ABSTRACT: This study examines a real-world case of prolonged purchasing-card (P-Card) misuse at NovaCure Pharmaceuticals, Inc. (pseudonym), a multinational pharmaceutical organization, to illustrate how weak governance, fragmented oversight, and the normalization of risk allowed fraud to continue undetected for five years. Using a qualitative case study approach, the analysis integrates fraud theory, systems thinking, organizational culture, change management, and the COSO Enterprise Risk Management (ERM) framework to explain how the misconduct evolved and persisted. The findings show that unclear accountability, limited monitoring, and weak ethical reinforcement created an environment where opportunity, rationalization, and concealment thrived. The misconduct was eventually uncovered through a whistleblower report supported by advanced analytics. The study translates these insights into practical, evidence-based recommendations for strengthening procurement governance, improving early fraud detection, and rebuilding ethical culture. Overall, the findings offer clear and actionable guidance for leaders in highly regulated industries who are seeking to improve transparency, strengthen compliance, and build long-term organizational resilience and trust. KEYWORDS: Procurement Fraud, Enterprise Risk Management, Governance Failure, Organizational Culture, Internal Controls