Olson, hands on the cart. >> what did you just say to me? This is the last shift this labor and delivery nurse will ever work. She doesn't know it yet, but 50 women in labor paid the price for what she did. And federal agents have been waiting for this moment for months. The version you've been running over the last 3 months across 50 L&D patients How dare you accuse me of something I would never even >> Christina. Every one of them came back saline straight from the You are out of your mind. Within 72 hours, federal agents from the DEA Office of Diversion Control and the FDA's Office of Criminal Investigations would be sitting across from Kiana Renee Whitmore in a small windowless interview room on the third floor of Allen Memorial Hospital in Waterloo, Iowa with a folder containing 53 patient charts, 81 Pyxis cabinet sign-out logs, and a forensic chemistry report confirming that the fentanyl vials she had signed out for women in active labor contained nothing but sterile saline. Three federal counts, 1 year and 1 day in federal prison, and at least 50 women who screamed through contractions, C-section recoveries, and late pregnancy emergencies while the medication charted into their veins was quite literally salt water. Before we go any further, I want to ask you something. If you were lying in a hospital bed about to give birth, would you ever in a million years think to question the nurse pushing medication into your IV? Drop your honest answer in the comments. And if you're new to this channel, go ahead and subscribe. We cover [snorts] the cases the local news buries on page nine every single week. Kiana Renee Whitmore was born in March of 1992 at Covenant Medical Center in Waterloo, Iowa, 3 miles down the same Logan Avenue corridor where she would, 3 decades later, walk into Allen Memorial Hospital wearing a navy nursing badge and a stethoscope. Her mother, Tenisha Whitmore, was a certified nursing assistant at a long-term care facility in Cedar Falls. Her father, Marcus Whitmore, worked the night shift at the John Deere Engine Works on Ridgeway Avenue for 28 years >> [snorts] >> until a back injury forced him onto partial disability in 2009. The Whitmores were what neighbors in the East 4th Street neighborhood called church folk. New Hope Missionary Baptist on Sundays, Wednesday night Bible study. Tenisha kept a framed photo above the kitchen sink of Kiana at age 5, missing her two front teeth, holding a paper certificate from the children's choir. By the time Kiana was 8, she was already telling people she wanted to be a nurse like her mama, except [snorts] she wanted to be the kind that wore the badge and gave the medicine, not the kind that lifted patients in and out of bed all day. She graduated from East High School in Waterloo in May of 2010 with a 3.4 GPA and a small academic scholarship from the Black Hawk County Community Foundation. The yearbook caption under her senior photo read, "Quote, future labor and delivery nurse, end quote." She had written it herself. She enrolled at Hawkeye Community College the following August, took her prerequisites, and transferred into the nursing program at Allen College, the small private college affiliated with the very hospital that would one day employ her and one day prosecute her. Clinical evaluations from her senior practicum at Allen Memorial in 2014 described her as {quote} calm under pressure, intuitive with patients in crisis, demonstrates a natural feel for high acuity environments. {end quote} Another evaluator wrote that she had {quote} the temperament of a labor nurse. Patient, steady, unshakable when the room got loud. {end quote} She passed the NCLEX RN on her first attempt in December of 2014. Starting salary at Allen Memorial as a new grad RN on the medical surgical floor. $26.81 per hour. She married Donovan Pierce, a regional sales rep for a medical device company out of Des Moines, in September of 2016 at a small outdoor ceremony at George Wythe State Park. Their daughter, Amara, was born at Allen Memorial in November of 2018. Delivered, by chance, by the very labor and delivery unit Kiana had been working in as a staff nurse since the summer of 2017. Co-workers brought her casseroles. The unit secretary, a woman named Pamela Eastman, who had been at Allen Memorial since 1991, hung a hand-lettered sign on Kiana's locker that read Welcome to motherhood, Nurse Whitmore. By 2020, Kiana had earned a reputation on the L&D floor as the nurse the charge would assign to the hardest patients. The teenage mothers. The high-risk preeclamptic cases. The women whose first language was not English and who arrived terrified and alone. She spoke softly. She held hands. She knew when to call the doctor and when to ride out a contraction. Her annual performance review for fiscal year 2020 rated her as, {quote} exceeds expectations, {end quote} in five of six categories. The sixth, professional development, was rated as, {quote} meets expectations, {end quote} with a comment that Keanna, {quote} should consider pursuing her certification in inpatient obstetric nursing within the next 24 months, {end quote}. She was making $41.12 per hour. She had a daughter she adored. She had a husband who traveled 4 days a week, but came home with takeout from Newton's Paradise Cafe every Friday night. She was, by every external measure, exactly the woman the 8-year-old in the choir robe had wanted to become. Then, in the spring of 2021, Keanna herniated a disc at the L4-L5 level lifting a 260-lb postpartum patient who had stood up too quickly and started to faint. The injury was documented in the Allen Memorial employee health file. She was prescribed a short course of oral hydrocodone by an orthopedic specialist in Cedar Falls. The prescription was for 2 weeks. She refilled it once, legitimately, in May of 2021. After that, the orthopedic clinic stopped writing for opioids and switched her to gabapentin, physical therapy, and a referral to a pain management specialist she never called. The back pain did not stop. The 12-hour shifts on her feet, the lifting, the leaning over delivery beds, all of it kept the herniation angry. By the late summer of 2021, according to a statement Keanna would later give to federal investigators. She had started taking small amounts of the IV fentanyl she was administering to her patients. At first, she said, it was a fingertip taste off the syringe before she pushed the dose. Then it was a quarter milliliter held back. Then a half. Then it was the entire vial replaced in the Pixis cabinet with a vial she had refilled herself using a sterile saline flush from the supply room. To understand exactly how Keana Whitmore was able to divert fentanyl from at least 50 laboring and postpartum women without anyone catching her for nearly 3 months, you have to understand how a modern hospital controls its narcotics. And you have to understand where in that system the gaps live. Allen Memorial Hospital is a 234 bed acute care facility on Logan Avenue in Waterloo, Iowa. Part of the Unity Point Health Network. The labor and delivery unit occupies the fourth floor of the South Tower. It runs three nursing shifts a day across 12 labor rooms, four operating suites for C-sections, and a 20-bed postpartum wing. On a busy weekend, the unit delivers 10 to 15 babies in a 24-hour period. Controlled substances on the L&D floor, fentanyl, morphine, hydromorphone, midazolam, are housed in an automated dispensing cabinet called a Pixis Med Station. The cabinet looks like a small refrigerator with a touchscreen on top and a series of drawers and bins underneath. To remove a controlled substance, a nurse has to log in using her hospital ID badge, scan her fingerprint on a biometric reader, select the patient from a drop-down, enter the medication and dose, and [snorts] witness the cabinet open the specific bin where the drug lives. Every transaction is logged, time-stamped to the second, the nurse's name, the patient's medical record number, the exact vial removed, identified by lot number and expiration date. In theory, the system is closed. In theory, every microgram of fentanyl that leaves the Pyxis cabinet is accounted for, either pushed into a patient's IV with a co-signing nurse watching, or wasted into a designated waste container with a co-signing nurse watching that, too. In practice, the system has one enormous, persistent weakness, and every diversion case in American hospital nursing exploits the same weakness in some version every single time. The weakness is this: the Pyxis cabinet tracks what comes out. It does not test what goes in. When a 1 ml vial of fentanyl, 50 micrograms per ml, is removed from the cabinet and signed for, the cabinet has no way to know whether the contents of that vial are still fentanyl, or whether they have been replaced with sterile saline, sterile water, or any other clear, colorless liquid of approximately the same viscosity. The labels on fentanyl vials are small, factory-printed, and easy to peel and reapply with a steady hand in a quiet break room. The vials themselves are simple glass with a rubber stopper. A 25-gauge needle and a 1 cc tuberculin syringe can withdraw the contents of a vial and replace them with saline in under 30 seconds, leaving the vial visually indistinguishable from a sealed one if the rubber stopper is reseated cleanly. At Allen Memorial, like at most hospitals across the country, the pharmacy department audited Pyxis transactions in two ways. First, it ran a daily reconciliation that compared the number of vials signed out to the number documented as administered or wasted. As long as those numbers matched, the system flagged nothing. Second, it ran a monthly statistical report comparing each nurse's controlled substance usage to her peers, looking for outliers who signed out significantly more narcotics than the unit average. Keanna Whitmore knew both of those audits existed. She had been a staff nurse at Allen Memorial for nearly 7 years. She knew exactly how to stay under the threshold. She knew the trick was not to sign out more fentanyl than her co-workers. The trick was to make sure every milligram she signed out was documented as administered to a real patient with a real charted indication. That way, the volume looked normal. The waste paperwork looked normal. The co-signing nurse, who only ever watched her draw the vial, never tested what came out of it, signed the electronic record, and walked away. The patients felt the difference. The patients almost always feel the difference. But the patients in this case were women in active labor. Women whose pain was expected to be severe, whose pain was expected to be variable, whose pain was, by every nursing school definition, subjective and hard to measure. When a woman in transition stage labor screams through a fentanyl push and her pain score does not drop, the assumption, almost every time, is that she is one of the unlucky ones for whom the medication is not working as well as it should. Not that the medication never entered her body in the first place. The first documented diversion in the federal indictment is dated January 11th, 2022. A 24-year-old patient, identified in the charging documents as KJ, in active labor with her second child, was charted by Keanna as having received 50 micrograms of intravenous fentanyl at 3:47 a.m. The patient's pain score before the push was documented as nine out of 10. The patient's pain score at the 15-minute reassessment was documented as five out of 10. The patient herself, interviewed 16 months later by a DEA special agent named Holly Castellanos, would tell a different story. She remembered the nurse, quote, "The black nurse with the kind voice, the one with the little gold studs in her ears." End quote. Pushing something into her IV port from a syringe. She remembered watching the plunger go down. She remembered waiting for the wave of relief she had felt during her first labor 2 years earlier at a different hospital. She remembered the wave never coming. She remembered asking, twice, if the medication had been given. She remembered the nurse smiling and saying, "It's in, sweetheart. Give it a minute." The documentation showed the dose. The witness, a second L&D nurse named Bethany Coleman, had been in the room and had signed the electronic co-signature on the Pixis withdrawal at 3:46 a.m. Bethany had watched Kianna draw the contents of the vial into a syringe. Bethany had not watched the syringe go into the patient. Bethany had been called to a fetal heart rate deceleration in the next room and had stepped out before the actual push. By the time she returned, Kianna was standing at the foot of the bed charting on the computer on wheels telling the patient she was doing great. This pattern repeated with subtle variations 53 times over the next 11 weeks. The method, reconstructed later from Pixis logs, MAR documentation, surveillance video, and Kianna's own statement to investigators, worked like this. At the start of a shift, Kianna would identify two or three patients on her assignment who were either in active labor or recovering from C-section. Patients with standing orders for breakthrough fentanyl or hydromorphone. She would wait until the appropriate moment in the patient's care, withdraw the controlled substance from the Pixis cabinet with a co-signing nurse as witness, and walk [snorts] it back to the patient's room. Somewhere between the cabinet and the patient. Sometimes in the medication room, sometimes in the staff bathroom on the fourth floor, sometimes in the small unmonitored alcove behind the nutrition station. She would draw the contents of the vial into a clean tuberculin syringe, transfer that liquid into a labeled empty vial she carried in a zippered pocket of her scrub top, and refill the original vial sterile saline from a 10 ml flush she had pre-broken. She would reseat the rubber stopper, wipe the vial with an alcohol swab to remove fingerprints and any moisture, and carry the saline-filled vial into the patient's room. She would scan the vial barcode at the bedside, draw the contents into a fresh syringe in front of the patient, and push the entire contents of the saline-filled vial into the patient's IV. She would chart the administration. She would chart the patient's pain reassessment 15 minutes later. Sometimes truthfully, sometimes generously. Sometimes with a number that the patient herself had never said out loud. The fentanyl she had withdrawn earlier, the actual narcotic, she carried home in a small black makeup case at the end of her shift, inside the inner pocket of her North Face jacket. She kept it in the back of a Tupperware container in the basement freezer, behind a bag of frozen broccoli her husband had bought 8 months earlier and never touched. The escalation was slow and then fast. The first 2 weeks of January, she diverted from one or two patients per shift. By early February, she was diverting from three to four. By the first week of March, the federal indictment would later allege, she was diverting from every single labor and post C-section patient on her assignment who had an active fentanyl order. Sometimes five or six women in a single 12-hour shift. Her co-workers noticed nothing, or rather, they noticed the things you notice and dismiss. Pamela Eastman, the unit secretary, mentioned to the charge nurse one morning in February that Kiana had been looking tired lately and had lost a little weight. The charge nurse, Christina Voorhees, replied that Kiana had a 4-year-old at home and a husband who traveled, and that was probably all it was. A patient care tech named Marquis Bell noticed that Kiana sometimes disappeared into the staff bathroom for 10 or 12 minutes at a stretch. But Marquis was 22 and had been on the unit for 3 months and did not feel like it was his place to mention it to anyone. Another nurse, Bethany Coleman, the same Bethany who had co-signed the very first diverted dose, noticed once in late February that a fentanyl vial Kiana had pulled looked, {quote} "weirdly clean", {end quote}. But Kiana had laughed and said the alcohol swabs were stronger than usual and Bethany had let it go. The patients were the only people in the building who knew something was wrong. And the patients had no language for what they knew. They had no chart access, no Pyxis training, no way to articulate that the syringe pushed into their arm at 3:47 a.m. on a January morning had contained nothing but salt water. They had only the experience of unrelieved pain. Pain they had been told in advance would be managed. One of those patients was a 31-year-old woman named Adrienne Mosley. Adrienne arrived at Allen Memorial at 11:14 p.m. On February 26th, 2022, in active labor with her third child. She had requested an epidural. The anesthesiology team was tied up with an emergency C-section on the next room. The plan, while she waited, was IV fentanyl to take the edge off her contractions. Keanna Whitmore was her nurse. Adrian, who had delivered her first two children at the same hospital with the same medication, would later testify that this third labor was, {quote} the worst pain of my entire life, including the labor where I had no medication at all because I went too fast for an epidural, {end quote}. She remembered begging for more. She remembered being told, gently, that she had just had a dose 10 minutes ago. She remembered her mother, who was in the room, asking the nurse if everything was okay, and the nurse smiling and saying, "This baby is just impatient." Adrian's son, Elijah, was born at 2:09 a.m. on February 27th. He weighed 8 lb 4 oz. He was healthy. Adrian, 16 months later, would sit in the gallery of the federal courthouse in Cedar Rapids and listen to a US attorney read the lot number of the vial that had been signed out for her labor, and tell the court that the contents of that vial, recovered from a sealed waste bag at Allen Memorial 3 days after the arrest, had been confirmed by an FDA laboratory in Kansas City to contain 0.9% sodium chloride. Sterile saline, nothing else. The unraveling began on March 22nd, 2022, with a phone call from a complaint nobody expected to take seriously. A 28-year-old postpartum patient named Whitney Reyes, who had delivered by emergency C-section on March 19th, had called the Allen Memorial patient relations Line 3 days after her discharge. She was not calling to complain. She was calling, in her own words, to ask a question. She wanted to know whether it was normal for the fentanyl she had been given in recovery to, quote, "do absolutely nothing," end quote. She had delivered her first child at the same hospital in 2019, and the medication had, quote, "made her float," end quote. This time, she said, she had felt no difference. She wanted to know if maybe she had built up a tolerance, or if maybe they had given her a lower dose because she was breastfeeding. The Patient Relations Coordinator, a woman named Loretta Ginsberg, took the complaint, logged it as a low-priority quality-of-care inquiry, and forwarded it to the nurse manager of labor and delivery, a registered nurse named Yvonne Whitcomb. Yvonne, who had been a nurse for 31 years and had run the L&D unit at Allen Memorial since 2014, did something she did not normally do with this kind of complaint. She pulled the patient's MAR. She pulled the Pyxis log. She looked at the timestamps. And she noticed something. The nurse who had administered every dose of fentanyl during Whitney Raye's recovery, six doses over 48 hours, was the same nurse who had been assigned to three other patients in the previous 2 weeks who had filed informal pain control complaints with the postpartum charge nurse. The same name, three times. Plus, a fourth complaint that had never been formally filed, but that Yvonne now remembered Pamela Eastman mentioning in passing Kiana Whitmore. Yvonne walked downstairs to the pharmacy department on the afternoon of March 23rd and asked the controlled substance pharmacist, a man named Anthony Loeffler, to run a focused audit on every controlled substance transaction Kiana had signed for in the previous 90 days. Anthony ran the report that evening. He brought the printout to Yvonne the next morning, March 24th, with a yellow sticky note on the top page that said "Quote, this is not normal, end quote." The report showed that Kiana had signed out 1,140 micrograms of fentanyl, 18 milligrams of hydromorphone, and 42 milligrams of morphine in the previous 90 days. A controlled substance volume that was, on its own, within the upper end of normal for a busy L&D nurse. What was not normal was the pattern. Kiana's withdrawals clustered tightly around shift change. They occurred almost exclusively with the same two or three co-signing nurses, all of whom were known to be easily distracted on a busy unit. And her associated patients had documented pain scores that, on review, were inconsistent. Patients reporting nine out of 10 pain at one assessment and three out of 10 15 minutes later without any other intervention being charted in between. On March 25th, Anthony Loeffler quietly pulled six unopened fentanyl vials from the L&D Pyxis cabinet. Vials that had been stocked the previous evening but not yet dispensed. He sent them to an independent reference laboratory in Kansas City for content verification. The vials had been on the unit for less than 18 hours. They had passed through Kianna's shift the previous night. The results came back to Allen Memorial's pharmacy director at 4:14 p.m. on Monday, March 28th. Of the six vials submitted, four contained the correct concentration of fentanyl citrate. Two contained no detectable fentanyl. Both of the tampered vials contained 0.9% sodium chloride, sterile saline. Both had been stocked into the Pyxis cabinet the previous evening by an automated restocking system, and both had been signed out, withdrawn, and replaced in the cabinet during Kianna Whitmore's shift in transactions cosigned by other nurses. The Allen Memorial Chief Nursing Officer made two phone calls that evening. The first was to the hospital's general counsel. The second was to the Iowa Board of Nursing. The next morning, March 29th, a federal task force agent from the DEA Office of Diversion Control in Des Moines, working in coordination with a special agent from the FDA Office of Criminal Investigations, was sitting in the Allen Memorial Chief Nursing Officer's office, drinking bad coffee out of a Styrofoam cup, and listening to Yvonne Whitcomb explain exactly how a labor and delivery nurse had spent the previous 3 months pushing salt water into the IV lines of women in labor. The investigation that followed was, by federal diversion case standards, fast. DEA Special Agent Holly Castellanos and FDA OCI Special Agent David Rommel set up a temporary office in a converted conference room on the second floor of Allen Memorial Hospital. Over the next 6 days, they pulled every Pyxis transaction Kiana Whitmore had ever signed in her career at Allen Memorial. Going back to her hire date in May of 2015. They cross-referenced those transactions with the MAR documentation in the Epic electronic health record. They cross-referenced both of those with the patient complaints database. They cross-referenced all three with the hospital's video surveillance. The surveillance footage was decisive. The hallway camera outside the L&D medication room had recorded from a fixed angle every entry and exit from that room for the previous 90 days. The medication room itself had no internal camera. Federal HIPAA considerations made internal cameras a complicated issue at most hospitals. But the hallway camera captured who went in, when, and for how long. The pattern on video was unmistakable. Kiana entered the medication room an average of 14 times per shift. Other nurses on the same unit entered an average of 6. Kiana's visits to the medication room lasted between 40 seconds and 2 minutes and 41 seconds. The average visit by her co-workers lasted 22 seconds. Agents pulled the contents of every unopened fentanyl vial that had been in the L&D Pyxis cabinet during the final 6 weeks of the diversion period. Of the 83 vials submitted to the FDA laboratory in Kansas City, 51 were confirmed to contain only sterile saline. Every one of those 51 vials had been stocked, withdrawn, or co-signed during a shift Kiana Whitmore had worked. The scope of the harm was, by the end of the first week of April 2022, fully visible. 53 patients, 47 of them women in active labor or post C-section recovery, six of them late-term pregnant patients receiving fentanyl for non-labor pain, kidney [snorts] stones, complicated placental conditions, surgical procedures. The youngest victim was 19. The oldest was 42. Three of the women had been military veterans. 11 had been first-time mothers. Two had delivered stillborn babies and had received the diverted medication while saying goodbye to their children. The agents interviewed Kiana's coworkers one by one in the conference room. Bethany Coleman cried. Christina Vorhees, the charge nurse, said she had trusted Kiana with her own daughter's delivery 18 months earlier and now did not know what to do with that information. Pamela Eastman, the unit secretary, said she had known something was wrong for weeks and had told herself it was nothing. The agents executed a search warrant on Kiana Whitmore's residence, a two-story house on Greenhill Road in Cedar Falls on the morning of April 6th, 2022. In the basement freezer, inside a Tupperware container behind a bag of frozen broccoli, they recovered 14 1-ml glass vials, each one labeled and lot numbered consistent with Allen Memorial Pyxis stock. Each one containing what FDA testing would later confirm was the original undiluted fentanyl citrate. Total volume recovered, 700 micrograms of pharmaceutical grade fentanyl. Street value, irrelevant. Medical value, enough to manage the labor of 14 women. In Kiana's nightstand drawer, agents recovered a handwritten notebook with the days of the week noted across the top of each page and small tally marks underneath. The earliest dated entry was January 9th, 2022, two days before the first documented diversion. The agents did not know at the time of the search what the tally marks counted. Kiana would later tell them in her sentencing allocution that the marks were the number of patients she had pushed saline into that day. She had counted them, she said, because she had wanted to know what number she would be answering for when the day came that she had to answer. The arrest was scheduled for the morning of April 7th, 2022. Special Agent Castellanos and Special Agent Rommel, accompanied by two uniformed officers from the Waterloo Police Department and one Iowa Board of Nursing Investigator, made contact with Kiana Whitmore at 8:41 a.m. in the staff break room on the fourth floor of Allen Memorial Hospital. She was sitting at the round table by the window with a paper cup of black coffee and a half-eaten granola bar. She was wearing navy scrubs. Her ID badge was clipped to her left chest pocket. Her stethoscope was around her neck. The conversation, captured on Agent Castellanos's body-worn camera, lasted 7 minutes and 12 seconds. Agent Castellanos, Kiana Whitmore? Kiana, yes, ma'am. Agent Castellanos. I'm Special Agent Castellanos with the Drug Enforcement Administration. This is Special Agent Rommel with the FDA. Do you know why we're here? Keana, after a pause of approximately 3 seconds. I think so. Agent Castellanos. Can you tell me what you think this is about? Keana. I'd rather you tell me, ma'am. Agent Castellanos. We're here regarding the diversion of controlled substances from the labor and delivery Pyxis cabinet at this hospital between January and March of this year. Specifically, the diversion of fentanyl that was charted as administered to your patients, but was in fact replaced with sterile saline. Do you understand what I just said? Keana, very quietly. Yes, ma'am. I understand. Agent Castellanos. I want to read you your rights before we go any further. You have the right to remain silent. Anything you say can and will be used against you in a court of law. You have the right to an attorney. If you cannot afford an attorney, one will be appointed for you. Do you understand these rights as I have read them to you? Keana. Yes. Agent Castellanos. With those rights in mind, are you willing to speak with us about what happened? Keana. After a longer pause. I am. I want to. I've wanted to for a long time. What followed in the recorded interview that took place after Keana was transported to the federal building in Cedar Rapids was not the denial pattern agents had expected. It was not the lawyer up shut down. It was something rarer in cases of this kind. Kiana Whitmore admitted everything. She named the date of her first diversion. She named the patients she could remember. She described the saline replacement technique step-by-step. She told the agents where the recovered fentanyl was in her basement freezer and which container it was in. She told them about the herniated disc, the orthopedic appointments that had stopped writing for opioids, the first fingertip taste, the slow walk into something she had known the entire time was destroying her. She asked twice whether her patients had been physically harmed. The agents told her, truthfully, that no patient had suffered permanent physical injury, that the harm had been the pain itself, the unrelieved pain, the betrayal of the medication chart. Kiana put her head in her hands and cried for nearly 4 minutes. The recording captured it. The transcript notes it as, {quote} subject weeping audibly, {end quote}. The last words she spoke on the recording before asking for her lawyer to be called were directed at no one in the room. She said, {quote} I keep thinking about Adrian, the one in February. She was screaming. I just want her to know I heard her. I heard every single one of them, {end quote}. Kiana Renee Whitmore was indicted by a federal grand jury in the Northern District of Iowa on June 15th, 2022, on three counts. Acquiring a controlled substance by misrepresentation, fraud, deception, and subterfuge in violation of 21 USC section 843A3. Tampering with a consumer product in violation of 18 U.S.C. section 1365A. And adulteration of a drug with intent to defraud or mislead in violation of 21 U.S.C. section 331I and 333A. Two. Her defense attorney was a federal public defender out of the Cedar Rapids office named Christopher Borland. Borland filed no motions to suppress. He filed no motions to dismiss. He filed a single motion in October of 2022 requesting that Kiana be allowed to remain on pre-trial release in the custody of her husband and mother pending resolution of the case. The motion was granted. Kiana surrendered her Iowa nursing license to the Board of Nursing voluntarily on August 4th, 2022. Three weeks before the board moved to revoke it. She pleaded guilty to all three counts on October 19th, 2023. The plea hearing in front of U.S. District Judge Linda R. Reade lasted 41 minutes. Kiana spoke clearly. She answered every question. When the judge asked her whether she understood that by pleading guilty she was giving up the right to a trial, she said, "Quote, I do, your honor, and I want to. These women deserve to hear me say it. End quote." The sentencing hearing was held on March 27th, 2024 at the federal courthouse in Cedar Rapids. 11 of Kiana's victims attended. Six of them gave victim impact statements. Adrian Mosley spoke last. She held her son Elijah, by then 25 months old, on her hip. She told the court that she had spent six months after Elijah's birth convinced that something was wrong with her. Convinced that her pain tolerance had collapsed, that her body had failed her, that maybe she had postpartum depression that was manifesting as physical suffering. She told the court that learning the truth, that the medication had never been in her body, had been, {quote} "a kind of grief I did not know existed." The grief of finding out that the worst night of your life was worse on purpose, {end quote}. When it was Kiana's turn to speak, she stood at the defense table in a plain gray cardigan and black slacks. She did not look at her attorney. She turned instead toward the gallery, where the victims were seated. She said, {quote} "I cannot give any of you back what I took. I took the medicine, and I took the trust, and I took the night you were supposed to remember as the night you met your baby, and turned it into the night you suffered. I will spend every day for the rest of my life trying to understand the woman who did that, because she does not look like me anymore, {end quote}. Judge Reed addressed Kiana before pronouncing sentence. She said, {quote} "Ms. Whitmore, the court has read every letter, every impact statement, and every page of the presentence report. The court accepts that your remorse is genuine, and that your cooperation has been complete. The court also accepts that you were a respected nurse, a mother, a wife, and a person of demonstrated competence and compassion before this conduct. None of that erases what you did. What you did was steal pain relief from women in labor. What you did was push salt water into the veins of mothers who trusted you. And then look them in the eye and lie about it. The court is sentencing you to a term of imprisonment that recognizes both the seriousness of that conduct and the credit you have earned for accepting responsibility. End quote. The sentence was 1 year and 1 day in federal prison. 3 years of supervised release. Restitution in the amount of 112,640 to be distributed among the identified victims. Permanent surrender of her nursing license. A prohibition on any future employment in a setting with access to controlled substances. The 1 year and 1 day sentence was deliberate. Federal sentences of exactly 1 year are not eligible for good time credit. Sentences of 1 year and 1 day are. Judge Reed had built 54 days of potential good time into the sentence, ensuring Keonna would serve approximately 10 and 1/2 months at FPC Greenville. A minimum security federal prison camp for women in Greenville, Illinois. She self-surrendered on May 14th, 2024. Her daughter Amara, then 5 years old, did not understand where her mother was going. Donovan Pierce filed for legal separation 11 weeks later. The house on Green Hill Road went on the market in September of 2024 for $249,000 and sold within 9 days. Keonna Whitmore is scheduled for release in late March of 2025. She will be 33 years old. She will never work as a nurse again. The Iowa Board of Nursing entered her revocation as permanent and non-reinstatable in May of 2024. Allen Memorial Hospital implemented in the months following the arrest a new policy requiring random forensic testing of controlled substance vials at six-week intervals across every clinical unit. The new policy, adopted across the entire UnityPoint Health Network in January of 2024, is known internally as the Whitmore protocol. No one calls it that out loud. The protocol has, in the 18 months since its implementation, identified two additional cases of suspected diversion at unrelated UnityPoint facilities. Both cases were caught within 10 days of the first diverted dose. 53 women in Waterloo, Iowa, did not get that protocol. They got Keanna Whitmore. And they got, instead of pain relief, the slow recognition, sometimes that night, sometimes years later, that the worst pain of their lives had been a pain someone else had chosen, deliberately, not to take away. This case was hard to sit with. But the case on the right side of your screen right now is the one I genuinely could not stop thinking about for a week after I finished writing it. Go ahead and click it.