I have received this information second-third hand but came from what I consider a very reliable source. There is a prescriber in the NW of the USA that is being charged with manslaughter over a pt’s death. The spouse of this pt told both the DEA and the county prosecutor that the pt COMMITTED SUICIDE… because a Pharmacist refused to fill the pt’s opiate prescription(s). The consequences of untreated pain and being thrown into cold turkey withdrawal… pushed the pt over the edge and the pt took a irreversible action.
Did this statement from the pt’s spouse get the charges dropped against the prescriber … NOT AS YET !!!
Has the Pharmacist, that intentionally threw this pt into elevated pain and cold turkey withdrawal suffered any legal consequences… NOT AS YET !
Has the surviving spouse sued the Pharmacist for his/her irresponsible professional negligence … NOT AS YET !!
Has the Board of Pharmacy taken any action against this Pharmacist … NOT AS YET !!
Those that lose a loved one to a opiate over dose typically get MAD AS HELL and “take to the street”
Why have those that have loss a loved one to denial of care and they have committed suicide… NOT MAD AS HELL ? and “take to the court system” ?
Filed under: General Problems
I don’t play doctor. How rude. I’m a more seasoned pharmacist than you. I care about my community and pride my profession. I trust my judgement. I’m confident, not playing games. Do you really think prescription drugs are not diverted? You are either playing games or are oblivious.
Priscilla…I take it that you’re a pharmacist. So am I. I agree that professional judgement is the key. We both know that such judgement is garnered through experience. I graduated and was licensed in 1992. I can say without a doubt that my professional judgement is markedly better in 2015 as compared to 1992.
Now, here’s the rub. We do not exercise our professional judgement in a vacuum, especially in the case where one is employed by one of the behemoth pharmacy chains. There is the ever present specter of corporate management and government regulatory agencies sitting in their “easy chair” and playing Monday morning Quarterback. When that pressure is added as an influencing factor that, whether we like to admit it or not, informs said judgement, our patients can and do get hurt. I can say with certain surety that I was much more intimidated by such outside entities in the first few years of practice than I am now. If I had to make an educated guess, I would agree that this was probably a recent grad that erred on the overly cautious side of the equation.
I, personally, would have filled the script for a partial quantity that would last at least 72 hours beyond what I would consider the first reasonable opportunity to be in contact with the prescriber. That takes care of the patient, it is within the constraints of the law (if the prescription appears to be in compliance) and it limits the amount of Controlled Substance that may be diverted if there is something nefarious going on. Like you said, we don’t have all the facts, but there are ways of handling this situation without having to jeopardize the welfare of the patient or to put one in harm’s way legally. After all, isn’t that what we get paid the big bucks for?
I understand that pharmacists are under a lot of pressure. Patients are too, and we don’t like it when our pharmacists “play doctor.”
Human psychology would suggest that someone with a “questionable” will not accept a couple of days off of the Rx and risk the chance of being arrested or losing the balance on the Rx when it is confirmed – or not confirmed with the prescriber …. however, a chronic pain pt who faces being thrown into cold turkey withdrawal..waiting a few days to be confirmed… will probably option to take the Rx somewhere else to get filled. This is where the term “Pharmacy crawl” was created.. The typical chronic pain pt is physically, mentally, financially exhausted/bankrupt and is forced to bounce from pharmacy to pharmacy trying to get their quality of life medication filled.
You’re right. And a big problem with that is we don’t have the energy to “pharmacy crawl” either. Giving up is easier. Especially when so many pharmacists have been rude rather than politely tell their truth.
As a patient I’m a chronic pain sufferer too. My pharmacy has never turned me down. I don’t come Friday’s at close, leave the rx overnight, don’t drive doped up. I go to the same pharmacy. Bill or Sonia fills my scripts. I don’t watch them when they fill, and if they verify my script or use PMP in not watching. But there are other CUSTOMERS. I am a patient.
I don’t have an answer to why the patient did not file a complaint and that is a good question. I have not heard both sides. However mannerisms of a patient make me nervous It’s rare. But I listen to myself. Pharmacists everywhere can refuse to fill a prescription, for any reason. I think recent grads are very nervous, and recent grads often have no sense or skills. There is nothing wrong for saying to the patient ” I don’t have this medication in stock. It should be here in three business days.” That gives time to verify and document. Especially the Friday night last patients….. Whenever I say Tuesday, they take the prescription back. My instincts are usually correct. Everyone must use professional judgement. Be careful. Some states want you to document the back of the Rx that you did not fill it. Not in stock is valid. If the BOP has concerns, they can talk to you. On a side note, I have filled narcotics that have ended up in a patient fatal overdose. It’s not a pleasant experience. We are not robots, and really, it’s not “have it your way” or please “give me super size. ” Don’t belittle “professional judgement.” It’s on the table…… Be careful ok?