Missing CII, Please help!!

[rxpharmdqd]

I have never been in this kind of situation before. Please help! My partner (Pharmacy manager) is on vacation and I found his note on narcotic log book on the same page we have problem. He wrote I lost 1 pill of morphine so I should fill out DEA 106 form. It looks like he decided that I lost it because a pharmacist who dispensed after I dispensed found 1 pill was missing.

I have OCD so I count 4 times for CII! I know I counted right. I emailed district manager about it already. District manager has not replied yet. Do you think it was too small issue to bother district manager?

I am little uncomfortable with this store at this point. I recently trasfered to this store little over a month ago. There were already some missing pills before I got there (I think it was like 8 percocet pills for unknown reason). Pharmacy manager told me floaters always mess up his CII inventories, and he filled out DEA 106 forms for that already.

For lost CII pills, does pharmacy manager or whoever found out about fill it out OR a person pharmacy manager decide who lost it fill it out? I really really really don't know how that happened! I back counted as well.

I am thinking about too much going crazy. I NEVER had this kind of problem missing CII from my fill(1 pill missing from my fill according to pharmacy manager) before for being a pharmacist 4 years so far.

Is it right that I was asked to fill out DEA 106 form since I am the one supposly lost it? According to the situation, what could possibly had happen to miss 1 pill in your opinion?

Please help! I underlined my main questions and any opinion would be greatly appreciated!

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[willrocks]

If you are confident that you did not lose the pill and are being accused of it, you have every right to defend yourself to your DM and should not second guess it.

 

[nnguyenc]

seriously?...one pill?

 

[rxpharmdqd]

seriously?...one pill?

Missin 1 pill of CII is not that serious in other places???

As far as I know, missing 1 pill is still big deal for CII. You have to print out dispensing report to see why it's missing. If everything still matches and 1 pill is still missing, then you have to fill out a report with plan of action or something like that to explain why it happened, what is your plan not to happen again...etc. I am not 100% sure how to fill it and how a form looks like exactly since I have never been in this kind of situation before.

 

[nnguyenc]

Missin 1 pill of CII is not that serious in other places???

As far as I know, missing 1 pill is still big deal for CII. You have to print out dispensing report to see why it's missing. If everything still matches and 1 pill is still missing, then you have to fill out a report with plan of action or something like that to explain why it happened, what is your plan not to happen again...etc. I am not 100% sure how to fill it and how a form looks like exactly since I have never been in this kind of situation before.

yeah...you're right...you might lose your job

 

[rxpharmdqd]

yeah...you're right...you might lose your job

please don't get me wrong. I am just wondering why your are annoyed.. I was just asking a question if it was not a big deal missing CII in other places and explained how I was told to do if I find any discrepency of on hand quantity for even 1 pill. Both pharmacy managers in my previous and current location makes a big deal with CII. Call other pharmacists if any pills are missing even on their day off as well.

I don't know.. Pharmacy manager makes such a big deal out of it and talks about it alot whenever there is missing pill. I am upset that I was picked on while I know I did it right.
I became a member here to have some advice and get info from other people..to learn more things. Please let me know what part of my post annoyed you.

 

[CK8652]

I was at an independent and did an inventory count of our CII's. We were 1-4 pills short on a couple of CII's, and it didn't seem like a big deal at all.

Also, do you guys count stock after each dispensing? Just because you were the last person to fill before the pill went missing doesn't mean it was you that did it.

I highly doubt you'll get fired or reprimanded for 1 pill, I mean jesus, one pill?

 

[slimcutt]

Dude. Calm down. I don't think 1 tab is even a significant enough loss to report. Also, It's not uncommon for unopened stock bottles to have 99 tabs or 101 tabs.

 

[rxpharmdqd]

Dude. Calm down. I don't think 1 tab is even a significant enough loss to report. Also, It's not uncommon for unopened stock bottles to have 99 tabs or 101 tabs.

That could explain the situation as well! Now I think about it, I have seen unopened clonazepam(not cii but still control drug) bottle came in with 99 pills before!

 

[DRxUGS]

One time when we were short 1 pill of morphine, I looked through the cotton we keep from the drug bottles (we use it for mail-outs) and that's where it was. Maybe it got caught in the cotton when it was pulled out and the person didn't notice.

 

[Doctor M]

seriously, 1 pill is not worth it...someone may have miscounted or someone dropped a pill...whatever...but filling out form 106 for 1 pill? Are they gonna investigate that 1 pill? let it go...100 pills, yes, 1 pill...chill

 

[type b pharmD]

if people are handing you paperwork, it is not likely that they are assigning blame or holding it against you. they probably just dont want to fill it out themselves.

however I know of one chain where the pharmacy manager is required by corporate regs to be the one to deal with all dea forms. if your chain is like this, then you pretty much wont have to worry about anything.

Worst case scenario is you have to do a bit of paperwork.

Try to stay calm about this. I know it is tough with OCD to let some small thing nag at your mind until it breaks, but this time, in this circumstance, an accident probably occurred and there is literally nothing you can do about it. I dont think it reflects poorly on your 4 year record of great performance, and 99% of managers will realize that it was not your fault.

This is one of those times to roll with the punches and give up trying to do anything about it, and instead just keep up your hard work and enthusiasm



Happened to us occasionally in the hospital. Numbers were usually fudged somewhere though. Be thankful that nothing illegal is going on.

I have lost controlleds myself, however, i have always found them in the cotton or on the floor underneath the countertop

 

[confettiflyer]

1 pill one time? no big deal...we didn't bother getting a DM involved until 100 pills went missing once (our unofficial threshold was.... 7-10 pills missing).

1 pill every week for a month? hmm...that's worth looking into.

every store will be different IMO, but i wouldn't sweat over the OP's situation. Fill out whatever forms you need to do but defend yourself along the way.

 

[Old Timer]

The only time you would report the loss of one pill is of someone witnessed the theft of the single pill by a fellow employee. Otherwise:

DEA has become aware of instances in which registrants have used a DEA Form 106 to document or explain minor inventory discrepancies, thereby "balancing the books.'' DEA wishes to stress that the DEA Form 106 should be used only to document thefts or significant losses of controlled substances. Minor inventory discrepancies, not attributable to theft, should not be reported to DEA or recorded on a DEA Form 106. Rather, registrants should make appropriate notations of minor inventory discrepancies in their records, indicating the amount of variance between the physical count and the amount accounted for through records. Such discrepancies need not be reported to DEA if they are not significant or actual losses. If a registrant is unsure of the significance of a loss after considering the factors described below, the registrant should file the report. Any continuing pattern of loss of seemingly insignificant quantities should always be considered significant.

http://www.deadiversion.usdoj.gov/fed_regs/rules/2003/fr0708.htm

In other words, if the PIC of the store in question discovered the loss HE is duty bound to report it to the DEA IMMEDIATELY AFTER it is discovered. By failing to do so and leaving it for you he has violated DEA regulations. In other words unless he is accusing you of theft, tell him to take his 106 form and shove it significantly far enough up his a** to locate any functioning brain cells.

 

[renetto]

Damn you Old Timer, you beat me to it.



But he's right, tell the DM you aren't doing **** because you are a DEA compliant employee.

 

[rxpharmdqd]

Thank you so very much everyone for your reply! So sweet of you to spend time on giving me information I didn't know much about and your opinion really means alot to me. I really appreciate it.

I feel so much better now...!

 

[genesis09]

For all you know, one of the tablets were broken. The tech discarded the tablet and didn't tell you.

 

[MountainPharmD]

Lots of whining lately about not being nice and professional blah, blah, blah. You want to know one of the biggest problems this forum has? Its right here in this thread. ******* students posting answers to questions they know nothing about. A Pharmacist starts a thread asking a very good question. A question that can only be answered by other Pharmacists with experience or a PIC. In typical SDN fashion there are 6 pharmacy students and someone listed as pre-pharmacy posting comments.

To all of you whinny little students out there crying about how "unprofessional" this forum is here a nickels worth of free advice. Stop throwing your 2 cents into places where it doesn't belong. There are many experienced Pharmacists who frequent this forum. A Pharmacist should answer a question posted by another Pharmacist concerning the practice of Pharmacy. Now one cares what a damn student or pre-pharmacy person thinks about a pharmacy practice question. Get out of school, pass your boards, get a job and then you can start posting answers to questions concerning the practice of pharmacy.

Until then read, learn and be quiet. If you feel the need to post there are plenty of what year in school should I get pregnant, or what bothers you most in school, or which year is the hardest threads to keep you occupied.

 

[Sparda29]

Lots of whining lately about not being nice and professional blah, blah, blah. You want to know one of the biggest problems this forum has? Its right here in this thread. ******* students posting answers to questions they know nothing about. A Pharmacist starts a thread asking a very good question. A question that can only be answered by other Pharmacists with experience or a PIC. In typical SDN fashion there are 6 pharmacy students and someone listed as pre-pharmacy posting comments.

To all of you whinny little students out there crying about how "unprofessional" this forum is here a nickels worth of free advice. Stop throwing your 2 cents into places where it doesn't belong. There are many experienced Pharmacists who frequent this forum. A Pharmacist should answer a question posted by another Pharmacist concerning the practice of Pharmacy. Now one cares what a damn student or pre-pharmacy person thinks about a pharmacy practice question. Get out of school, pass your boards, get a job and then you can start posting answers to questions concerning the practice of pharmacy.

Until then read, learn and be quiet. If you feel the need to post there are plenty of what year in school should I get pregnant, or what bothers you most in school, or which year is the hardest threads to keep you occupied.

 

[The Sonoran]

One lost pill is no big deal, I wouldn't be too concerned about getting in trouble or getting blamed about it. One missing pill happens everywhere.

To put things in perspective, I once worked at a chain where after doing the count on night, we were missing 200 methadone 10 mg. I thought that this was a SERIOUS problem. When then pharmacy manager came in the next morning, I explained the shortage. He gave me an apathetic look, shrugged his shoulders, and said "no big deal, it's less than 5% of the inventory", or something to that effect. THAT'S how many narcs we filled in that store.

Nothing ever happened and no one got in trouble for it. Compared to that situation, you've got nothing to worry about.

BTW - I quit working at that store lickety-split.

 

[CK8652]

Lots of whining lately about not being nice and professional blah, blah, blah. You want to know one of the biggest problems this forum has? Its right here in this thread. ******* students posting answers to questions they know nothing about. A Pharmacist starts a thread asking a very good question. A question that can only be answered by other Pharmacists with experience or a PIC. In typical SDN fashion there are 6 pharmacy students and someone listed as pre-pharmacy posting comments.

To all of you whinny little students out there crying about how "unprofessional" this forum is here a nickels worth of free advice. Stop throwing your 2 cents into places where it doesn't belong. There are many experienced Pharmacists who frequent this forum. A Pharmacist should answer a question posted by another Pharmacist concerning the practice of Pharmacy. Now one cares what a damn student or pre-pharmacy person thinks about a pharmacy practice question. Get out of school, pass your boards, get a job and then you can start posting answers to questions concerning the practice of pharmacy.

Until then read, learn and be quiet. If you feel the need to post there are plenty of what year in school should I get pregnant, or what bothers you most in school, or which year is the hardest threads to keep you occupied.

And you contributed to this thread, how? I'll defend my post as the "pre-pharm" you mentioned above. Obviously the poster was hysterical, so while I am not an authority on the matter (nor did I pretend to be), I thought I'd offer some comfort in saying I've observed a similar situation and it was not a big deal. My post was within a short period after the OP posted the question, so I decided to throw my **** for brains 2 cents in order to maybe calm him down a little. So while I believe I may have added a slight degree of relief to the OP, your post did jack **** besides portraying you as someone who probably has too much fun with farm animals.

Yours truly,
Pre-pharmer CK8652

 

[Old Timer]

And you contributed to this thread, how? I'll defend my post as the "pre-pharm" you mentioned above. Obviously the poster was hysterical, so while I am not an authority on the matter (nor did I pretend to be), I thought I'd offer some comfort in saying I've observed a similar situation and it was not a big deal. My post was within a short period after the OP posted the question, so I decided to throw my **** for brains 2 cents in order to maybe calm him down a little. So while I believe I may have added a slight degree of relief to the OP, your post did jack **** besides portraying you as someone who probably has too much fun with farm animals.

Yours truly,
Pre-pharmer CK8652

Touch ... well said......

 

[MountainPharmD]

Touch ... well said......

Ha ha no surprises there...what do they say? Birds of a feather flock together....Figures one worthless poster would side with another.

Pre-pharmer CK8652, I find your comment does nothing but support my earlier statement. But hey, thats SDN today. The uniformed, inexperienced and blow hards making all the comments.

 

[Old Timer]

Ha ha no surprises there...what do they say? Birds of a feather flock together....Figures one worthless poster would side with another.

Pre-pharmer CK8652, I find your comment does nothing but support my earlier statement. But hey, thats SDN today. The uniformed, inexperienced and blow hards making all the comments.

Listen, people are entitled to their opinion. I agree with you that those who are not in practice lack a certain amount of perspective, but calling them useless is really a little overboard. His post was an observation of what he saw happen at a pharmacy.

I probably have 2-3 times the experience that you have, does that make my opinion 2-3 times more valuable than yours? It just means I have more perspective. So lighten up dude. This is still the Student, Doctor Network and students can post and we have to realize sometimes they are going so say things that are uninformed and it's up to us to educate them.

I don't mind calling out the stupid and mindless post. But, if a student posts something about an experience he or she had, it doesn't make it invalid because they are not a pharmacist.

OK, Deputy Downer. Take a chill pill

 

[MountainPharmD]

Listen, people are entitled to their opinion. I agree with you that those who are not in practice lack a certain amount of perspective, but calling them useless is really a little overboard. His post was an observation of what he saw happen at a pharmacy.

I did not specifically call his post useless. I was pointing out how ridiculous it is that we get all these students commenting on things they have no clue about. How many times have you seen this response "I am not a pharmacist or a pharmacy student and have never worked in a pharmacy but..." to pharmacy practice or pharmacy work place issues and questions?

You are absolute correct this is the Student Doctor network. If you re-read my post I was suggesting that students can learn a lot form the experienced pharmacist on this forum and perhaps listening more and commenting less especially on things they know nothing about would be beneficial.

I probably have 2-3 times the experience that you have, does that make my opinion 2-3 times more valuable than yours? .

No, it does not make your opinion more valuable than mine. However, on cetain issues of pharmacy practice 2-3 times more experience does count for more. Everyone's opinion is valued weather a student or a pharmacist. The OP wasn't asking everyone's opinion. He specifially was asking questions about a Pharmacist and Pharmacy Managers responsibilities concerning missing C-II's.

OK, Deputy Downer. Take a chill pill

Thats Deputy Debbie Downer to you thanks.

 

[litetigre]

Ha ha no surprises there...what do they say? Birds of a feather flock together....Figures one worthless poster would side with another.

Pre-pharmer CK8652, I find your comment does nothing but support my earlier statement. But hey, thats SDN today. The uniformed, inexperienced and blow hards making all the comments.

with yr arrogant attitude...I can only sum up in one word... As*h*le..
Have a good day.

 

[Rebel78]

"no big deal, it's less than 5% of the inventory"

Not that I agree, but that's the threshold that's generally used in my experience.

As far as a missing pill, a 106 should not be filled out, it's not required. I have counted sealed bottles of CII meds that were shorted or over a tab a few times. Don't sweat it. The DEA isn't out to punish people for honest mistakes, and I get the feeling it was along those lines. Either a bottle shorted a tab, fell on the floor, caught in the cotton, etc.

Working for a PIC that wanted a 106 filled out for a missing pill would concern me much more than the pill.

 

[CK8652]

Ha ha no surprises there...what do they say? Birds of a feather flock together....Figures one worthless poster would side with another.

Pre-pharmer CK8652, I find your comment does nothing but support my earlier statement. But hey, thats SDN today. The uniformed, inexperienced and blow hards making all the comments.

If I would have looked up the info that Old Timer posted, it would have been less valuable coming from a "pre-pharm"? Yeah I'm sure you have more experience than me and if you're opinion was half way on subject then it might actually make a difference. So maybe if you contribute something pharmacy or billy-goat blowing related we can actually listen to what you say instead of facepalm.

 

[CK8652]

I did not specifically call his post useless.

I would think an almighty pharmacist, such as yourself, would have basic skills of inference and "reading between the lines". By your logic, calling you the stinky thing that **** comes out of and possibly your birth location, I'm not calling you an a......?

 

[type b pharmD]

I would think an almighty pharmacist, such as yourself, would have basic skills of inference and "reading between the lines". By your logic, calling you the stinky thing that **** comes out of and possibly your birth location, I'm not calling you an a......?

I have found mountain pharmD is not going to change anytime soon (although I hope he will for the sake of his health) - i try to limit it to only one or two posts per quarter. So basically, it's not worth getting worked up over. Then you've only allowed his negativity to spread and influence others lives.

 

[MountainPharmD]

with yr arrogant attitude...I can only sum up in one word... As*h*le..
Have a good day.

I would think an almighty pharmacist, such as yourself, would have basic skills of inference and "reading between the lines". By your logic, calling you the stinky thing that **** comes out of and possibly your birth location, I'm not calling you an a......?

I have found mountain pharmD is not going to change anytime soon (although I hope he will for the sake of his health) - i try to limit it to only one or two posts per quarter. So basically, it's not worth getting worked up over. Then you've only allowed his negativity to spread and influence others lives.

Thank you all for further driving home my point. I rest my case and will now go bang my head against a brick wall which is far more productive than this.

 

[type b pharmD]

Thank you all for further driving home my point. I rest my case and will now go bang my head against a brick wall which is far more productive than this.

Why do you choose to stay in a situation that you hate and then complain about it instead of looking for a job in order to become a happier person?

 

[renetto]

Thank you all for further driving home my point. I rest my case and will now go bang my head against a brick wall which is far more productive than this.

Ladies and gentlemen, this user is the perfect example of what is wrong with our profession. He practically bends over in front of retail pharmacies, yells "F ME UNTIL I BLEED!", and complains to everyone that his ass is bleeding.

 

[CK8652]

Thank you all for further driving home my point. I rest my case and will now go bang my head against a brick wall which is far more productive than this.

What is this elusive point you keep hiding behind? We haven't been on topic since since billy wouldn't put out and you got mad and decided to go off on your irate tangent.

 

[CK8652]

Ladies and gentlemen, this user is the perfect example of what is wrong with our profession. He practically bends over in front of retail pharmacies, yells "F ME UNTIL I BLEED!", and complains to everyone that his ass is bleeding.

It's pretty interesting that you say that. I'm sure tons of people are in the same situation but don't put themselves out there like Mountain does. I actually admire the fact that he's put his bad situation out there and is open to talking about it. I prefer to give people **** when they make ******ed comments and believe it or not you can learn a lot from a disgruntled worker about a profession. It's hard to put the parts of your life out there that people can scrutinize and make fun of, I think that itself is deserving of a little respect.

 

[Doctor M]

Ladies and gentlemen, this user is the perfect example of what is wrong with our profession. He practically bends over in front of retail pharmacies, yells "F ME UNTIL I BLEED!", and complains to everyone that his ass is bleeding.

Thats a bit uncalled for...Graphic to say the least...Anyway, I was in the business of retail chain for 5 years when i decided to jump ship...Its not an easy decision and needs lots of planning...you are going from 6 figures to god knows what...But you do it without any fear and reap the consequences later...Or you can try to get into hospital pharmacy....

 

[clachan3]

Dude. Calm down. I don't think 1 tab is even a significant enough loss to report. Also, It's not uncommon for unopened stock bottles to have 99 tabs or 101 tabs.

It happened to me before when at another store 2 years ago. I opened a bottle that had 99 tablets. I counted it many times, still 99. I asked an older pharmacist, he said that was possible, and he wasn't worried about it

 

[Apteka]

The only time you would report the loss of one pill is of someone witnessed the theft of the single pill by a fellow employee. Otherwise:


http://www.deadiversion.usdoj.gov/fed_regs/rules/2003/fr0708.htm

In other words, if the PIC of the store in question discovered the loss HE is duty bound to report it to the DEA IMMEDIATELY AFTER it is discovered. By failing to do so and leaving it for you he has violated DEA regulations. In other words unless he is accusing you of theft, tell him to take his 106 form and shove it significantly far enough up his a** to locate any functioning brain cells.

HURRAY for OldTimer. THANK YOU for being (one of the very few) useful posts to this thread. I've wondered myself how the 106 form is used, and your response gives the exact answer. thank you again.

 

[ancienbon]

My store was flagged a couple weeks a ago for missing 200 generic percocet 7.5/325. Could not believe it because ever since CVS has kept perpetual inventory electronic , we never missed anything. Pic had to fill a report.There is no record of the loss as inventory record is right on target.

 

[doublehh03]

My store was flagged a couple weeks a ago for missing 200 generic percocet 7.5/325. Could not believe it because ever since CVS has kept perpetual inventory electronic , we never missed anything. Pic had to fill a report.There is no record of the loss as inventory record is right on target.

Sometimes the electronic system has glitches (3 glitches for me since we started electronic record keeping). Double check to make sure. Don't file a report unless you know for sure a loss occurred.

 

[ancienbon]

Sometimes the electronic system has glitches (3 glitches for me since we started electronic record keeping). Double check to make sure. Don't file a report unless you know for sure a loss occurred.

I would not file the report if it were me. But lp made the pic file it.

 

[Old Timer]

My store was flagged a couple weeks a ago for missing 200 generic percocet 7.5/325. Could not believe it because ever since CVS has kept perpetual inventory electronic , we never missed anything. Pic had to fill a report.There is no record of the loss as inventory record is right on target.

who flagged you?

 

[ancienbon]

who flagged you?

Corporate.pic received a phone call from lp

 

[doublehh03]

Corporate.pic received a phone call from lp

Did your PIC investigate it a little bit first?

Twice the computer glitch said I have 2 C2s that I never included in the initial load so it said I was off by like a bottle when I did the state count. And one it forgot to subtract after a fill so I was over by like 120.

I know other stores had the same issues.

 

[ancienbon]

Did your PIC investigate it a little bit first?

Twice the computer glitch said I have 2 C2s that I never included in the initial load so it said I was off by like a bottle when I did the state count. And one it forgot to subtract after a fill so I was over by like 120.

I know other stores had the same issues.

Never had an issue with electronic record . Supervisor said it may not be true loss.

 

[zelman]

Never had an issue with electronic record . Supervisor said it may not be true loss.

I had an issue when I rebilled a prescription that was filled before the electronic inventory went live. You do anything like that?

 

[Sine Cura]

If you had an NDC with an erroneous non zero count in rxconnect that wasn't accounted for in the initial load, that might cause a phantom discrepancy. The initial load only accounted for existing inventory and never asked people to confirm zero qty on hand

 

[sosoo]

our store lost hundreds of c2's and they were reported, but neither the board nor dea came to bother about it. the supervisor was like oh.. ok...... so no worries if the lost is not your own, or if small quantity is lost. anyone who discover the discrepancy is responsible for reporting it in a timely manner. if they don't report it, make sure u report it. and in your report, make sure u include their name and that they were the one who discovered the discrepancy.

 

[ancienbon]

our store lost hundreds of c2's and they were reported, but neither the board nor dea came to bother about it. the supervisor was like oh.. ok...... so no worries if the lost is not your own, or if small quantity is lost. anyone who discover the discrepancy is responsible for reporting it in a timely manner. if they don't report it, make sure u report it. and in your report, make sure u include their name and that they were the one who discovered the discrepancy.

The pic freaked out . He still cant sleep at night over it.
I told him nothing to worry. Everyrhing will be fine

 

[doublehh03]

I was at an independent and did an inventory count of our CII's. We were 1-4 pills short on a couple of CII's, and it didn't seem like a big deal at all.

Also, do you guys count stock after each dispensing? Just because you were the last person to fill before the pill went missing doesn't mean it was you that did it.

I highly doubt you'll get fired or reprimanded for 1 pill, I mean jesus, one pill?

It depends. If it's one pill of a fast mover like norco, then sure you can let it slide b/c most likely it was a dispensing error. But if it happens repeatedly, then you have to look into it.

However, it it's a non fast mover like methadone or something like that, I would definitely investigate a little further.