A little background first:
When the process kicks off it checks a mailbox to see if there are any e-mails that match a key phrase in the subject line. If the subject line equals the key phrase, a series of tickets are created and the e-maill is deleted at the end of the process.
The issue was that the ticket creation process was taking too long and timing out against the Altiris ASDK, In turn never deleting the e-mail. So the next time the process runs the same thing was happening creating the multiple tickets. To resolve this, I adjusted the process to authenticate against the ASDK further down stream and removed serval Pause Execution components in the process so the ticket creation would fit into the "time allowed" by the ASDK.