Email steve@steveariens.com 502-938-2414
Pay Attention
“Just doing my job harassing and searching a stage 4 cancer patients bags for a plant.” This is TRULY pathetic. Not bravery. Not protecting the community. Just pathetic! This man could have days to live but you waste his time searching his possessions because ‘it’s the law?’ Disgusting!
Filed under: General Problems | 6 Comments »
ISSUE OF THE CASE
When a transcription error by a pharmacy technician while taking medication orders over the phone led to the death of a patient, did the trial court judge make an error when disallowing the surviving family members to seek damages based on aggravating circumstances?
FACTS OF THE CASE
A female patient was hospitalized in a Midwestern state for fluid buildup in her lungs. When the time came for her to be discharged, a nurse at the hospital called in prescriptions for multiple medications to a local chain pharmacy. One of those orders was for a diuretic, metolazone.
The tech made numerous transcription errors, misspelling the names of several medications being ordered, misspelling the name of the nurse on the other end of the phone call, and recording an incorrect birth date for the patient. The tech also made an error related to the dosage of an inhaler being prescribed, with what she recorded being 10 times the correct dosage.
The gravest hazard, however, came from misrecording a daily dosage of methotrexate instead of the metolazone that was intended. How could that occur? The pharmacy expert retained by the family testified that the approach used in the pharmacy was for the tech to look in the computer where the medications were arranged alphabetically by name. A drop-down menu would appear after the first 3 letters or so of the drug name that had been entered. The pharmacy expert opined that entering m-e-t and a dosage strength of 2.5 mg would bring up methotrexate before metolazone.
The pharmacist who had been on duty the day the dispensing error was made testified that he had approved the prescription before it was dispensed. He stated that the dosage being prescribed would have been safe if administered once or twice per week but not on a daily basis. His statement at trial was that “for some reason, I didn’t recognize the weekly versus daily. It didn’t click in my mind.”
The pharmacy expert testified that the Institute for Safe Medication Practices classifies methotrexate as a “high-alert” drug product and that many pharmacy computer systems include a “hard stop” that prevents printing a label indicating that it should be taken once per day.
When the husband picked up the medication, he was asked whether he had any questions for the pharmacist. When he responded that he did not, the pharmacy staff member provided no further counseling or warning about the medication, even though the pharmacy manual of the chain specified that it “strongly recommends” that all patients with new prescriptions receive patient counseling, even if not required by state law. The pharmacy expert opined that such counseling should be provided with high-alert drugs.
The family filed the lawsuit based on wrongful death reasoning, naming the hospital and pharmacy as defendants. They also sought additional damages, due to aggravating circumstances (ie, those present in the transaction that increase the culpability or severity of the action). The hospital settled the claim, and the matter against the pharmacy chain proceeded to court. The trial court jury returned a verdict in favor of the plaintiffs in the amount of $2 million, but that amount was reduced to $125,000, pursuant to damage caps included in state law. The pharmacy chain made a motion that the aggravating circumstances portion of the case be dismissed, and the judge granted that motion. The family appealed the judge’s denial of that portion of the case.
THE RULING
The 3-judge panel of the state court of appeals concluded that the trial court erred when deciding in favor of the pharmacy chain on the aggravating circumstances damages issue. The case was remanded to the trial court for a new trial on the sole issue of aggravating circumstances.
THE COURT’S REASONING
The court looked at several issues related to the aggravating circumstances. The judges said that a jury could conclude that the chain’s “decision to leave the decision whether to counsel patients to the discretion of individual pharmacists exhibited conscious indifference to patient safety, when the consequences of prescription errors were potentially lethal.” Further, the evidence “would have permitted the jury to conclude that [the chain] has made no meaningful changes to its proce- dures as a result of [the woman’s] death.”
The court stated that the chain’s “failure to take any meaningful corrective action following [the woman’s] death supports the conclusion that its conduct exhibited complete indifference or conscious disregard for [her] safety.”
Filed under: General Problems | 1 Comment »
Three Felonies A Day: How the Feds Target the Innocenthttps://www.amazon.com/Three-Felonies-Day-Target-Innocent/dp/B07J488Q3B/ref=sr_1_1
The average professional in this country wakes up in the morning, goes to work, comes home, eats dinner, and then goes to sleep, unaware that he or she has likely committed several federal crimes that day. Why? The answer lies in the very nature of modern federal criminal laws, which have exploded in number but also become impossibly broad and vague.
In Three Felonies a Day, Harvey A. Silverglate reveals how federal criminal laws have become dangerously disconnected from the English common law tradition and how prosecutors can pin arguable federal crimes on any one of us, for even the most seemingly innocuous behavior. The volume of federal crimes in recent decades has increased well beyond the statute books and into the morass of the Code of Federal Regulations, handing federal prosecutors an additional trove of vague and exceedingly complex and technical prohibitions to stick on their hapless targets. The dangers spelled out in Three Felonies a Day do not apply solely to “white collar criminals,” state and local politicians, and professionals. No social class or profession is safe from this troubling form of social control by the executive branch, and nothing less than the integrity of our constitutional democracy hangs in the balance.
Filed under: General Problems | 5 Comments »
https://www.medpagetoday.com/gastroenterology/gerd/82238
One manufacturer of generic ranitidine (Zantac), Novartis’s Sandoz unit, has reportedly decided to halt distribution of the antacid drug until a contamination issue is resolved.
Last week, the FDA said some lots of ranitidine, a histamine H2 inhibitor, were found to contain small amounts of N-nitrosodimethylamine (NDMA), considered to be a human carcinogen. NDMA is a member of the nitrosamine family of chemicals also found to have contaminated some angiotensin receptor blocker drugs, sparking an uproar that still hasn’t died down.
“A precautionary distribution stop of all Sandoz ranitidine-containing medicines in all our markets will remain in place under further clarification, this includes capsules in the USA,” according to a Novartis statement quoted in the Wall Street Journal. “Our internal investigation is ongoing to determine further details. In case of concerns, adequate additional measures will be implemented in alignment with relevant Health Authorities as required.”
Ranitidine is sold in both prescription and over-the-counter (OTC) forms primarily to relieve gastroesophageal reflux and for gastric and intestinal ulcer prevention. The FDA didn’t indicate which particular products were affected since they are not being recalled at this time; the generic drug is available from other companies besides Sandoz.
Although no recall was ordered, the FDA said last week that patients using OTC ranitidine “could consider using other OTC medicines approved for their condition. There are multiple drugs on the market that are approved for the same or similar uses as ranitidine.”
Patients taking prescription ranitidine who wish to switch to another medication should consult their physicians, the FDA said.
Filed under: General Problems | Leave a Comment »
https://ktla.com/2019/09/17/dea-serves-inspection-warrants-at-kaiser-pharmacies-across-the-country/
The Drug Enforcement Administration served inspection warrants at Kaiser Permanente pharmacies across the country, officials said Tuesday.
The Kaiser Permanente in Woodland Hills is seen in a photo taken on Sept. 17, 2019. (Credit: KTLA)
Agents are monitoring the prescription and administering of controlled substances and inspecting pharmacy records, Special Agent Kyle Mori, a spokesman for the DEA, told KTLA.
It is unclear how many warrants were issued Tuesday, but some Southern California locations include Woodland Hills, Riverside and Victorville.
Mori said the warrants are under seal and he couldn’t comment on the investigation.
He added, however, that inspections are typically conducted to help officials regulate the health care and pharmaceutical industry and those involved in prescribing, manufacturing or handling controlled substances.
The inspections tend to take a few hours and at the conclusion, the affected pharmacies will reopen.
In a statement, Kaiser said officials are cooperating fully with the federal agency.
“As always, we are committed to complying with state and federal regulations and ensuring the safety of our patients and members,” the statement read.
Filed under: General Problems | 3 Comments »
Purdue Pharma filed for bankruptcy. What does it mean for lawsuits against the opioid manufacturer?Law firms seem to follow the same path on many lawsuit issues… with Purdue Pharma… even though Oxycontin was only some 2+% of the opiate prescription market place, Law firms are accusing (suing) them over causing the theoretical opiate crisis. Of course, Purdue Pharma placed a “premium price” on their brand name medication and thus was able to generate a great deal of revenue.
Causing Purdue to file for Chapter 11 bankruptcy with consultation from the Philladelphia chapter 7 bankruptcy lawyer who is the best in this field and makes sure that the client’s problem is sorted out efficiently which gives them the courage to re-establish their business in a much better way.
What is very concerning about this settlement with Purdue… is that these lawsuit are wanting money from the family that owns this closely held corporation. A corporation is suppose to separate the assets of the corporation from the assets of the stock holders. Could this establish a new precedent ? Could our legal system go after the assets of people, mutual funds or others who own stock in a publicly held company.. who own stock in a particular company who our legal system targets for lawsuits for selling legal product that – our legal system decides needs to make restitution for selling a legal product that may cause health issues to people you buy/use their product. In case of financial issues, you can find chapter 13 bankruptcy lawyers help to get out of the problem.
Historically, stock holders only have at risk the value of the stock that they own in a particular company … if the business “folds” because of lawsuits and get assessed damages greater than the worth of the company assets …
Anything seems possible within our legal system ?
This is a similar path the state AG’s and legislatures after the company that brought Zohydro to market abt 5 yrs ago. Zohydro was a long acting Hydrocodone .. unlike Norco and other Hydrocodone products that contain Acetaminophen and are immediate release. Again Zohydro was a fairly pricey medication costing $10- $20/day for two of the 12 hr tablets.
Because Zohydro contained up to 50 mg of Hydrocodone and did not contain an anti-abuse formula… many of the State AG’s went “ape-shit” on this product being on the market. They had no proof that the product was being abused or that these attorneys believed that their was a potential to be abused… Zohydro was the only product that company had and so there was no “deep pockets” to go after and no proof of it being abused… so many State AG’s filed sue at the state level, causing the company to hire law firms in the various states… which the legal fees ended pushing the company into bankruptcy. You can get a legal expert from https://www.attorneyhelp.org/guide/understanding-the-steps-related-to-declaring-bankruptcy-1413.shtml to provide you with apt advice on what needs to be done.
Filed under: General Problems | 5 Comments »
Congressional Democratic leaders warned President Donald Trump on Sunday that any proposal on gun control must include a House-passed bill to expand background checks for gun purchases — or else risk no legislation at all.
The question has to be asked … why is no one talking about enhanced background checks for people who want/need controlled substances to be prescribed and filled ?
Here is a system ( https://www.clearme.com/ )that is being used at more and more major airports to clear people and “skip the line”..
Many in our healthcare system – especially Pharmacists – have no way to “validate” the person handing them a driver’s license and Rx for a controlled substance is who they say they are. The Pharmacist has no option but to put that pt information into the state’s PMP database. So the serious substance abuser or diverter that has a dozen or more fake driver’s license and going to multiple prescribers and multiple pharmacies… prescribers and pharmacies can run PMP reports until the cows come home and they will never show up as being a doc/pharmacy shopper.
The first time that a person used the www.clearme.com – or comparable – system, it would not matter who they say they are… that system uses a digital recognition of face and finger prints… and after the first time… when they interact with the system they come up ID’d as to whoever they said they were the first time that they interacted with the system.
It could be SO SIMPLE to be utilized in the healthcare system… when a pt comes to a prescriber or pharmacy… they login into the system … which interacts with the state’s PMP program and automatically generates a PMP report that is emailed to the office/pharmacy.
The PMP system could be programmed to apply certain parameters that would be highlighted on the report that could suggest that the pt is a doc/pharmacy shopper. Saving the healthcare professional time in doing a in depth evaluation of the report.
The system could also be used to isolate prescribers/pharmacies that was not routinely using the system, by comparing PMP reports being sent to prescribers/pharmacies against prescriptions being written/filled. Could suggest healthcare providers that could be involved in diversion.
Potentially simple solution, using current technology… and why is it not being at least being tested in some markets ? One possible reason why it is not… is because the bureaucrats don’t really want to see the war on drugs to GO AWAY ?
Filed under: General Problems | 11 Comments »
https://behavenet.com/blog/dealusion
According to this press release, DEA wants U.S. sucker taxpayers to think we can reduce the number of opioid overdose deaths by reducing the amount of pharmaceutical grade opioids legally produced in the U.S.
In fact, what this restriction will accomplish is an increase in prices, increase in diversion, and decrease in safety of available opioids while putting more money in the pockets of the cartels.
We need reduced demand — not reduced supply — to effectively address this problem. DEA’s continued failure to grasp the simple economic principles in operation here will continue to kill Americans every day. Prohibition causes more harm than good.
The best way to save lives in this debacle? Flood the market with the safer opioid: buprenorphine, and shut down DEA.
Filed under: General Problems | 3 Comments »
Congressman Greg Steube, R-District 17, introduced a bill to reschedule marijuana from a schedule I controlled substance to a schedule III controlled substance, his office announced Thursday.
The Marijuana 1-to-3 Act of 2019, would let further research on the substance be conducted.
“As marijuana is legalized for medical and recreational use across the United States, it is important that we study the effects of the substance and the potential impacts it can have on various populations,” Steube said in a news release last week. “By rescheduling marijuana from a schedule I controlled substance to a schedule III controlled substance, the opportunities for research and study are drastically expanded. With this rescheduling, researchers can now access federal funds to research this substance and determine its medical value.”
According to the US Drug Enforcement Administration, schedule I controlled substances “have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.” Some examples include: heroin, LSD and ecstasy.
Schedule III controlled substances “have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence,” according to the DEA.
Examples of schedule III narcotics include: Tylenol with Codeine, and Suboxone.
Examples of Schedule III non-narcotics include: Didrex, ketamine, and anabolic steroids, according to the DEA.
The bill directs the Attorney General of the United States to make changes to the Controlled Substances Act to move marijuana from schedule I of the Act to schedule III of the Act.
“We hear every day about the positive health benefits of marijuana. Whether it’s young children with seizure disorders, or veterans suffering from chronic pain, it is clear that there are medical benefits to marijuana and I think it’s time we remove the bureaucratic red tape that prevents us from thoroughly studying this substance,” said Steube in the release.
The bill will be referred to the House Committee on the Judiciary, where Steube is a member.
Filed under: General Problems | 2 Comments »
