Hypothetical Legal Question

[Sparda29]

Pharmacist denies refills to a psych patient. Tells the patient to get the doctor to call in the refills. Doctor is on vacation, patient never gets refills and goes off the meds. Patient goes on a rampage and kills 100+ people before being killed by police.

Is the pharmacist legally responsible at all?

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[inverness2012]

I am not so sure. You can fill an emergency supply for maintenance medications.

 

[RxMonkey]

This would probobly never make it to court, but since we're talkin in hypotheticals...

Depending on how your State handles emergency supplies, a case might be made. I know in FL, you are allowed to provide a 72 hour supply of a non schedule II if you feel that going without the med will cause undue mental discomfort. One could argue that if standard judgement leads to this conclusion, a pharmacist would be obligated to meet the request. Then it becomes a question as to whether the refusal to fill is directly responsible to said rampage. I would imagine that this would be hard to do in a court of law.

 

[Digsbe]

I would hope not.

 

[KidPharmD]

Not every state addresses the situation, but I know that some specifically say that the pharmacist cannot be held legally responsible for refusing an "emergency" supply. Maybe... California?

That being said, I would hope most of us would serve the patient the best way we legally could in this case.

 

[josh6718]

Pharmacist denies refills to a psych patient. Tells the patient to get the doctor to call in the refills. Doctor is on vacation, patient never gets refills and goes off the meds. Patient goes on a rampage and kills 100+ people before being killed by police.

Is the pharmacist legally responsible at all?

Of course- clearly no individual in today’s society is ever responsible for his/her own actions. If not the pharmacist for denying an unauthorized refill, then it’s the social media for depicting violence on TV, the lawmakers for not having stricter gun control laws….

On a serious note, a lot comes down to the relationship you have with the patient, the physician, and/or what the circumstances were.

When was the prescription last filled, and for what day supply? (I've had people ask to 'loan' a few days worth for their Keppra RX they last filled nearly 9 months ago.)

Is it a routine medication they have been taking for quite some time at your store? (I don't care if it was filled at Walgreen's, Rite Aid... if you have never had it filled with my pharmacy, I won't authorize you an emergency refill for a script I've never had)

Is this the first time the patient had run out, or is it a recurring issue month-to-month?

Was an effort made to contact any covering physician?

Setting aside the ‘legal’ aspect of things, I suppose there would be an ethical side to consider as well. Say instead for example, it were a diabetic patient that came to pharmacy counter with their meter reading 40 mg/dL afraid they had used too much insulin and passed out unresponsive. Would it be ‘legal’ to administer a glucagon injection prior to a prescription, no. But ethical to do so?

 

[npage148]

There's always the ER for refills.

 

[Dred Pirate]

There's always the ER for refills.

I work in an ER - seriously do not send your patients here - we are Emergency department - all MD's have an oncall service for things like this.

 

[BenJammin]

Why would you be in trouble for not breaking the law? Outside of emergency refills per state law, I don't see why it's your fault that you refused to practice medicine and authorize a new refill.

 

[njac]

I work in an ER - seriously do not send your patients here - we are Emergency department - all MD's have an oncall service for things like this.

It was a joke.

 

[Gombrich12]

Why would the pharmacist be liable for not playing doctor? As for an emergency supply situation, I could see there being some sort of liability if it was reasonably foreseeable the patient was going to harm themselves or someone else.

 

[npage148]

I work in an ER - seriously do not send your patients here - we are Emergency department - all MD's have an oncall service for things like this.

Well, according to the patient being out of htn meds for 4 days is an emergency. Am I to doubt them? What do you expect me to tell the patient when they don't want to "be bothered" having their doctor paged or go to some bootleg scum doctor with no answering service. "If you don't want your doctor pages you can go sit in the ER for 5 hours for 10 hctz, have fun!"

 

[Dred Pirate]

Well, according to the patient being out of htn meds for 4 days is an emergency. Am I to doubt them? What do you expect me to tell the patient when they don't want to "be bothered" having their doctor paged or go to some bootleg scum doctor with no answering service. "If you don't want your doctor pages you can go sit in the ER for 5 hours for 10 hctz, have fun!"

in your position - yes, you can tell them to page their Doc or to go to the ED - but damn, those type of people plugging up my ED annoy me because they are usually the same ones who complain they have to wait for 5 hours while we treat a ICH or trauma patient

 

[Carboxide]

in your position - yes, you can tell them to page their Doc or to go to the ED - but damn, those type of people plugging up my ED annoy me because they are usually the same ones who complain they have to wait for 5 hours while we treat a ICH or trauma patient

Yeah, not ideal. I usually recommend urgent care instead to these patients because the higher-acuity patients don't go there. Patients are also usually seen in the order they arrive.