Paralegal seeking info on life behind the counter

[jtellerelsberg]

Hello Pharmacists, I'm a paralegal with a client facing Board of Pharmacy professional misconduct charges. I'd like to ask advice about an aspect of pharmacy work at issue. On some occasions, our client would get home and realize that medications had rolled off the work table into their apron pockets. The client would flush them.

1. How common is it in your pharmacies, if at all, for tablets, etc., to roll/slide off the work counter into a pocket without the person noticing? I'm asking about everyone who works in the pharmacy, techs included.

2. Assuming this is something that does happen to others, how common would it be for the person to flush the meds when they got home and realized that they had them?

3. How acceptable in the profession would it be to dispose of discovered meds like that?

4. Is there any reason to think answers to the above depend on region/state in terms of practice culture?

Thanks in advance!
JT

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[JustFillIt]

If it is a controlled substance - I think, those of us who have lived through the nightmare behind the counter, would all agree that this is highly unlikely.

Especially if it’s a CII. CII’s are monitored by the by the pill count. The feeling that we get when we are even one off is intense. I try to put myself into the shoes of someone who drops an oxycodone and have it accidentally drop into my pocket without detection is just practically impossible.

On the other hand - if I was flying through counting 360 metformin and one fell off the counter I would not exactly loose time to find a single metformin. I suppose this could happen.

Everyone deserves legal representation. However I have a hard time believing controlled substance falling into the folds of my clothes.

You mentioned nothing about controlled substance, but I feel like I can guess where this is going.

However - something we have become more accustomed to is a situation where someone accidentally drops controlleds into their pockets and flushes them at home via esophageal disposal with a cardboard box of wine as the flushing agent..... this is possibly more common than the accidental taking home of controlled substance and dutifully flushing it down the toilet

 

[owlegrad]

Back when I used to wear my white lab coat from my school as an intern I did occasionally fine tablets in the pockets. I have no idea how common it is but whenever it happened I just threw them away.

Somehow tablets never end up in my scrub pockets even though they’re relatively in the same place.

 

[aqb]

It happens enough. I keep my lab coat at work so never really worry about taking a pill accidentally home unless it’s laundry time. If I find one there then I usually throw it away. The right answer would be to give it to inventory to properly return a “damaged” med.

For controls, the likelihood of it happening is less but I wouldn’t say it’s impossible.

 

[lord999]

Let us know how that defense goes. I'm pretty sure if you tried to pull that sort of excuse for a controlled substance, well, the client is going to find out.

 

[steveysmith54]

I once took counted money from the register put in my white coat and forgot to give it to the front end manager. I got into my car and drove 30 minutes. Then realized that I did that and drove back. Hope that helps

If you're a RPH and you find pills in your white coat, proly makes sense to return them.

 

[Momus]

I dumped it. It happened to me twice. I didn't care enough to return it. It can happen to any drug. Controlled or not.

Corporate/LP won't pat you down/check your coat unless you are a sus. There is more to the story.

 

[Deja]

i think it happened to me once or twice in all my years working in the pharmacy.... would never happen on a C2 since you should back count it... I have dropped c2 bottles on the floor by accident and had to search for like half hour for that one missing pill each time

I think I noticed the tablet in my pocket the next day when i went to work and I just "damaged" it out

 

[zelman]

If we’re talking about more than 1 tablet per month, your client is lying. It happens, but it is extremely rare with the typical amount of care being taken.

 

[WVUPharm2007]

I accidently had a pill roll into my pocket and make it back home exactly one time since I've been working in pharmacy starting in 2002. It's pretty rare.

 

[M0df]

You got me. It is always Concerta that rolls off the tray, onto the counter, and into my pocket. Must be that odd shape.

 

[mentos]

When I was at CVS we were supposed to check everyone's white coat pockets when they left. In 4 years I only found one pill in one, it was a pharmacist with one gabapentin cap and she was terrified that it rolled in her pocket.

 

[Pronounce Doxazosin]

10+ years of working and it only has happened once and it was not a controlled substance.

 

[Chrish]

Just get the drug test done for a suspect.. Done!

 

[Gombrich12]

If I discovered a controlled medication in my pocket at home I would bring it back the next day and put it in our controlled waste area. There is no way I would flush it down the toilet. You guys have to come up with a better strategy than that lol

 

[Rockinacoustic]

I really can't wait to read the legal proceeding where the defense presents a poll from SDN in their client's defense

 

[jtellerelsberg]

Thank you to one and all for the information and the laughs. You are a fun bunch--gallows humor maybe? I wish I could play fair and say more about the client's situation, but confidentiality has me bound and gagged.

 

[BenJammin]

I suppose that's possible. I've had a 2mL bottle of furosemide fall into my white coat that I didn't notice for over a year. But that's not something that regularly happened to me. Yes I threw it away.

 

[johnpharm01]

Thank you to one and all for the information and the laughs. You are a fun bunch--gallows humor maybe? I wish I could play fair and say more about the client's situation, but confidentiality has me bound and gagged.

Bound and gagged? We need to meet.

 

[JustFillIt]

Bound and gagged? We need to meet.

The paralegal dominatrix.. (whip crack sound effect)

If I ever get in trouble I know where I’m seeking legal advice

 

[mentos]

Thank you to one and all for the information and the laughs. You are a fun bunch--gallows humor maybe? I wish I could play fair and say more about the client's situation, but confidentiality has me bound and gagged.

BTW how is the job market for paralegals? We pharmacists are always looking for backup career plans when our jobs go away.

 

[jtellerelsberg]

BTW how is the job market for paralegals? We pharmacists are always looking for backup career plans when our jobs go away.

You got me. I'm a lawyer in waiting. I graduated from law school in June, passed the bar exam in October, and am waiting for the gears of justice to grind away until being officially admitted to practice. I'm working as a paralegal until then at a place I interned at during school, and where I'm all set to lawyer once I am official. It all worked out pretty much storybook. Small, well-established law firm within walking distance of home, so it really couldn't have worked out better.

And here I was thinking (before seeing all your all responses) that being a pharmacist would have been a good alternative. What is crimping the field? Mail order pharmacies?

 

[Rouelle]

As a pharmacist, if I heard this “tablets in the pocket” defense, I would assume your client is guilty of diverting drugs.

 

[mentos]

You got me. I'm a lawyer in waiting. I graduated from law school in June, passed the bar exam in October, and am waiting for the gears of justice to grind away until being officially admitted to practice. I'm working as a paralegal until then at a place I interned at during school, and where I'm all set to lawyer once I am official. It all worked out pretty much storybook. Small, well-established law firm within walking distance of home, so it really couldn't have worked out better.

And here I was thinking (before seeing all your all responses) that being a pharmacist would have been a good alternative. What is crimping the field? Mail order pharmacies?

Congrats! I thought law was even more saturated than pharmacy.

There's too many damn pharmacy schools. I think the number of schools has doubled in the past 20 years or so. There's 15,000 new pharmDs per year. They keep opening new schools, lowering standards and pumping out more students each year. There is no barrier to entry, anyone can become a pharmacist. These for-profit schools only care about taking students' $200k tuition.

Profit margins are razor thin in pharmacy due to the PBMs. So the chains have to fill thousands of prescriptions per day in order to profit. They cut as much overhead as possible (pharmacist and tech hours) so the working environment sucks.

Once Amazon pharmacy gets going, the chains are in trouble.

 

[Momus]

Lawyers can ambulance chase and make bank negotiating with insurance without going to court in 90% of cases. Most car accidents, trip and fall, dog bites net clients $10-300k+ Lawyers take 33.3%-40% of the payout.

They can set up a website and a small office to do this easy.

My roommate was basically living the easy life doing the above. He was a solo practitioner. You can literally be Saul Goodman and make a living as a lawyer. The same can't be said for unemployed rphs.

 

[iamapharmacist]

Lawyers can ambulance chase and make bank negotiating with insurance without going to court in 90% of cases. Most car accidents, trip and fall, dog bites net clients $10-300k+ Lawyers take 33.3%-40% of the payout.

They can set up a website and a small office to do this easy.

My roommate was basically living the easy life doing the above. He was a solo practitioner. You can literally be Saul Goodman and make a living as a lawyer. The same can't be said for unemployed rphs.

I need info on this. I've heard patent lawyers make alot of money too. Couldn't we potentially be a pharmaceutical patent lawyers?

 

[jtellerelsberg]

Congrats! I thought law was even more saturated than pharmacy.

[snip]

Overall, yeah, entry jobs in law are not easy to find unless you graduate from a tippy-top tier school. I got lucky with my particular internship leading to a job offer. Also, there's been a bit of a shift. Law jobs totally evaporated in 2008 when the economy tanked. Lower tier schools saw admission drop by half. I think some schools still aren't back up to their pre-2008 admission numbers. So a little more slack got into the system, but it still isn't any sure thing. Not to mention the sad souls who graduate from law school and then flunk the bar exam. Pass rates on the last two rounds of the exam (remember, exam is not identical in all states, though 35 states use a Uniform exam) ranged from 29% to 93%. Typical was around 75-80%. I think Covid and the exam work-arounds caused the few outliers way down at low pass rates. Some individual states are known to be uncommonly hard. California's pre-Covid pass rate has been around a measly 40%.

 

[jtellerelsberg]

I need info on this. I've heard patent lawyers make alot of money too. Couldn't we potentially be a pharmaceutical patent lawyers?

Lawyers can ambulance chase and make bank negotiating with insurance without going to court in 90% of cases. Most car accidents, trip and fall, dog bites net clients $10-300k+ Lawyers take 33.3%-40% of the payout.

They can set up a website and a small office to do this easy.

My roommate was basically living the easy life doing the above. He was a solo practitioner. You can literally be Saul Goodman and make a living as a lawyer. The same can't be said for unemployed rphs.

I'm in a more rural area. Plenty of lawyers around here struggle to clear $50K a year. Not enough ambulances to chase, I guess.

I wouldn't hire a lawyer fresh out of school in solo practice, not unless they had some sweet malpractice insurance. Law school, like most schools, only prepares you to learn on the job. You don't know squat about how to really do it until you are in the thick of it for a few years.

Patent law same as ambulance chasing--depends highly on your location, location, location. Lots of tech nearby? Plenty of patenting. Lots of working stiffs? Not so much.

 

[iamapharmacist]

I'm in a more rural area. Plenty of lawyers around here struggle to clear $50K a year. Not enough ambulances to chase, I guess.

I wouldn't hire a lawyer fresh out of school in solo practice, not unless they had some sweet malpractice insurance. Law school, like most schools, only prepares you to learn on the job. You don't know squat about how to really do it until you are in the thick of it for a few years.

Patent law same as ambulance chasing--depends highly on your location, location, location. Lots of tech nearby? Plenty of patenting. Lots of working stiffs? Not so much.

Interesting... I used to date this girl who was in law school at the time. We broke up because I found out that she was sleeping with one of the partners at the firm she was interning for. Her excuse when she got caught was that it would be so difficult to find a job unless she does something that extreme. I guess she was right. ha.

 

[PharFromNormal]

Thank you to one and all for the information and the laughs. You are a fun bunch--gallows humor maybe? I wish I could play fair and say more about the client's situation, but confidentiality has me bound and gagged.

Let me know if you need an sworn expert opinion, rates negotiable.

Typical pharmacists on here always providing trade secrets with no reimbursement...

 

[JustFillIt]

You got me. I'm a lawyer in waiting. I graduated from law school in June, passed the bar exam in October, and am waiting for the gears of justice to grind away until being officially admitted to practice. I'm working as a paralegal until then at a place I interned at during school, and where I'm all set to lawyer once I am official. It all worked out pretty much storybook. Small, well-established law firm within walking distance of home, so it really couldn't have worked out better.

And here I was thinking (before seeing all your all responses) that being a pharmacist would have been a good alternative. What is crimping the field? Mail order pharmacies?

Unfortunately, it is the nature of capitalism and greed woven into the fabric of health care that has ruined our profession. Working as little as possible for the most amount of money as possible does not mix well with the people that you depend on to prepare your medications.

I am as much of a supporter of capitalism as anyone - but it has clearly crushed high quality care in the pharmacy. It’s actually quite tragic

 

[M0df]

Very easy solution to this. Purchase a counting tray for $5-10, find some hctz pills in your grandma's cabinet, make sure it is 90 count but more the better. Put on your iphone to record and start counting with your white coat on. It might take 2 hours, it might take 6, but at some point you will get the take you want. It is possible but not probable especially with controls but who can argue against some video footage.

 

[jtellerelsberg]

Unfortunately, it is the nature of capitalism and greed woven into the fabric of health care that has ruined our profession. Working as little as possible for the most amount of money as possible does not mix well with the people that you depend on to prepare your medications.

I am as much of a supporter of capitalism as anyone - but it has clearly crushed high quality care in the pharmacy. It’s actually quite tragic

It's funny you say that. Lately I've been souring on capitalism. I'm not sure how much I would like the alternatives, but regardless this system has some real rot in its core.

 

[owlegrad]

It's funny you say that. Lately I've been souring on capitalism. I'm not sure how much I would like the alternatives, but regardless this system has some real rot in its core.

It's funny how time changes perspective. I remember when "freedom" seemed like the highest possible ideal one could ever hope to achieve to me. Now I am like...no thanks, I would rather have a sensible health care system. Once you set aside the indoctrination/propaganda it becomes pretty clear that a lot of stuff isn't exactly as simple as it once might have seemed.

 

[PharFromNormal]

It's funny how time changes perspective. I remember when "freedom" seemed like the highest possible ideal one could ever hope to achieve. Now I am like...no thanks, I would rather have a sensible health care system. Once you set aside the indoctrination/propaganda it becomes pretty clear that a lot of stuff isn't exactly as simple as it once might have seemed.

Once you set aside indoctrination/propaganda and understand individuals value different things differently, concepts of right/wrong, good/evil slip away.

While others may have a different opinion which i totally support them having. Our healthcare system is sensible once you apply the lens that generally every stakeholder needs to make more than they spend. If they want to spend more on bonuses, salaries, hours, growing, getting better tech, innovating new stuff, being compliant with new regs, etc. they need to make more to cover that cost.

If we want the cost of healthcare to decrease somewhere in the system those things need to be cut.