Shorting controlled

[nikei3ball]

What's the process that a pharmacist should take if a patient comes into a store and claims that he was shorted on controlled substance tablets?

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[PharmDstudent]

I don't think there is much you can do at that point. There should have been precautionary measures that prevented a shorted controlled in the first place.

 

[Priapism321]

What's the process that a pharmacist should take if a patient comes into a store and claims that he was shorted on controlled substance tablets?

First of all, there should always be some indication on the bottle dispensed to the patient that the medication was double counted. However, this does not guarantee a pharmacy has dispensed the correct amount. If it is a C-II, you can just check the inventory of the particular medication. If you count every oxycodone 15 mg tablet and have one more than your inventory should, you may have actually shorted the patient.

One summer, we had a patient who consistently did this, and after the second time my manager made sure that the patient received the contents of a previously unopened bottle from the manufacturer (90-100 count poured directly from the stock bottle into the prescription vial). When the patient showed up complaining, my manager informed the patient of our process for preparing his prescription; he backed down and changed his story rather quickly. My manager handed him the telephone number to the manufacturer and urged him to give them a call.

 

[Doctor M]

My policy is to double count the medicine, circle the quantity and initial it. This is not 100% full proof as I have seen miscounted medicine that was circled. Once in a while I will count the medicine myself after a tech or intern has counted so it is triple counted. I have found that sometimes they miscounted. Today I had an intern count 11 tablets instead of 16 vicoden. Dont know how it happened. I counted it myself after it was "double counted". WE laughed about it, but in reality had I not counted it and let it go and the patient returned i probably would said too bad, it was double counted and it was only 16 tabs!! Anyway, "DC" is never 100% full proof and i usually give the patient the benefit of the doubt the first time. Once it happens a second time, then we have an issue. It's very hard to call someone a liar when indeed miscounting happens. People rarely comeback for CII's as I triple count them myself and we inventory them every month. I think I have miscounted 1 CII once like 2 years ago and we were 30 pills over!

 

[dgroulx]

At Walgreens, the scale will give you a count plus you must hand count it. If it's dispensed by a baker cell or a parata, then it is counted there, too. All controls must be at least double counted and circled on the label to show that it was double counted. If we're not super busy, I'll count it again while verifying.

 

[alwaystired]

We might give the benefit of the doubt once in a while unless its a CII, which we can just look at the inventory. If they say it again and again, we will put a note to count their pills at pick up. So we have to take a tray down there and count them out for them.... I'd be really embarrased, but the people dont seem to care.

 

[Doctor M]

We might give the benefit of the doubt once in a while unless its a CII, which we can just look at the inventory. If they say it again and again, we will put a note to count their pills at pick up. So we have to take a tray down there and count them out for them.... I'd be really embarrased, but the people dont seem to care.

ehh, i wont do that, unless the pt really really wanted that. It just takes up space at the consultation window or regristrar. Overall, it's just a pain in the arse. Once I get a pt claiming shortages, i give them my card and my partners card and just tell them to call us when they need a refill and i will just count it myself. this is extreme cases, but generally there isn't much i can do.

 

[huzeifa52]

I am an intern at a fairly busy store and I have been instructed by the pharmacist to always double count the CIIs, and i think he also counts them if its not busy. I miscounted a CII yesterday, my first and last time I hope. We laughed about it at the store because it was a rather stupid error. I laughed along but deep inside i was embarrased because It wasnt a big number of pills I had to count. If it wasnt for the pharmacist recounting the pills the patient would have had less pills and we at the pharmacy would have denied giving the patient less pills since they were 'double counted'. My point here is that double counting is a good practice but is not completely accurate if you are counting the wrong number of pills to begin with. I have learnt from this mistake and a few others i have made during the past month and a half I have been interning at a retail store. I try to move on keeping these mistakes in my head for when i actually become a pharmacist they will be the things I will have to watch out for.

 

[Doctor M]

I am an intern at a fairly busy store and I have been instructed by the pharmacist to always double count the CIIs, and i think he also counts them if its not busy. I miscounted a CII yesterday, my first and last time I hope. We laughed about it at the store because it was a rather stupid error. I laughed along but deep inside i was embarrased because It wasnt a big number of pills I had to count. If it wasnt for the pharmacist recounting the pills the patient would have had less pills and we at the pharmacy would have denied giving the patient less pills since they were 'double counted'. My point here is that double counting is a good practice but is not completely accurate if you are counting the wrong number of pills to begin with. I have learnt from this mistake and a few others i have made during the past month and a half I have been interning at a retail store. I try to move on keeping these mistakes in my head for when i actually become a pharmacist they will be the things I will have to watch out for.

I knew you would be on here! Dont worry about that! We were laughing with you! I have done worse things as an intern! Remember, we like to have fun even if its at your expense. j/k. You, my friend, are doing exceptional!

 

[Doctor M]

I am an intern at a fairly busy store and I have been instructed by the pharmacist to always double count the CIIs, and i think he also counts them if its not busy. I miscounted a CII yesterday, my first and last time I hope. We laughed about it at the store because it was a rather stupid error. I laughed along but deep inside i was embarrased because It wasnt a big number of pills I had to count. If it wasnt for the pharmacist recounting the pills the patient would have had less pills and we at the pharmacy would have denied giving the patient less pills since they were 'double counted'. My point here is that double counting is a good practice but is not completely accurate if you are counting the wrong number of pills to begin with. I have learnt from this mistake and a few others i have made during the past month and a half I have been interning at a retail store. I try to move on keeping these mistakes in my head for when i actually become a pharmacist they will be the things I will have to watch out for.

It was a CIII, not CII. I dont let you count CII's Maybe in 3 years ill let you!

 

[huzeifa52]

Yeah..thats what I meant....was just checking if you were using the magnifying glass to read stuff on your screen....hahahahhahah...you are funny as hell man....have you shared that story here yet?

 

[Doctor M]

I am an intern at a fairly busy store and I have been instructed by the pharmacist to always double count the CIIs, and i think he also counts them if its not busy. I miscounted a CII yesterday, my first and last time I hope. We laughed about it at the store because it was a rather stupid error. I laughed along but deep inside i was embarrased because It wasnt a big number of pills I had to count. If it wasnt for the pharmacist recounting the pills the patient would have had less pills and we at the pharmacy would have denied giving the patient less pills since they were 'double counted'. My point here is that double counting is a good practice but is not completely accurate if you are counting the wrong number of pills to begin with. I have learnt from this mistake and a few others i have made during the past month and a half I have been interning at a retail store. I try to move on keeping these mistakes in my head for when i actually become a pharmacist they will be the things I will have to watch out for.

You have to move on, you cant dwell on any mistake. You can learn from them, but don't dwell. Again, like I always say, i say things to only make you better, never to make you feel bad, even if my tone isn't always pleasant

 

[Doctor M]

Yeah..thats what I meant....was just checking if you were using the magnifying glass to read stuff on your screen....hahahahhahah...you are funny as hell man....have you shared that story here yet?

No because you never know who could be on here! We'll keep that between us. I have to run, gotta go shopping, ill be on later. Im addicted to this site

 

[huzeifa52]

true....you never know....im out too....I havent done any reading for school in a while....id better get started....later

 

[huzeifa52]

I understand.....never felt bad about anything....its all good

 

[alwaystired]

I am an intern at a fairly busy store and I have been instructed by the pharmacist to always double count the CIIs, and i think he also counts them if its not busy. I miscounted a CII yesterday, my first and last time I hope. We laughed about it at the store because it was a rather stupid error. I laughed along but deep inside i was embarrased because It wasnt a big number of pills I had to count. If it wasnt for the pharmacist recounting the pills the patient would have had less pills and we at the pharmacy would have denied giving the patient less pills since they were 'double counted'. My point here is that double counting is a good practice but is not completely accurate if you are counting the wrong number of pills to begin with. I have learnt from this mistake and a few others i have made during the past month and a half I have been interning at a retail store. I try to move on keeping these mistakes in my head for when i actually become a pharmacist they will be the things I will have to watch out for.

When I first started, I had a couple incidents where I double counted 30 instead of 60, because of the habit of counting out 30. what I did from then on (i was embarrased) was write out how many i counted x 2 on the sticker to put in the log. that way it was a double check for me + we could come back and see the sticker if it were questioned. It forced me to look at the quant more than just autocount and autocircle.

 

[no-see-um]

When I first started, I had a couple incidents where I double counted 30 instead of 60, because of the habit of counting out 30. what I did from then on (i was embarrased) was write out how many i counted x 2 on the sticker to put in the log. that way it was a double check for me + we could come back and see the sticker if it were questioned. It forced me to look at the quant more than just autocount and autocircle.

I was told a story once by a friend.. that once a tech ended up spilling a controlled solution. And the pharmacy had very strict rules on being short on all cs's so when the technicians went to clean it up, he was like 'leave the stain in the carpet!!'. It was good thinking and one of the funnier things I have heard in pharmacy.

 

[OUTexan]

Have you ever had a store manager tell you to give the customer controls so they will stop complaining about being shorted? We had a store manager once tell the pharmacist to give 60 suboxone to someone because the customer picked up 30 at one CVS but had paid for 90, and that store still owed them for 60 tabs. Store manager just said give it to him.

 

[Doctor M]

Have you ever had a store manager tell you to give the customer controls so they will stop complaining about being shorted? We had a store manager once tell the pharmacist to give 60 suboxone to someone because the customer picked up 30 at one CVS but had paid for 90, and that store still owed them for 60 tabs. Store manager just said give it to him.

You call the board or DEA, or whoever, SM is not a pharmacist. SM is a civilian and if he gave him the suboxone w/o the pharmacist consent, I would say goodbye that that SM. Suboxone is a controlled substance schedule III (I think) and that SM has absolutely no business being in a pharmacy to make decisions like that. I would have beat him down to a ...I mad just thinking of that. If the patient were shorted, the patient goes back to the pharmacy he originated from. Oh man, I would be in that SM face for a while. End of rant, gotta go to work...

PS I really do have a great relationship with my SM

 

[no-see-um]

You call the board or DEA, or whoever, SM is not a pharmacist. SM is a civilian and if he gave him the suboxone w/o the pharmacist consent, I would say goodbye that that SM. Suboxone is a controlled substance schedule III (I think) and that SM has absolutely no business being in a pharmacy to make decisions like that. I would have beat him down to a ...I mad just thinking of that. If the patient were shorted, the patient goes back to the pharmacy he originated from. Oh man, I would be in that SM face for a while. End of rant, gotta go to work...

PS I really do have a great relationship with my SM

I totally agree with that.

SMs may be the greatest folks in the world, and do an incredible amount of work and are under a lot of pressure a lot of the time. But anyone could be an SM. Here's why:

I'd point to the wall and ask where their license is. When he/she's dumbfounded I would then say, 'that's why I can not just give a patient 60 tablets of one of the most highly controlled substances in pharmacy'.

I would have reservations about having such an SM in the pharmacy area after such a comment.

Technically, what are your thoughts on SMs being allowed back behind the pharmacy?

 

[All4MyDaughter]

At Walgreens all store managers and assistants are trained and certified pharmacy techs. I've worked at three different Wags and I've never seen a store manager do anything in the pharmacy besides work the register. I'm sure that there are stores where the SM is all over the pharmacy's business and if I were the pharmacist I don't think I'd like that at all.

At Kroger our SM mostly handled pharmacy customer complaints. Which were usually about junk like:

"I am on passport (Medicaid) and I know that this coupon for a $25 gift card with new RX says 'not to be used for passport prescriptons' but I want my gift card anyway."

"I tried to return this used glucose testing meter and strips b/c I got blood all over them and they are dirty and I want another one. But that pharmacist said no."

"I'm a redneck and I don't like the 'looks' of that 'foreign' pharmacist. Ain't ya'll got no 'MERICAN druggists to hire?"

 

[alwaystired]

At Walgreens all store managers and assistants are trained and certified pharmacy techs. I've worked at three different Wags and I've never seen a store manager do anything in the pharmacy besides work the register. I'm sure that there are stores where the SM is all over the pharmacy's business and if I were the pharmacist I don't think I'd like that at all.

At Kroger our SM mostly handled pharmacy customer complaints. Which were usually about junk like:

"I am on passport (Medicaid) and I know that this coupon for a $25 gift card with new RX says 'not to be used for passport prescriptons' but I want my gift card anyway."

"I tried to return this used glucose testing meter and strips b/c I got blood all over them and they are dirty and I want another one. But that pharmacist said no."

"I'm a redneck and I don't like the 'looks' of that 'foreign' pharmacist. Ain't ya'll got no 'MERICAN druggists to hire?"

In Nevada, you have to complete 1000 or 1200 (something like that) hours as a tech in training before you can be a tech. I find it hard to believe that every Walgreens manager has spent that many hours to get their tech license...and I think you only have a certain number of days (like a year or something) to do it, so they can't even be "tech in training" forever....

 

[Doctor M]

I totally agree with that.

SMs may be the greatest folks in the world, and do an incredible amount of work and are under a lot of pressure a lot of the time. But anyone could be an SM. Here's why:

I'd point to the wall and ask where their license is. When he/she's dumbfounded I would then say, 'that's why I can not just give a patient 60 tablets of one of the most highly controlled substances in pharmacy'.

I would have reservations about having such an SM in the pharmacy area after such a comment.

Technically, what are your thoughts on SMs being allowed back behind the pharmacy?

I do not mind a SM being in the pharmacy as long he/she is HIPAA certified. They can come back all they want, I don't care. But no SM or even a pharmacy supervisor is going to tell me to give a patient a CS if It don't seem fit. My SM and I have an understanding and we have had it out in the past but he knows his boundries and I know mine. As far a SM being tech certified, i dont care if he/she was tech certified X 10 certifications, he /she still has no license to make desicions like who we "give" CS to. Whomever the pharmacist was who let that SM give Suboxone out should be along with the SM.

 

[Doctor M]

At Walgreens all store managers and assistants are trained and certified pharmacy techs. I've worked at three different Wags and I've never seen a store manager do anything in the pharmacy besides work the register. I'm sure that there are stores where the SM is all over the pharmacy's business and if I were the pharmacist I don't think I'd like that at all.

At Kroger our SM mostly handled pharmacy customer complaints. Which were usually about junk like:

"I am on passport (Medicaid) and I know that this coupon for a $25 gift card with new RX says 'not to be used for passport prescriptons' but I want my gift card anyway."

"I tried to return this used glucose testing meter and strips b/c I got blood all over them and they are dirty and I want another one. But that pharmacist said no."

"I'm a redneck and I don't like the 'looks' of that 'foreign' pharmacist. Ain't ya'll got no 'MERICAN druggists to hire?"

I am under the impression that SM at walgreens pretty much control the pharmacy. Thats pretty much why i never made the switch to walgreens. I really wouldn't need a SM telling me what I need to do to make my pharmacy run effeciently. I guess I have a control issue. Sometimes pt's will go up front and complain to the SM and he'll come back and find out what happened. Usually its a P/A, DWCB, or a GC issue and there is nothing he can do. I just dont get it sometimes.

 

[Doctor M]

At Walgreens all store managers and assistants are trained and certified pharmacy techs. I've worked at three different Wags and I've never seen a store manager do anything in the pharmacy besides work the register. I'm sure that there are stores where the SM is all over the pharmacy's business and if I were the pharmacist I don't think I'd like that at all.

At Kroger our SM mostly handled pharmacy customer complaints. Which were usually about junk like:

"I am on passport (Medicaid) and I know that this coupon for a $25 gift card with new RX says 'not to be used for passport prescriptons' but I want my gift card anyway."

"I tried to return this used glucose testing meter and strips b/c I got blood all over them and they are dirty and I want another one. But that pharmacist said no."

"I'm a redneck and I don't like the 'looks' of that 'foreign' pharmacist. Ain't ya'll got no 'MERICAN druggists to hire?"

haha, ive been called a "dirty mexican".