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As the US opioid epidemic continues to soar, physicians have been held criminally responsible for patients' overdose deaths. Now, it appears pharmacists are also criminally liable.
That's the opinion of pharmacy law experts who have watched the crisis unfold during the past decade.
Keith Yoshizuka, PharmD, JD, assistant dean for administration at the Touro University College of Pharmacy, Vallejo, California, notes, for example, that in 2015, a California physician, Lisa Tseng, MD, was convicted of second-degree murder for the overdose deaths of three patients. She was later sentenced to 30 years to life in prison.
"I don't think it's too large of a leap to expect a pharmacist to face criminal liability in the event that one or several of the patients overdose on medications that were filled by that pharmacy," Dr Yoshizuka told Medscape Medical News. "I can see the district attorney going after that pharmacy or the pharmacist for second-degree murder for, basically, recklessness — criminal negligence. But demonstrating that liability is still not clear-cut," he added.....
Lost Licenses, Businesses, Careers
Some pharmacists in California seem not to be heeding the call to mind their corresponding responsibility or do their best to address red flags. Or perhaps they are just too harried — or don't have the right tools ― to weed out inappropriate or illegal prescriptions.
But judging by the rising number of investigations and disciplinary actions relating to controlled substances by the California Pharmacy Board, more often, pharmacists are paying the price in lost licenses, pharmacies, and careers.
The board fired a significant warning shot in 2013 when, after a long investigation that uncovered multiple failures to address red flags, it revoked the licenses of Pacifica Pharmacy and its pharmacist, Thang Q. Tran. An appeal was rejected.
The decision was considered precedential because it contained "a significant legal or policy determination of general application that is likely to recur," according to the board.
Others, such as a long-time owner of a pharmacy in the Los Angeles area, believe the board is going too far. That pharmacist says he chose to give up his license — and sell his business ― rather than fight the board any further after an investigation that lasted a year. The inquiry started in 2011, when the family of a young man who died in 2010 of an opioid overdose initiated a complaint with the board.
The prescribing physician — who eventually became an addict — took his own life before a medical board investigation had been completed. The pharmacy board conducted an on-site inspection of the pharmacy in 2013, and in a subsequent report, said that between 2008 and 2010, the pharmacist had filled more than 4500 controlled substance prescriptions from the doctor but failed to call him to verify any of them. The report also cited numerous failures to address red flags, such as filling prescriptions too early and making unauthorized refills.
The pharmacy provided lengthy explanations to the board to justify its practices and hired an attorney to represent it and its pharmacists during conferences with the board and an administrative law judge.
The pharmacy also paid for a forensics expert, who provided the coroner's records that showed that although the young man died from oxycodone intoxication, he had numerous other substances in his system, including MDMA (ecstasy) and metabolites of marijuana.
The pharmacist lost the case and chose not to spend more money on an appeal. The store paid a $35,000 fine, and the pharmacist paid a $7500 fine. Liability insurance covered some of the attorney's fees, but nothing else.
In another recent case, two Santa Barbara pharmacists agreed to surrender their licenses and pay a $15,000 fee to cover the costs of a board investigation that determined that they had ignored red flags with patients who had received prescriptions for controlled substances from a local physician who had come to be known as the "Candyman." The doctor, Julio Diaz, MD, was convicted in 2015 of 79 felony counts and received 27 years in federal prison.
The California Board of Pharmacy expects pharmacists to "use their judgment," said Virginia Herold, executive officer of the board. For every prescription, "they are to evaluate and make sure it is the right drug for the patient," she told Medscape Medical News.
Errors are not unexpected, and "unless it is a grossly negligent error, we will cite and fine," she said.
More: Medscape: Medscape Access
Sent from my iPhone using SDN mobile app
That's the opinion of pharmacy law experts who have watched the crisis unfold during the past decade.
Keith Yoshizuka, PharmD, JD, assistant dean for administration at the Touro University College of Pharmacy, Vallejo, California, notes, for example, that in 2015, a California physician, Lisa Tseng, MD, was convicted of second-degree murder for the overdose deaths of three patients. She was later sentenced to 30 years to life in prison.
"I don't think it's too large of a leap to expect a pharmacist to face criminal liability in the event that one or several of the patients overdose on medications that were filled by that pharmacy," Dr Yoshizuka told Medscape Medical News. "I can see the district attorney going after that pharmacy or the pharmacist for second-degree murder for, basically, recklessness — criminal negligence. But demonstrating that liability is still not clear-cut," he added.....
Lost Licenses, Businesses, Careers
Some pharmacists in California seem not to be heeding the call to mind their corresponding responsibility or do their best to address red flags. Or perhaps they are just too harried — or don't have the right tools ― to weed out inappropriate or illegal prescriptions.
But judging by the rising number of investigations and disciplinary actions relating to controlled substances by the California Pharmacy Board, more often, pharmacists are paying the price in lost licenses, pharmacies, and careers.
The board fired a significant warning shot in 2013 when, after a long investigation that uncovered multiple failures to address red flags, it revoked the licenses of Pacifica Pharmacy and its pharmacist, Thang Q. Tran. An appeal was rejected.
The decision was considered precedential because it contained "a significant legal or policy determination of general application that is likely to recur," according to the board.
Others, such as a long-time owner of a pharmacy in the Los Angeles area, believe the board is going too far. That pharmacist says he chose to give up his license — and sell his business ― rather than fight the board any further after an investigation that lasted a year. The inquiry started in 2011, when the family of a young man who died in 2010 of an opioid overdose initiated a complaint with the board.
The prescribing physician — who eventually became an addict — took his own life before a medical board investigation had been completed. The pharmacy board conducted an on-site inspection of the pharmacy in 2013, and in a subsequent report, said that between 2008 and 2010, the pharmacist had filled more than 4500 controlled substance prescriptions from the doctor but failed to call him to verify any of them. The report also cited numerous failures to address red flags, such as filling prescriptions too early and making unauthorized refills.
The pharmacy provided lengthy explanations to the board to justify its practices and hired an attorney to represent it and its pharmacists during conferences with the board and an administrative law judge.
The pharmacy also paid for a forensics expert, who provided the coroner's records that showed that although the young man died from oxycodone intoxication, he had numerous other substances in his system, including MDMA (ecstasy) and metabolites of marijuana.
The pharmacist lost the case and chose not to spend more money on an appeal. The store paid a $35,000 fine, and the pharmacist paid a $7500 fine. Liability insurance covered some of the attorney's fees, but nothing else.
In another recent case, two Santa Barbara pharmacists agreed to surrender their licenses and pay a $15,000 fee to cover the costs of a board investigation that determined that they had ignored red flags with patients who had received prescriptions for controlled substances from a local physician who had come to be known as the "Candyman." The doctor, Julio Diaz, MD, was convicted in 2015 of 79 felony counts and received 27 years in federal prison.
The California Board of Pharmacy expects pharmacists to "use their judgment," said Virginia Herold, executive officer of the board. For every prescription, "they are to evaluate and make sure it is the right drug for the patient," she told Medscape Medical News.
Errors are not unexpected, and "unless it is a grossly negligent error, we will cite and fine," she said.
More: Medscape: Medscape Access
Sent from my iPhone using SDN mobile app
