartwig self-reported by email to the Iowa Dental Board and others that he had “skimmed” fentanyl from the office to deal with chronic lower back pain. He admitted to diluting the fentanyl so the patients still would receive some from the tampered vials.

According to court documents, the FDA lab analysis found 299 vials of fentanyl were tampered with at the dental office. However, prosecutors said the office never received any patient complaints regarding insufficient sedation, pain control or infection.

The analysis also found that of the 14 randomly selected punctured vials, six were contaminated with bacteria and “all 14 had diluted fentanyl levels of varying degrees,” according to court documents. The percentage of fentanyl in those ranged from 5.04 percent to 99.8 percent.

Hartwig admitted he had been diverting fentanyl to himself from at least April through July 2019. During the investigation in August 2019, one of the surgeons said a nurse had reported another issue with boxes of fentanyl being taped about a year and half before.

According to Iowa Dental Board documents, a settlement agreement was signed by Hartwig on Dec. 3, 2019, which suspended his license indefinitely for unprofessional or unethical conduct based on the allegations.

His dental license and general anesthesia permit both expired Aug. 31, 2020, according to the board documents.

Hartwig also agreed to pay a civil penalty of $10,000, the settlement stated. The money goes to the state’s general fund.

In December 2021, a surgeon notified investigators that an electrician had been installing a light in the ceiling of a one of the dentist’s restrooms and found six vials in a box hidden in the ceiling. Five boxes were labeled as fentanyl and one was another pain killer with expiration dates as 2015 and 2016, according to court documents.

Those vials were tested by the FDA and found to have punctures on the surfaces of the stopper and the fentanyl was “heavily” diluted.

Prosecutors, in a sentencing document, asked the court for a prison sentence because Hartwig’s actions violated patients’ trust and “damaged the integrity of the health care system.”

“The defendant jeopardized the livelihood of his colleagues through his criminal acts,” Assistant U.S. Attorney Amy Jennings said in the document. She recommended 30 months in prison.

U.S. District Judge Rebecca Goodgame Ebinger sentenced Hartwig to 24 months in prison. She also ordered him to pay a $50,000 fine and be on two years of supervised release after serving his prison term.

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