As the demand for black market narcotics grows, so has the level of hospital security around drugs.
Safeguards at Chattanooga hospitals include restricted rooms, heavy surveillance, pill counts performed each shift and dispensing machines that track every drug withdrawal.
In spite of all this, 26-year-old Ryan Epperson was still able to repeatedly foil security for weeks at all three of Chattanooga's major downtown hospitals to steal painkillers like Demerol, fentanyl and morphine, according to an affidavit.
"The hospitals may have had every security measure in place, but they may not have anticipated someone so brazen," said Tennessee Board of Pharmacy President Reggie Dillard.
"Once he developed the scenario that worked at one hospital, he probably found it would work at any hospital. Nothing is bulletproof."
Epperson -- a corrections officer at the Hamilton County Jail who also ran for the county's register of deeds post last year -- faces his first court appearance on Tuesday on multiple drug, vandalism, trespassing and impersonation charges.
He was apprehended by Erlanger security guards at the hospital Wednesday, wearing scrubs and posing as a surgeon. He then led investigators to large quantities of drugs in his car and home.
Chattanooga Police say the arrest was the culmination of an ongoing investigation into drug thefts at Erlanger hospital, Parkridge Medical Center and CHI Memorial hospital. In multiples cases, Epperson physically broke into computerized drug dispensaries called Pyxis MedStation machines, police say.
Officials at all three hospitals say they have strict rules about employee IDs, and tight measures to prevent medicine theft. State and federal regulations have recently tightened standards on both fronts.
"There are multiple levels of security," said Memorial spokeswoman Lisa McCluskey. "You have to have badge access to get into the medication room, and then bar-coding to access the medication. [Theft] isn't an easy thing to do."
Especially, officials add, since hospitals bustle with 24/7 activity.
But such buffers may not have anticipated an impostor like Epperson, who police say had enough familiarity with Parkridge that he knew when a radiology lab would be unoccupied. At Erlanger, he parked in a physician lot and entered a surgery wing, leaving his jacket and some burglary tools in a stairwell, police say.
Dillard suspects such savvy indicates Epperson knew the hospitals' systems through personal experience or through a health professional he knows.
A man reached at Epperson's phone number Friday who identified himself as a family friend said he could not speak about the case.
Epperson's Facebook page says he is in a pre-pharmacy program at Chattanooga State Community College. College officials confirmed Epperson was a student there last fall and this past spring, but said he was not enrolled in the school's pharmacy tech program, meaning he would not have been learning in clinical settings.
Epperson told arresting officers he was "feeding an addiction," his affidavit states. He has been suspended from the Hamilton County Sheriff's Office with pay pending his court appearance.
Drug thieves at hospitals are typically not impostors, but medical workers, officials say. That is one reason why drug security has become more sophisticated.
Erlanger spokeswoman Pat Charles said a complete inventory of all narcotics is performed at designated times at the hospital, counted by a nurse from the oncoming shift and witnessed by an off-going shift nurse.
Incidents of inaccurate or missing drugs "are brought to the attention of the nurse manager," Charles said.
Those flags are usually thrown up by the Pyxis MedStation. The machine, essentially a digital medicine cabinet, requires specific log-in information to open the compartments where drugs are stored.
"When a medicine is removed, the machine shows when and who removed it," said Dillard.
But even a Pyxis MedStation could not account for the smash-and-grabs at Erlanger and Parkridge. At Memorial, McCluskey said no Pixys machines were broken into, but some drugs were stolen in recent months from hospital "crash carts," which hold emergency drugs.
Tennessee Health Department spokesman Woody McMillin said dispensing machines at hospitals must meet security standards set out both by the state and the Joint Commission, an independent organization that accredits and certifies health care organizations.
Hospitals must also report stolen controlled substances to the U.S. Drug Enforcement Agency, McMillion said. Brad Bylerly, the resident agent-in-charge of the DEA's Chattanooga office, said his office did not participate in Epperson's particular case.
Parkridge officials said after the theft they are taking steps to "evaluate the security" of their drug dispensing procedures. Dillard said the other hospitals will likely do the same.
"They will beef up their security," he said. "And they'll probably rethink who is allowed near those machines."
Contact staff writer Kate Belz at firstname.lastname@example.org or 423-757-6673.