YAFI Online Programming //Law Related to Pharmacy Practice

Law

Prescription for Murder

Educational Objectives

After participating in this activity, pharmacists will be able to:

  • Discuss the kinds of behaviors by health care practitioners that can lead to criminal charges
  • Describe the potential legal and regulatory outcomes of reckless prescribing
  • Identify the "red flags" that should cause a pharmacist or pharmacy technician to question a prescription's legitimacy
  • Discuss the positive and negative consequences of increased scrutiny of aberrant prescribing habits

Session Offered

Release Date: December 15, 2019

Expiration Date: December 15, 2022

Course Fee

$7 for pharmacists

$4 for technicians

Session Codes

19YC75-JMT49 Pharmacist

19YC75-KVE34 Pharmacy Technician

Accreditation Hours

2.0 hours of CE

Abstract

When health care practitioners demonstrate substandard behavior, they can be penalized by license suspension, loss of a license or certification, or paying damages in a law suit. However, their behavior can also lead to criminal charges and more severe penalties including incarceration. This continuing education activity provides examples of indifferent behavior by pharmacists that has resulted in legal jeopardy. It also describes the increasing scrutiny and occurrence of criminal charges, including murder, being brought against health care practitioners for excessive or reckless prescribing and dispensing of controlled substances. It reminds pharmacy staff members of their obligations to prevent abuse and overdose.

Accreditation Statements

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and pharmacy technicians are eligible to participate in this application-based activity and will receive up to 0.2 CEU (2 contact hours) for completing the activity, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor on- line system and your participation will be recorded with CPE Monitor within 72 hours of submission

ACPE UAN:
0009-0000-19-061-H03-P 0
009-0000-19-061-H03-T

Grant funding: None

Cost: $7 for pharmacists $4 for technicians

Initial Release Date: December 15, 2019
Expiration Date: December 15, 2022

To obtain CPE credit, visit the UConn Online CE Center

Use your NABP E-profile ID and the session code 19YC75-JMT49 for pharmacists or 19YC75-KVE34 for pharmacy technicians to access the online quiz and evaluation.

First- time users must pre-register in the Online CE Center. Test results will be displayed immediately and your participation will be recorded with CPE Mon- itor within 72 hours of completing the requirements.

For questions concerning the online CPE activities, email joanne.nault@uconn.edu

Faculty

Gerald Gianutsos, Ph.D., J.D., R.Ph., is an Emeritus Associate Professor of Pharmacology at the University of Connecticut, School of Pharmacy.

Faculty Disclosure

Dr. Gianutsos has no actual or potential conflicts of interest associated with this article.

Disclosure of Discussions of Off-label and Investigational Drug Use

This activity may contain discussion of off label/unapproved use of drugs. The content and views presented in this educational program are those of the faculty and do not necessarily represent those of the University of Connecticut School of Pharmacy. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Content

Introduction

Pharmacists and technicians are well aware that misconduct and mistakes in the pharmacy can bring about serious consequences and potential penalties. The most familiar repercussions from misdeeds by pharmacists result in cases of civil liability (e.g., a malpractice suit). If found liable, pharmacists will have to pay monetary damages to the injured party, and/or face imposition of sanctions by a regulatory board which could lead to suspension or forfeiture of their license or a fine. However, health care professionals are increasingly facing the threat of criminal charges for various transgressions. Tougher penalties may include incarceration. This continuing education activity examines some recent instances of health care professionals who have been accused, and in some cases, convicted of criminal behavior for their actions.

References

Full List of References

1. Peled S, Tsuru K. Pharmacist linked to fungal meningitis outbreak gets 9 years in prison. CNN. June 26, 2017. Retrieved from: https://www.cnn.com/2017/06/26/health/meningitis-pharmacistsentencing/index.html

2. Romine T, Johnston C, Boyette C. Two pharmacists sentenced for roles in 2012 meningitis outbreak. CNN. May31, 2019. Retrieved from: https://www.cnn.com/2019/05/31/health/sentencing-new-englandmeningitis/index.html

3. Draper R. The Toxic Pharmacist. NY Times. June 8,2003. Retrieved from: https://www.nytimes.com/2003/06/08/magazine/the-toxicpharmacist.html

4. Pharmacist Robert Courtney Admits he Diluted Drugs. KC Star. Retrieved from: https://www.kansascity.com/news/special-reports/kctrue-crime/article705846.html

5. American Greed. Episode 11: Deadly Rx for Greed. First Aired: February 27, 2008. Retrieved from: https://www.cnbc.com/id/100000091

6. Vivian JC. Criminalization of Medication Errors. U.S. Pharmacist. 2009; 34(11): 66-68. Retrieved from: https://www.uspharmacist.com/article/criminalization-of-medicationerrors

7. Weixel N. DOJ charges doctors across multiple states with illegally prescribing millions of narcotics. The Hill. April 17, 2019. Retrieved from: https://thehill.com/policy/healthcare/439338-doj-chargesdoctors-across-multiple-states-with-illegallyprescribing?utm_source=&utm_medium=email&utm_campaign=21926

8. Weingartner T. 60 Arrested In 'Largest Opioid Prescriber Takedown Ever'. WVXU (Cincinnati). April 17, 2019. Retrieved from: https://www.wvxu.org/post/60-arrested-largest-opioid-prescribertakedown-ever#stream/0

9. Connolly KP, Allen S. Avalon Park-area pharmacist gets 24 years for pill conspiracy. Orlando Sentinel. June 24, 2016. Retrieved from: https://www.orlandosentinel.com/news/breaking-news/os-valentineokonkwo-sentenced-prison-20160624-story.html

10. U.S. Immigration and Customs Enforcement. Pharmacist and pharmacy technician sentenced to prison for diverting hundreds of thousands of opioids. 11/29/2018. Retrieved from: https://www.ice.gov/news/releases/pharmacist-and-pharmacytechnician-sentenced-prison-diverting-hundreds-thousands

11. Clark C. Doctors call California’s probe of opioid deaths a ‘witch hunt’. LA Times. January 28, 2019. Retrieved from: https://www.latimes.com/science/sciencenow/la-sci-sn-opioidprescription-crackdown-20190117-story.html

12. Clark C. Calif.'s 'Death Certificate Project' Nabs 11 More Physicians. Medpage Today. November 6, 2018. Retrieved from: https://www.medpagetoday.com/publichealthpolicy/generalprofessio nalissues/76160

13. Massachusetts General Hospital. Sins of the Past. Proto. January 22, 2019. Retrieved from: http://protomag.com/articles/sins-past

14. Doctors Call California's Probe of Opioid Deaths a 'Witch Hunt' - Medscape - Jan 25, 2019. Retrieved from: https://www.medscape.com/viewarticle/908262?nlid=127687_381&src =WNL_mdplsnews_190201_mscpedit_wir&uac=66051BV&spon=17&im pID=1874303&faf=1#vp_2

15. Dahlburg JT. Jurors Convict Physician in OxyContin Deaths. LA Times. February 20, 2002. Retrieved from: https://www.latimes.com/archives/la-xpm-2002-feb-20-mn-28941- story.html

16. Yang YT, Haffajee RL. Murder Liability for Prescribing Opioids: A Way Forward? Mayo Clin Proc. 2016; 91(10): 1331-1335. Retrieved from: https://www.mayoclinicproceedings.org/article/S0025- 6196(16)30336-6/pdf

17. Freeman M. Jury Acquits Former Pain Clinic Doctor of Murder, Convicts him of Minor Drug Charge. Orlando Sun-Sentinel. September 16, 2015. Retrieved from: https://www.sun-sentinel.com/local/palmbeach/fl-doctor-murder-trial-verdict-watch-20150915-story.html

18. People v Tseng. California Second Appellate District. Filed December 14, 2018. Retrieved from: https://oag.ca.gov/system/files/attachments/pressdocs/b270877opfpeople-v.tseng.pdf

19. Berman SJ. What is Murder? Is Murder Different from Homicide. NOLO. Retrieved from: https://www.nolo.com/legalencyclopedia/homicide-murder-manslaughter-32637.html

20. Christian P. Hamilton doctor found guilty of killing patient by overprescribing opioids. WCPO (Cincinnati 9). April 11, 2019. Retrieved from: https://www.wcpo.com/news/local-news/i-team/hamiltondoctor-found-guilty-of-killing-patient-by-overprescribing-opioids

21. Castillo A. Dracut doctor faces January court date State alleges Miron overprescribed opioids, leading to death of patient. Valley Dispatch. December 28, 2018. Retrieved from: http://www.thevalleydispatch.com/ci_32354747/dracut-doctor-facesjanuary-court-date-state-alleges

22. Staff. Milford “Pill Doctor” Sentenced to 27 Years. Pocono Record. April 4, 2019. Retrieved from: https://www.poconorecord.com/news/20190404/milford-pill-milldoctor-sentenced-to-27-years

23. Morgan-Besecker T. Conviction of Milford’s “Pill Mill” Doctor Upheld. Pocono Record. March 19, 2019. Retrieved from: https://www.poconorecord.com/news/20190319/conviction-ofmilfords-pill-mill-doctor-upheld

24. Winter T. NY Doctor who Prescribed “Holy Trinity” Charged in Patient Deaths. NBC News. June 7, 2018. Retrieved from: https://www.nbcnews.com/news/crime-courts/ny-doctor-whoprescribed-holy-trinity-charged-patient-deaths-n880916

25. Emery S. Santa Barbara doctor, nicknamed the “Candy Man,” who gave out large amounts of painkillers and sedatives, found guilty by Santa Ana jury. Orange County Register. August 28, 2015. Retrieved from: https://www.ocregister.com/2015/08/28/santa-barbara-doctornicknamed-the-candy-man-who-gave-out-large-amounts-of-painkillersand-sedatives-found-guilty-by-santa-ana-jury/

26. Holcombe M. Kansas doctor gets life in prison for selling opioids that led to patient's death. CNN. March 9, 2019. Retrieved from: https://www.cnn.com/2019/03/09/us/wichita-doctor-prescriptiondeath/index.html

27. Thompson D. California alleges doctor killed 4 patients with opioids. AP News. August 14, 2019. Retrieved from: https://www.apnews.com/fc5421eacde648c1a9e94ad3d7f8a1e4

28. Winter T, Connor T. New York Doctor Eugene Gosy Accused in Six Opioid Deaths. NBC News. November 8, 2017. Retrieved from: https://www.nbcnews.com/storyline/americas-heroin-epidemic/newyork-doctor-eugene-gosy-accused-six-opioid-deaths-n818456

29. Tan S. Doctors warn of criminalizing painkiller prescriptions. Buffalo News. February 27, 2017. Retrieved from: https://buffalonews.com/2017/02/27/physicians-raise-alarmcriminalizing-efforts-treat-patients-pain/

30. Huntoon LR. The Perils of Opioid Prescribing. J Am Phys Surg. 2017; 22(4): 98-100.

31. National Institute on Drug Abuse. Overdose Death Rates. Retrieved from: https://www.drugabuse.gov/related-topics/trendsstatistics/overdose-death-rates

32. Dent RB. No Duty to Warn of Drug Interactions: A Dangerous Prescription. John Marshall Law Rev. 2013; 46: 533-559.

33. National Association of Chain Drug Stores. Pharmacist’s Duty to Warn. Retrieved from: https://www.nacds.org/pdfs/membership/duty_to_warn.pdf

34. Ault A. Pharmacists May Be Legally Liable for Opioid Overdoses. Medscape. Jun 30, 2017. Retrieved from: https://www.medscape.com/viewarticle/882358

35. U.S. Drug Enforcement Agency. Pharmacist’s Manual – Appendix D. Retrieved from: https://www.deadiversion.usdoj.gov/pubs/manuals/pharm2/appendix /appdx_d.htm

36.Goldman S. Santa Barbara Pharmacists Surrender Licenses for Filling, Mishandling Dr. Julio Diaz Prescriptions. Newzhawk February 14, 2017. Retrieved from: https://www.noozhawk.com/article/santa_barbara_pharmacists_disci pline_dr_julio_diaz_prescriptions_20170214

37. U.S. Drug Enforcement Agency. Pharmacy Doctors Enterprises d/b/a Zion Clinic Pharmacy; Decision and Order. Fed Reg. 2018; 83(49): 10876-10903. Retrieved from: https://www.deadiversion.usdoj.gov/fed_regs/actions/2018/fr0313.p df

38. West Virginia Senate Bill 333. Requiring all DHHR-licensed facilities access WV Controlled Substances Monitoring Program Database. April 8, 2017. Retrieved from: https://legiscan.com/WV/text/SB333/2017

39. Rose ME. Are Prescription Opioids Driving the Opioid Crisis? Assumptions vs Facts. Pain Med. 2018; 19(4): 793-807.

40. Pitcher MH, Von Korff M, Bushnell MC, Porter L. Prevalence and profile of high impact chronic pain in the United States. J. Pain. 2019; 20(2): 146-160.

41. Ray S, Hoffman K. Opioid stigma is keeping many cancer patients from getting the pain control they need. Stat News. July 6, 2018. Retrieved from: https://www.statnews.com/2018/07/06/cancer-patients-pain-opioidstigma/