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H.R. 485 – Protecting Healthcare for All Patients Act
Is it Rite Aid 2.0 or Bye-Bye Rite Aid
In 2017 Rite Aid had abt 4500 stores, in 2019 Rite Aid had a 20:1 REVERSE STOCK SPLIT which moved its stock that was < 1.00 up to in the low $30/share range. Recently – pre-bankruptcy – the stock price was again < $1. Anyone who owned Rite Aid stock when it officially declared bankruptcy, their shares became WORTHLESS. Rite Aid is now left with 1600 stores, which may be “sold off”. If they are sold off, most likely, the “BIG BOYS” will come in and will buy those stores up at fire sale prices and most stores will be closed and Rx business transferred to one of their closest stores. I have seen times when there is no close store and they have closed down the store, rebuild a new store in their “footprint” and reopen the stores under their name. How many “pharmacy deserts” will be created, will not be known until all the dust settles from the bankruptcy.
The Scoop on Rite Aid from Anonymous:
As of yesterday we are “Rite Aid 2.0” – the closures of 600 stores are over. Selling to competitors isn’t out of the question however. 2/3rds of middle management is gone. 50% of pharmacy DMs and 75% of retail DMs. Elixir sold for $575m. AP was cut in the field significantly. Each pharmacy DM was put up to 30 stores. There’s now 5 divisions instead of 10. 58 regions instead of 111. Conference call yesterday was basically explaining the restructure and saying if you’re here now your store isn’t closing and your job is safe.
The asset sale ended 2 days ago. The auction allowed anyone to bid on anything, but RA can choose whether or not to accept the bids. All remaining 1600 stores are profitable.
Lots of various administrative office workers in corporate, positions that didn’t add value, etc. so payroll went WAY down. Store employees basically weren’t affected. Things are looking up unless they sell to CVS or WAG, or if they go to Ch. 7 somehow.
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CVS pharmacist’s death becomes cautionary tale of crushing stress at work
CVS pharmacist’s death becomes a cautionary tale of crushing stress at work
On the morning she died, Ashleigh Anderson researched her symptoms.
Nausea.
Jaw pain.
Chest pain.
Cold sweats.
“I think I am having a heart attack,” the 41-year-old texted her longtime boyfriend from the CVS store in Seymour, Indiana, where she had just begun her shift as the sole pharmacist on duty.
It was Sept. 10, 2021. Retail pharmacy was reeling from the pressures of the pandemic, and frontline workers like Anderson were dangerously burned out. For months, they had been filling prescriptions and vaccinating patients without bathroom breaks or a bite to eat.
Anderson’s phone buzzed.
“I hope not!” replied her boyfriend, Joe Bowman, who suggested the symptoms could just as easily be indigestion, stress or something with her lungs.
Anderson was a smoker, and her job induced plenty of stress. But she had just been to the doctor two weeks earlier and, according to her family, received a clean bill of health.
“Can you take a long lunch and decompress?” Bowman asked.
“I can’t,” she texted back.
The CVS in Seymour was a 24-hour store whose pharmacy counter never closed, not even for lunch. Patients came at all hours to pick up medications, ask questions and get shots. It was a relentless grind made worse by the recent departure of two staff pharmacists and the pharmacy manager. In their absence, the remaining crew struggled to fill the hundreds of prescriptions coming in each day and had soon fallen behind by more than 1,000.
Tensions were especially high that week after Anderson learned her boss had assigned her the role of pharmacy manager despite her repeated refusals to take the promotion.
“I am livid,” she messaged a coworker four days earlier when she discovered the change in the company’s HR system.
State law at the time required every pharmacy to designate a pharmacist in charge, someone to hold accountable for complying with regulations and to discipline for violations.
But Anderson didn’t want the extra responsibilities. After 17 years with CVS, including previous stints as a manager, she was content being a regular staff pharmacist. She could clock in, clock out, and go home to Bowman and her beloved basset hounds without the job following her there.
If anyone could handle the gig, though, it was Anderson.
Whip-smart, selfless and dependable, she had managed one of the busiest CVS pharmacies in Indiana just a few years out of college. When a historic flood inundated her store in 2008, she kept working until the National Guard arrived in boats to rescue everyone. The following year, she won the company’s highest honor, the coveted Paragon Award.
Anderson was calm amid chaos. But that morning when she texted Bowman, she was worried.
If she was having a heart attack, she needed immediate medical attention. But if she left without another pharmacist to take her place, she would have to close the counter. Prescriptions would get even more backed up. Patients would be upset. And the store’s performance, closely tracked by a series of corporate metrics, would suffer more than it already had.
Anderson couldn’t reach her boss, so she texted his assistant at 10:11 a.m.
“I know this sounds crazy but I am having symptoms of a heart attack. Can you get someone here long enough for me to go to the ER and get checked out?”
Three minutes later, the assistant called. The two spoke briefly, then hung up.
“I talked to Jessica,” Anderson texted Bowman, referring to the assistant. “She told me to close and go, but I told her to find someone if she could.”
Bowman replied: “Are you coming home or going to the closest ER? Do I need to pick you up?”
Home was 35 minutes to the south, in Henryville, Indiana. The closest emergency room was just down the street, at Schneck Medical Center. Anderson could drive there in three minutes.
The assistant called again, and the two spoke for 46 seconds.
Then Anderson sent Bowman what would be her final text: “Bob is coming now. I will go to Schneck here. Hopefully it’s nothing and I will come back to work.”
Fifteen minutes later, Anderson collapsed on the pharmacy floor.
A customer who happened to be a nurse raced behind the counter and started CPR while a pharmacy tech called 911, a coworker told USA TODAY.
First responders arrived within minutes. They ventilated her. They gave her chest compressions. They jolted her with a defibrillator. Nothing made a difference. They loaded her onto an ambulance and drove her to the emergency room at Schneck. Her pupils were fixed and she had no pulse.
Staff at Schneck administered three rounds of epinephrine to stimulate Anderson’s heart, but it had long since stopped pumping blood. Her skin became mottled.
She was gone.
An autopsy later revealed severe atherosclerotic cardiovascular disease with 99% blockage of her left descending coronary artery, leading to what’s referred to as a “widowmaker” heart attack.
“If she had gone in quickly when she realized she was having a heart attack,” said Dr. Eric Topol, a longtime cardiologist and the executive vice president of Scripps Research, “the artery would have been opened up, and she most likely would have survived.”
By waiting, Anderson had made the ultimate sacrifice to an industry that notoriously demands too much of its workers.
Corporate culture’s role blamed in Anderson’s death
Over the past decade, corporations like CVS, Rite Aid, Walgreens and Walmart have steadily slashed pharmacy staffing levels while saddling remaining employees with a burgeoning list of additional duties.
Stores that once had two pharmacists and six pharmacy technicians filling an average of 500 prescriptions a day now may have half the staff and an even higher prescription volume – plus an endless crush of vaccine appointments, rapid COVID tests and patient consultation calls.
Every task is timed and measured against corporate goals that reward speed and profits. Staff who do not fill prescriptions fast enough, answer the phones quickly enough or drum up enough vaccination business can face discipline, reassignment or termination.
Read USA TODAY’s investigation:Prescription for disaster: America’s broken pharmacy system in revolt over burnout and errors
No chain exemplifies this ethos more than CVS, dozens of current and former pharmacists told USA TODAY. Many recalled how they have been pressured to work through sickness, physical injuries and mental breakdowns.
One pharmacist said her boss refused to give her a day off even though she was suffering a full-blown panic attack. Another said he was asked to stay behind the counter instead of taking his injured son to the emergency room. Two pharmacists said they worked while actively miscarrying because their bosses couldn’t find anyone else to cover their shifts.
“You’re just programmed that if you’re sick or you need to go home, you can’t. You have to wait until someone comes,” said Wendy Lear, a former CVS pharmacist who worked while miscarrying.
Although she had never met Anderson, Lear knew her name.
They all did.
Word of Anderson’s death spread like wildfire among retail pharmacists. It became a cautionary tale of corporate martyrdom. It spawned a hashtag, #SheWaited, and a social media campaign that urged pharmacists to listen to their bodies, stand up to their bosses and take care of themselves.
Not long after she died, a bright orange billboard went up on Interstate 65 in Indiana, between Seymour and Henryville. It featured a photo of Anderson along with the hashtag and a simple message: “Your job can wait, your heart can’t.”
Anderson’s family had paid for the sign.
“We were trying to get exposure to this, because we thought it would gain media attention, and CVS would have to deal with this on some level,” said Larry Anderson, Ashleigh’s father. “But unfortunately that didn’t pan out.”
USA TODAY interviewed Anderson’s father and stepmother, her long-term boyfriend and 10 former colleagues who worked with Anderson at various times during her career with CVS. Many of them described Anderson’s dedication to a job that, some of them believe, ultimately killed her. Some of those colleagues still work for the company and spoke on the condition of anonymity to protect their jobs.
The media organization also examined text messages and calls to and from Anderson’s phone the morning she died, as well as reviewed a summary of her final moments detailed in a coroner’s report obtained through a public records request. A reporter additionally spoke to dozens of retail pharmacists from CVS and other chains across the country about the conditions and demands of the job.
Taken together, the interviews and records paint a portrait of an industry that conditions employees to work beyond their limits and put their own needs behind those of the job. So strong is the culture that those close to Anderson say that even when she got permission to close the pharmacy, she must have decided it was in her best interest to wait for backup before seeking help.
“She was, in our opinion, afraid to go to the emergency room and be told, ‘No it’s not a heart attack at all, it’s just anxiety,’” said her father, Larry Anderson. “Because then she would have to come back and face her bosses.”
Michael DeAngelis, CVS’ executive director of corporate communications, called Anderson’s death a “tragedy that never should have happened.” He pushed back, though, on the notion that CVS bears responsibility for her death, noting that she was told to leave and highlighting the company’s “culture of safety.”
Under no circumstances, he said, does CVS expect or want its employees to work when they are unwell, and it encourages them to seek medical treatment when necessary.
“It’s impossible for me to comment on why Ashleigh made the decision she made,” DeAngelis said. “I think, by and large, pharmacists are highly dedicated health care professionals, and I would not be surprised if there are pharmacists who have the mindset of, ‘I need to keep taking care of my patients,’ versus ‘I’m afraid of being punished by my employer.’”
Although they acknowledge Anderson alone made the call to wait, Larry Anderson and his wife, Donna, still blame CVS for her death. If the company cared about its employees, Anderson said, it would have properly staffed its locations so that no one pharmacist was stuck behind the counter, reluctant to leave.
“There is an intimidation factor,” Larry Anderson said. “You don’t feel like you can take your lunch. If you have a doctor’s appointment, you’re extremely reluctant to do it. You just can’t be away from work.”
Pharmacist was a rising star at CVS
Anderson grew up in and around Lafayette, Indiana, the eldest child and only daughter of Larry and his first wife, Nancy.
As a girl, Anderson was adventurous, spirited and naturally gifted. She excelled at everything, especially academics, and she had a soft spot for animals. Friends and family often called her “the smartest person in any room.” She didn’t even have to try.
She graduated high school as class valedictorian, and attended the prestigious Purdue University, located in her hometown. Anderson could have chosen any major, but she gravitated toward medicine and especially liked the idea of becoming a veterinarian. The only problem: She hated the sight of blood.
“She was maybe a year or two into college when she decided to go into pharmacy,” her father said. “Pharmacy was an option that allowed her to be in the medical field without seeing a lot of blood.”
Anderson threw herself into her studies, learned everything she could and earned a doctorate of pharmacy in 2004. She was 24 years old. Bursting with optimism and eager to prove her worth.
Ashleigh Anderson (center) graduated from Purdue University in 2004 with a doctorate of pharmacy. She is pictured here with her parents, Larry Anderson and Nancy Rockstroh, at her graduation ceremony.
No one was surprised when she quickly landed a job. CVS was lucky to get her, they thought. Anderson felt like she was the lucky one. She loved everything about her work as a retail pharmacist – the fast pace, the stimulating environment, the patient interactions. It was endlessly challenging, and Anderson relished a challenge.
Her coworkers soon took note.
“I knew right from the start that she was going to be our next boss,” said Trish England, who worked as a pharmacy technician at the CVS in Columbus, Indiana, where Anderson started her career. “She was a rising star. She was the best pharmacist we had. They praised her for everything she did.”
CVS soon promoted Anderson to pharmacist in charge at one its busiest locations in the state. Employees working in Columbus at the time recall handling between 3,000 and 6,000 prescriptions a week.
Anderson thrived in her managerial role. She was a master of the pharmacy who could rattle off the answer to any question, efficiently clear a queue of backlogged prescriptions and make patients feel like she really cared.
She ran a tight ship, her coworkers said, and was an absolute stickler for quality control.
“CVS has a thing where technicians count prescriptions out and put them in a box that takes a picture and sends it to the pharmacist to verify and look at it,” said one pharmacy technician. “She made us take the pills and bundle them in groups of five so she could count them herself. We all grunted, like, ‘Why do we have to do this?’ But it was all for patient safety.”
Anderson’s competency initially intimidated some of her coworkers, who said they thought she was “scary” or “cold” until they got to know her. Then they became fiercely loyal, describing her as a true friend whose warmth was surpassed only by her wit.
Managers at other stores sent their pharmacists to Columbus to train with Anderson. Around the time she won the company’s Paragon Award, she was invited into its emerging leaders program, a stepping stone to upper management.
Anderson set her sights on a district leader position, a role overseeing a dozen or so pharmacies and ensuring they hit their corporate targets. She seemed a shoo-in for it.
“She was one of the best pharmacists in the area,” recalled a CVS pharmacist who was sent to train under Anderson. “She was the kind of pharmacist people wanted other pharmacists to be.”
Then, one day, Anderson stunned her coworkers by leaving it all behind.
In August 2013, she abruptly transferred from the Columbus location to a lower-volume CVS in Greensburg, Indiana, where she worked an overnight shift as a staff pharmacist. She dropped out of the emerging leaders program. She stopped talking about career advancement.
Ashleigh Anderson is buried at Tippecanoe Memory Gardens in West Lafayette, Indiana. Atop her grave sits a large headstone, upon which are etched five drawings representing the most important parts of her life. A basset hound, a golfer, a palm tree and two half-full wine glasses each appear in one of the panel’s four corners. Occupying the most prominent spot in the middle is a mortar and pestle – the iconic symbol of a pharmacist.
It made no sense, her colleagues said. Some figured she just needed a change. Others assumed corporate forced her out for falling short of its rising targets.
“It was always numbers, numbers, numbers – you have to hit your numbers,” said a pharmacist who worked with Anderson in Columbus. “The district manager would come in and be like, ‘How come you can’t hit this number? How come you can’t hit that number?’”
At the same time, he said, the store’s prescription volume was exploding as staff size steadily dwindled. CVS decided not to replace a pharmacist who had recently left, and there were fewer technicians at any given time.
“Working conditions just got worse and worse and worse,” England recalled. “The more we did, the more they expected us to do.”
When the numbers fell too far behind, “they took her out.”
But one former colleague said Anderson’s performance at the store wasn’t the issue. It was an ethics hotline complaint that led to her removal.
A pharmacy technician took offense at the way Anderson had handled a situation, said the former colleague, a longtime CVS administrator who worked closely with Anderson over the course of her career.
“She was snappy,” the colleague said of Anderson. “You have to be snappy in that job, but one day she said something in the heat of the moment that she probably should not have said.”
Human resources investigated the complaint, the colleague said, and determined Anderson should step down. The decision gutted Anderson, who felt she did not get a fair hearing.
“They knocked her down a peg,” Donna Anderson said. After that, she stopped trying to be anything more than a staff pharmacist.
Anderson spent the next several years commuting from Columbus to the CVS in Greensburg and then the one in Shelbyville and then the one in Nashville, Indiana. All were within 30 miles of her house.
When she and Bowman bought a newly constructed home in Henryville, 50 miles to the south, Anderson sought a shorter commute.
She found it in Seymour.
Anderson feared dying alone
The final CVS in Anderson’s career sat at the intersection of a busy commercial strip, flanked by a large parking lot, which on that late summer morning was teeming with emergency vehicles.
Khandie Tharp would have seen them had she pulled in just minutes earlier. But the pharmacy tech was late for her shift, and, by the time she arrived, the lot was eerily empty except for two crying coworkers.
One of them approached Tharp as she got out of her Mustang to tell her what had happened. Distraught, Tharp got back in her car and drove to the hospital.
During her 18 months working at the Seymour CVS, Tharp had bonded with Anderson. The experienced pharmacist had taken the new tech under her wing and given her the support she needed to excel in an environment rife with seemingly endless tasks.
In rare lulls, the two shared details about their lives and learned they had a lot in common. As neither of them had any children, they confided in each other about their fears of dying alone.
Tharp was determined that morning not to let that happen.
She introduced herself to the emergency room receptionist and asked that someone inform Anderson of her presence. Since she was not family, staff could say nothing about her friend’s condition but promised to let someone know Tharp was there.
And then she waited.
“I wanted her to know that somebody was there for her,” Tharp said. “I was there for her.”
Bowman was at home when his phone rang. The call came from the CVS store in Seymour, and when he answered, he heard the rattled voice of another pharmacy tech saying Anderson had collapsed and that paramedics were on their way.
Bowman jumped in his vehicle and kept a lookout for state troopers as he sped north on I-65 to Schneck Medical Center, not knowing what he would find when he got there.
Tharp greeted him when he arrived. The two had never met, but she recognized him from photos Anderson had shared. Bowman was grateful she was there.
A doctor appeared and asked Bowman to follow him into a room. Bowman knew right then that Anderson was gone. He remembers feeling his feet carry him into the room and his ears listen to the doctor explain that her heart had stopped.
The explanation ended, and Bowman was led into another room. This one held Anderson’s body. Bowman was given time to say goodbye.
Time passed – five minutes, an hour, an eternity – before Bowman reappeared in the waiting room. He looked at Tharp and shook his head. She knew then, too. Tharp felt her knees buckle. Bowman caught her before she fell. Then the two strangers cried together in the hospital over a woman they both loved.
It was Bowman who broke the news to Anderson’s parents.
When they saw his number pop up on their phone, Larry Anderson said, he and Donna figured Bowman was calling to thank them for the large patio umbrella they’d had delivered that morning to his house.
Instead, Larry Anderson said simply, “What a shock.”
Family seeks answers amid misunderstanding
When the shock wore off, the family wanted answers as to how a seemingly healthy, active woman in the prime of her life could collapse and die at work.
They knew CVS had expected Anderson to work through lunch breaks and bathroom breaks, that she felt pressured to come in even when she was sick. They knew her job stressed her. Now they wanted to know if it killed her.
Larry Anderson said he found the numbers for his daughter’s boss and his assistant and called them, but neither one would talk.
“After two or three attempts, her boss finally did talk to me, but he was very careful of what he would say to me,” Larry Anderson said. “He said he had been instructed not to answer (questions) and said ‘I shouldn’t even be talking to you.’ But he was trying to be nice.”
Members of Ashleigh Anderson’s family stand next to her gravestone in Tippecanoe Memory Gardens in West Lafayette, Ind. From left are her stepfather Mike Rockstroh, mother Nancy Rockstroh, stepbrother Jeremy Stockdale, brother Nate Anderson, father Larry Anderson and stepmother Donna Anderson.
Even the company’s gesture of establishing a scholarship in his daughter’s name at Purdue fell flat, he said, when CVS made a one-time donation of $10,000 that December instead of sustaining it annually as the family thought it would.
DeAngelis denied that CVS avoided conversations with the family or that it ever committed to funding a scholarship beyond the one-time donation.
“We regret if there was any misunderstanding,” he said.
Misunderstanding was taking root online, too. Messages about Anderson’s death started appearing on Facebook, Reddit and Twitter. They claimed her bosses had forbidden her from seeking immediate medical attention and made her wait until a backup pharmacist arrived.
Among those who saw the posts was Bled Tanoe, a former Walgreens pharmacist who amassed a large online following advocating for better retail pharmacy working conditions under the hashtag #PizzaIsNotWorking – a nod to companies’ hollow offerings of free pizza to appease stressed employees.
Anderson’s death struck Tanoe as further evidence of an industry that mistreats its employees, she told USA TODAY. She wanted to amplify the story and create a new hashtag around it. So she reached out to CVS pharmacists in Indiana to verify the story. They confirmed that Anderson could not leave, according to messages Tanoe shared with USA TODAY.
In October, Tanoe launched the #SheWaited hashtag, and the story exploded among retail pharmacists online. By the time Tanoe heard the details might not be correct, she said, her sources had either stopped talking or were no longer sure, and the story had already taken on a life of its own.
Regardless, Tanoe said, the message behind the movement she started remains the same.
“It is established in our profession, there is a culture where you cannot put yourself first,” said Tanoe, who also is the vice president of the online pharmacist advocacy community, RPhAlly. “It might not be written in a handbook and they would never say it to your face, but the message, through their actions, is that the company comes first.”
In the two years since her death, Anderson’s name has transcended social media.
It now echoes through the college classroom of Haley Howard, an assistant professor of pharmacy practice at Manchester University in Fort Wayne, Indiana, where she teaches first-year students about professional self-advocacy.
Howard uses Anderson’s story to remind her students that they have a right to reasonable working conditions and to voice their concerns. Most importantly, she tells them, they can’t fulfill their duty to care for their patients if they don’t take care of themselves first.
It’s one of several examples Howard includes in an accompanying slide show that shares advice with future pharmacists about how to advance their careers at a time when many are leaving the profession and enrollment to pharmacy schools is in decline.
Howard, who also works as an acute care pharmacist at Cameron Memorial Community Hospital in Angola, Indiana, never met Anderson. But she said she heard about her death from a fellow pharmacist who had heard about it from somebody else. It felt, she said, like a wake-up call that more people needed to hear.
“Pharmacists need to be in safe working environments,” Howard said. “I wanted to share with my students and say, ‘This stuff happens in pharmacy, and it shouldn’t be happening.’”
Emily Le Coz is a reporter on the USA TODAY investigations team. Contact her at elecoz@usatoday.com or on X @emily_lecoz.
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Emmalyn’s Journey – funding raising for her therapy
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Former doctor:charged second-degree manslaughter: for witnessing the death of a woman, who had severe, chronic pain.
So this pt who had severe, chronic pain, was it because she could not find a practitioner who would properly treat her pain? In the 2020 Presidential election Biden got 61% of the vote. In New York, abortion can/will be provided for up to 24 weeks and after that can still get an abortion if your health or pregnancy is at risk. https://www.ny.gov/programs/abortion-new-york-state-know-your-rights
According to this Usually, after week 22. It’s rare that premature babies born before week 22 survive. But micro-preemies born between 22 and 26 weeks will need lots of medical attention to prevent any lasting damage to their brains, lungs, and other organs. That’s because babies continue to grow and develop right up until 39 weeks, so the longer your baby stays inside the womb, the better their health. https://www.babycenter.com/baby/premature-babies/whats-the-outlook-for-a-premature-baby-born-at-28-31-33-or-3_10300031 And they are referencing not to a fetus but as a BABY. NY state legislature has tried to pass a “death with dignity ” bill – like 10 other states have laws – but has been stuck in a Senate committee for over ONE YEAR.
It would seem that the state’s judicial & legislative bodies are bifurcated on when a life must be allowed- or forced – to continue and when it is legally permitted to be terminated.
The question should be asked, why was a practitioner not complicit in this person’s suicide? It is well-documented that pain, especially intractable chronic pain goes untreated and the pt is known to be at risk of suicide.
Former doctor accused of helping person die by suicide in New York motel is charged with manslaughter
Stephen P. Miller, 85, who is on the advisory board of an end-of-life advocacy group, was charged with second-degree manslaughter, accused of aiding a person to die by suicide.
An 85-year-old former doctor from Arizona has been arrested and charged with manslaughter, accused of aiding a person to die by suicide in a New York motel in November, officials said.
Stephen P. Miller, of Tucson, Arizona, was arraigned Friday and pleaded not guilty to charges of second-degree manslaughter and first- and second-degree assault, court records show.
The investigation started shortly before noon on Nov. 9, when police responded to a report about an unconscious and unresponsive person at a Super 8 on Washington Avenue in the city of Kingston, about 100 miles north of New York City, Kingston police said in a statement Friday.
First responders found a person who initially appeared to have died by suicide alone in the motel room, police said.
But further investigation led to evidence that a second person had been present who “contributed to or assisted in the suicide,” the statement said.
An investigation by police and the Ulster County district attorney’s office led to an arrest warrant being issued for Miller citing second-degree manslaughter under the state penal code regarding a person who “intentionally causes or aids another person” to die by suicide.
Authorities did not identify the dead person, but they said Miller was not related.
Miller’s attorney, Jeffrey Lichtman, did not immediately respond to a request for comment.
Lichtman told The New York Times that it was a woman who died in the motel room that night and that she had contacted Miller through a national organization that advocates for the legalization of medical aid in dying. Lichtman said Miller traveled to New York from Arizona to witness the death of the woman, who had severe, chronic pain. He said his client had provided similar services before.
“This was done carefully, compassionately, and with a lot of research and reflection,” Lichtman told the Times. Speaking to The Times Herald-Record of Middletown, New York, Lichtman said, “Providing advice on ending one’s life does not necessarily run afoul of the law.”
Miller serves on the advisory board of Choice and Dignity — an end-of-life nonprofit group based in Arizona that believes “everyone has the right to have their individual end-of-life plans respected and honored,” according to its website.
Medical aid in dying has long been controversial. It is legal in 10 states — including California and New Jersey — and Washington, D.C., according to Death with Dignity, an end-of-life advocacy and policy reform organization.
It is not legal in New York state, though it has been proposed — and has stalled — in the Legislature.
New York’s Medical Aid in Dying Act, Senate Bill S2445A, follows an outline used in other states. It says a terminally ill patient who is mentally competent may request medication to be self-administered to hasten death, provided certain requirements are met. The bill was introduced in January 2023 and is in a Senate committee.
Miller was remanded to the Ulster County Jail on $500,000 cash bail or $1 million bond, or $3 million partially secured bond. Inmate records show he was bonded out the same day.
Miller is a former family practice doctor who graduated from Rosalind Franklin University of Medicine and Sciences in Chicago in 1964. He was issued a license to practice in Arizona in 1994, which expired in 2005, according to Arizona Medical Board records.
He was also issued a medical license in California in 1969, which was revoked in 2009, board records show, citing that Miller had been convicted of tax evasion in Texas in 2006. In that case, he was sentenced to a little less than four years in prison and three years of supervised release.
Miller is due back in court March 14.
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An Ohio CVS store was a month behind on filling prescriptions. State regulators slapped it with a $250,000 fine
An Ohio CVS store was a month behind on filling prescriptions. State regulators slapped it with a $250,000 fine.
COLUMBUS, Ohio – State regulators fined a Canton CVS pharmacy $250,000 after discovering it was over a month behind in filling prescriptions, had closed the lobby to all customers not seeking vaccines and sent them to the drive-thru, didn’t have properly working phones and couldn’t check the temperature in cold storage because monitors weren’t working.
The Ohio Board of Pharmacy also put the store at 7292 Fulton Drive, NW, on probation indefinitely, but for a period of at least three years. During that time, the store will be subject to enhanced monitoring, according to a statement from the board.
Amy Thibault, a spokeswoman for Rhode Island-based CVS Pharmacy, said that the company will continue to work with the Ohio Board of Pharmacy collaboratively.
“The allegations stem from BOP inspections in 2021, during the height of the COVID-19 pandemic, and we’ve made great strides to improve the conditions there in the years since, including putting a strong pharmacy team in place that continues to provide high-quality care to patients,” she said. “We’re committed to ensuring there are appropriate levels of staffing and resources at our pharmacies.”
Regulators discovered the problems and a lack of sufficient staffing in September 2021. The store is just one that’s been under state investigation for insufficient staffing, according to the Ohio Capital Journal. Attorneys for CVS, during hearings before the pharmacy board, have blamed the staffing and other problems on additional responsibilities it gained during the pandemic.
But the Ohio Board of Pharmacy wanted to send a message with the fine announced on Tuesday, said Steven Schierholt, its executive director.
“We hope that this decision will send a strong message to Ohio pharmacies that they have an obligation to serve their patients by ensuring appropriate staffing levels,” he said. “The Board will continue to inspect and hold those accountable for working conditions that endanger patients and pharmacy staff.”
In addition to inspections, the board recently filed a set of rules for public consideration that it believes will strengthen regulations on working conditions in pharmacies.
The 2021 investigation found high levels of staff turnover at the Canton store. All pharmacy staff at the September 2021 inspection had quit or transferred to another store when the state regulators followed up about 40 days later, the state investigation said.
At the first inspection, board staff noticed two open totes from a wholesale distributor on the counter next to the window and accessible from outside the pharmacy barricade. An unlocked freezer containing the Moderna COVID-19 vaccine was outside of the pharmacy barricade. The door between the pharmacy and vaccination room was kept open with a magnet inside the door jam, according to the investigation.
CVS pharmacy staff and an assistant store manager asked district leaders to temporarily close down the store so they could catch up on unfilled prescriptions, as well as to clean and organize the pharmacy. The request was denied, as was a request for additional staff, the investigation said.
At 7:30 p.m. each night, the pharmacy technician at the Canton CVS store had to walk out to the drive thru and notify waiting patients that the store closes at 9 p.m., and they would not be able to get medications after then, as the CVS system shuts down, according to the investigation.
State regulators found the store was over a month late in filling prescriptions in its October follow-up, roughly 40 days later. The pharmacy staff were trying to triage to ensure they could fill lifesaving and life-sustaining medications, such as antibiotics, pain meds and birth control.
The proposed Ohio Board of Pharmacy rules include requirements for pharmacies to develop a process to address staffing concerns, ensure pharmacy employees receive rest breaks and bans the use of quotas to perform work tasks. Pharmacists inside stores would get more power over staffing to ensure most prescriptions are filled within 72 hours.
The pharmacy board told CVS in Canton that prescriptions must be filled in a maximum of three business days after it was dropped off. If it cannot be filled in that time, the Ohio Board of Pharmacy must be notified.
CVS shall not retaliate against or discipline a pharmacist, pharmacy technician, trainee, intern or other employee who communicates a request for additional staff or reports staffing concerns to the state, the board states.
Pharmacists, pharmacy technicians and interns shall not be required to administer vaccines when only a single pharmacist is on duty, and in that pharmacist’s professional judgment, the vaccine cannot be administered safely, the board states.
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SATIRE:Post-op Pain Relief for Mr. Merrick Garland?
Post-op Pain Relief for Mr. Merrick Garland?
He’s recovering from an interlaminar decompression
https://www.daily-remedy.com/post-op-pain-relief-for-mr-merrick-garland/#comment-8893
Mr. Merrick Garland had back surgery over the weekend. Specifically, he had an interlaminar decompression to address his lumbar spinal stenosis. It’s a common, minimally invasive surgery. But, surgery is surgery. There’s always risk. So we pray for a speedy recovery and we wish him nothing but the best long term.
However, we can’t help but conjecture about his post-operative pain management. He’s the nation’s top federal law enforcement agent, after all. He oversees the Department of Justice (DOJ) and, by extension, all subsidiary law enforcement agencies, including the Drug Enforcement Agency (DEA). Over the weekend, he added another title – surgical patient – and as part of that role, he likely received opioids during and after the surgery for his pain management. That’s the standard of care for a laminar decompression.
It poses an interesting conundrum. Does Mr. Garland accept opioids for his pain relief, knowing that opioids are at the epicenter of the DOJs and DEAs modern, medical iteration of its ‘war on drugs’? At what point does he act like a patient or a law enforcement agent when receiving opioids? We can only imagine. But we surmise it would go something like this:
While Mr. Garland is recuperating from surgery, the physician overseeing his recovery would assess the surgical incision and would monitor for adequate pain relief. At some point in the clinical encounter, Mr. Garland would answer the perfunctory question rating his pain on a scale from one to ten.
When Mr. Garland responds with a numerical value, should the attending physician believe him? It would be the clinically sound thing to do. But legally, would the physician place himself or herself in jeopardy by trusting Mr. Garland? It’s Churchill’s riddle wrapped in a mystery inside an enigma.
Here you have a patient recovering from surgery who also happens to be a federal law enforcement agent – the top one at that – who oversees the very agencies that could put the overseeing physician in prison depending on the clinical decision made in this exact circumstance.
What happens when Mr. Garland says his pain is increasing? Should the physician document the presence of breakthrough pain? Or should the physician document that Mr. Garland is likely malingering and exhibiting drug-seeking behavior? Or maybe document both? Hedge against both options, just in case Mr. Garland decides at first to act like a patient and then decides to behave like a federal agent after the fact.
But this is only one decision at one point in time. For patients recovering from an interlaminar decompression, the average recovery time is a little over two days. This means the attending physician would have to review Mr. Garland’s pain management for at least six encounters, assuming three shifts per day and one clinical encounter per shift. What happens after the initial encounter?
Should the attending physician reflexively implement a tapering schedule without first discussing it with Mr. Garland? Or, to be extra safe, should the physician simply discontinue any post-operative pain management that involves opioids? Better yet, discontinue any and all prescription opioids and provide medical literature that discusses the psychosomatic nature of pain – let Mr. Garland know that his post-operative pain is simply in his head.
What about proper oversight? What if Mr. Garland monitors the number of times he’s asked to take a urine drug screen or the number of times he’s asked to repeat imaging studies? Assuming Mr. Garland stays the average number of post-operative days, should the attending physician repeat imaging studies on the second post-operative day – or just assume that Mr. Garland is in continued pain because he recently had surgery? Wouldn’t Mr. Garland chalk that up as a lack of proper oversight?
If we were in the attending physician’s shoes, we’d order as many urine drug screens and imaging studies as possible. In case, as Mr. Garland recovers, he transitions from patient to agent faster than he’s cleared for discharge. On the other hand, what if Mr. Garland suspects that the attending physician is over-utilizing urine drug screens and imaging studies? How should the physician respond in that case?
Maybe the attending physician should ask Mr. Garland what to do. In this way, the physician can claim he or she sought the counsel of law enforcement when making a clinical decision. It’s probably the safest way to go.
What if Mr. Garland decides not to act as either a patient or a law enforcement agent, but as an undercover agent? In that scenario, by asking Mr. Garland for advice on whether to adjust or continue pain management, or to order urine screens or imaging studies, is the physician failing to provide sufficient oversight?
Perhaps the physician can ask Mr. Garland what he believes the appropriate course of care management regarding his pain relief should be – but then do the opposite. In this scenario, the physician covers all bases and treats Mr. Garland the patient, the agent, and the undercover agent.
Or, thinking more realistically, the physician should just transfer the post-operative care for Mr. Garland to another unit and take a few days off. Why take the risk? After all, you can’t get targeted if you abandon your duty as a physician.
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This satire mimics a speculative clinical scenario that sadly is far too real for far too many physicians across the country. We pray that Mr. Garland recovers well and returns to work in as timely a manner as possible. But we also hope that Mr. Garland learns from his experiences as a patient and recognizes the harms the DOJ and DEA are causing physicians and patients alike.
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Jurors given instruction defective in light of a 2022 U.S. Supreme Court decision
Doctor who prescribed more than 500,000 opioid doses has conviction tossed
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Lawyers plot gambling addiction suits as casinos go online
This article is abt 10 yrs old, but according to some news on TV tonight. There are more and more law firms and attorneys – who were involved with the Tobacco Settlement and are taking a closer look. Just a couple of months ago the state of Kentucky made online gambling legal and in doing so. In the law, they are to put aside a couple of percentage points of the state’s gambling revenue to fund assisting those who end up with gambling addiction. Within a couple of months, the number of calls made to the gambling hotline tripled. Is the word “ADDICTION” a dog whistle to law terms. Is this an indication that they believe that they have gotten all they are going to get out of the “opioid crisis” and with the Tobacco settlement money drying up this year, they need to find another industry providing a legal product/service that they can extract money out of?
Lawyers plot gambling addiction suits as casinos go online
https://www.reuters.com/article/us-casinos-litigation-idUSBRE9410V620130502/
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DOJ reaches $59M settlement with eBay over sales of thousands of pill presses
Does this point to a lack of commitment to our war on drugs? Normally in our legal system, anyone involved in a crime where someone is killed, even if they were just driving the get-a-way car. The person driving the car is equally guilty of the murder created during the crime. Here is a corporation that is selling paraphilia to create tablets from illegal fentanyl and nearly 300/day of our citizens are killed from such illegal fentanyl tablets. eBay doesn’t directly sell these products, they are just a conduit for some entity that is selling these paraphilia. Most/all of these sales are being done using some sort of currency to finalize the transaction. I mentioned THREE LEVELS in causing these deaths, and all the DOJ goes after is the deepest pockets. Will those people who are selling and buying all these paraphilias, will just find new sources and continue killing our citizens?
DOJ reaches $59M settlement with eBay over sales of thousands of pill presses
https://abcnews.go.com/US/doj-reaches-59m-settlement-ebay-sales-thousands-pill/story?id=106834145
The Justice Department announced a $59 million settlement with eBay on Wednesday to resolve allegations that the e-commerce company made it easy for thousands of pill presses to be sold on its website that could be used by criminals to make illegal drugs.
The company has agreed to pay the steep financial penalty — the fourth largest settlement ever through the Controlled Substances Act – and implement a series of changes that will make it harder for the pill presses and other related items to be sold in the future.
The DOJ said it found that through a review of the company’s policies that it failed to require identity verification of purchasers of the pill processers, some of which had the capability of pressing thousands of pills per hour. Such machines are commonly used by drug dealers who manufacture counterfeit pills that can be laced with fentanyl, the DOJ said.
“Counterfeit pills laced with fentanyl are a significant contributor to the deadly overdose epidemic,” said Associate Attorney General Vanita Gupta, chair of the Department of Justice’s Opioid Epidemic Civil Litigation Task Force. “The Department is committed to using all available enforcement measures to ensure that companies involved in selling the equipment that makes it possible to create these dangerous pills comply with the Controlled Substances Act.”
MORE: eBay to pay $3 million for harassment targeting Massachusetts couple over newsletter
In addition to the monetary settlement, eBay agreed to maintain and enhance its compliance program with respect to its prohibited and restricted items policy on the sales of pill presses, counterfeit molds, stamps and dies, and encapsulating machines, the department said.
In a statement, the company said it “expressly denies the DOJ’s allegations and the settlement does not include any admission of wrongdoing.”
The statement added, “eBay’s actions to remove products that could be used for counterfeit pills – including dies, molds and pill presses – prior to any request from the DOJ or other authorities, and years before the government turned its attention to these products, prevented tens of thousands of potentially problematic listings from appearing on our marketplace. Government officials have repeatedly commended eBay for our partnership with law enforcement and efforts to support investigations into illegal pill press usage.”
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