1-ribbonFirst they came for the mentally ill addicts, and I did not speak out—
Because I was not a mentally ill addict.

Then they came for the empathetic prescribers, and I did not speak out—
Because I was not a empathetic prescriber.

Then they came for the Pharmacists, and I did not speak out—
Because I was not a Pharmacist.

Then they came for me—and there was no one left to speak for me

Florida Senate on Civil Asset Forfeiture Reform

ATR Commends the Florida Senate on Civil Asset Forfeiture Reform

Florida Senate Bill 1044 passed the Senate Judiciary Committee today with a 5-2 vote today. The proposal would attempt to fix Florida’s lax civil asset forfeiture rules in favor of stricter protections for property rights and due process. State law enforcement receives close to $20 million per year in confiscations through asset forfeiture thanks in part to some of the weakest protections against arbitrary forfeiture in the nation. Currently, agencies are not required to report the amount of assets seized leading to a blurred system that violates citizens’ rights.

Under the new law, law enforcement would be required to have a conviction of a crime and proof that the property in question was connected to the crime for assets to be seized. The legislature should now take up forfeiture reform and take their place among the states willing to put their residents first.

Read the full endorsement below:

Dear Chairman Diaz,

State legislatures across America have been changing their laws concerning the controversial practice of “civil asset forfeiture.” Now, Florida has an opportunity to be a national standard-bearer on due process protections. Americans for Tax Reform is proud to endorse SB 1044—a bipartisan bill that would secure the property rights of Floridians from arbitrary seizures from overzealous authorities.

Florida has some of the weakest protections for property in the nation—leading to a staggering $20 million per year in confiscations through asset forfeiture. Since agencies are not required to report the actual amount of assets seized, the full amount is unclear.

This is unacceptable.

Agencies should not have the ability to fund themselves by confiscating the property of innocent individuals. The founders established Fifth Amendment due process protections for this very reason.

Civil asset forfeiture is the kind of system which undermines the trust between hardworking law enforcement and their communities. By leaving the door open to arbitrary abuse, mutual trust between communities and the men and women tasked to protect them is compromised. In a country based on the rule of law, no one should fear that they could be deprived of their property without the opportunity to defend themselves.

Furthermore, the perverse incentive created by civil forfeiture encourages law enforcement to profiteer from the communities rather than fight crime as they were meant to do.

Senate Bill 1044, written by senators Jeff Brandes, Joe Negron, and Jeff Clemens allows for asset forfeiture but under the necessary conditions required to protect the rights of the innocent. The new law would require both a conviction of a crime and proof that the property in question was connected to the crime for assets to be seized and appropriated.

I encourage the both the committee and the legislature to support SB 1044. Civil asset forfeiture was an old idea poorly implemented and damaging to both police departments and communities. With this legislation, Florida can be considered a national leader in due process and civil rights. If you have any questions, please contact ATR’s criminal justice manager Jorge Marin at jmarin@atr.org.

Sincerely,

Grover G. Norquist                                                    

President                                                                    

Americans for Tax Reform      

Prescription for harm: Dangerous drug mix leaves woman fighting for life

An ordeal

Prescription for harm: Dangerous drug mix leaves woman fighting for life

http://www.chicagotribune.com/news/watchdog/druginteractions/ct-drug-interactions-skin-reaction-met-20160209-story.html

The first symptoms mimicked the flu. Becki Conway had a sore throat, a dry cough and irritated sinuses.

But the next signs were more puzzling.

A sharp pain radiated through her chest. Her eyes turned red and itchy. It seemed like she was fighting off some strange bug, or maybe it was just the normal exhaustion of keeping up with twin toddlers.

Then the scalding rash began.

Red spots popped up on Conway’s face and neck. The next day, painful sores appeared in her mouth and then her throat.

Within hours Conway was in a hospital bed, watching with alarm as the rash spread across her torso, arms and face. The red dots turned into blisters that welted so quickly it looked like her skin was burning from the inside out.

No treatment could stop it. Within a day or two she wasn’t recognizable. Eventually, the rash covered her eyelids with blisters and attacked the lining of her lungs. Her skin peeled off in sheets.

Only after it was too late to stop the rash did anyone figure out that Conway had taken a potentially dangerous mix of medications that can trigger the immune system to attack the body’s own cells.

Drug interactions in which one drug alters the effect of another are a hidden epidemic in America, a decadeslong threat to public health that has been barely acknowledged, let alone addressed.

Many interactions involve relatively safe drugs that become dangerous only when taken at the same time. Hundreds of risky combinations involve common antibiotics, blood thinners, antidepressants, cholesterol drugs and medicine to treat migraines, heart problems and high blood pressure.

The tragedy is that much of the harm is preventable. The particular drug interaction that hospitalized Conway was identified years ago. But experts estimate that thousands of patients still become sick every year from drug interactions because of errors and neglect by front-line providers of medical care.

The result in such cases: Victims and their families are left with few answers, and the underlying safety failures go uncorrected.

The doctor who prescribed Conway’s medications did not heed a black box warning about a fatal rash that could result from the drug pairing, according to medical and legal records and interviews. The pharmacy that dispensed the medicine did not call her attention to the danger. And as her symptoms rapidly worsened, a string of doctors and nurses missed the connection to the drug combination.

Most patients rely on their doctors to protect them, but studies show that prescribers often are unaware of harmful drug combinations or trust that pharmacists have more expertise. Pharmacists, in turn, tend to respect the discretion of doctors.

For pharmacists, warning patients about the risky mixing of drugs is one of the major responsibilities of the profession, according to the National Association of Boards of Pharmacy. Yet when injured patients sue, pharmacies often take the legal position that they have no duty to do so.

Pharmacies and hospitals use computer programs to screen for unsafe drug pairs. But those systems trigger so many alerts about potential drug interactions — including many that pose little risk to patients — that doctors and pharmacists frequently ignore them. Research has found that some pharmacists are more likely to approve dangerous mixes of prescriptions while working busy shifts.

When drug interactions hurt patients, the Food and Drug Administration along with most state medical and pharmacy boards do not require doctors and pharmacists to report cases. Pharmacists and doctors rarely face sanctions unless patients take the initiative to complain, according to the national pharmacy group.

“When you look at it from every conceivable aspect, the system is badly broken,” said Philip Hansten, a professor of pharmacy at the University of Washington who has studied drug interactions for nearly 50 years. “It’s really disheartening to see people are still dying from interactions we’ve known about for decades.”

Dozens of legal complaints reviewed by the Tribune described how patients became sick or died from a toxic mix of drugs that was mishandled in nearly every health care setting, from family practice offices and corner pharmacies to specialty clinics, hospitals, emergency rooms and nursing homes.

One physician prescribed the cholesterol drug simvastatin to a patient in north suburban Niles who was already taking ketoconazole and cyclosporine because of a kidney transplant years earlier. The potentially lethal mix led to a toxic buildup of the heart medication and left the patient too sick to walk and requiring hospital care, according to a lawsuit that was later settled.

In North Carolina, the state pharmacy board found that a CVS pharmacist had ignored computer safety warnings about combining allopurinol for gout and the kidney transplant drug azathioprine. The 49-year-old woman who took the medications together for weeks grew increasingly ill as her bone marrow failed to produce enough blood cells, leaving her hospitalized, according to pharmacy board and medical records.

The interactions don’t always set off a toxic reaction. In many cases, one drug makes the other drug ineffective, leaving patients vulnerable to the effects of HIV, cancer and other serious ailments.

When Becki Conway sought help, trusted health care providers failed her at nearly every turn, leaving her in a fight for her life.

A case of anxiety

At 37, Conway was a high-energy mother of five children ranging in age from 2-year-old twin boys to a 17-year-old son.

The summer of 2009 was one of the most hectic periods in her life. She and her husband were working full time, installing a new roof on their two-story brick home in central Michigan and preparing to open a pizzeria in a month. Their twins were not yet potty-trained.

Making matters worse, Conway was battling an ex-boyfriend in a child custody dispute and had been feeling extremely anxious. She found herself lashing out at her husband and shouting at the kids.

Conway worked at Sparrow Urgent Care in the town of Mason, registering patients as they arrived at the clinic. She decided to seek help from a doctor she was friendly with, Thomas Bellinger. The two met for 15 minutes in a break room where employees chatted, drank coffee and ate lunch, according to interviews and documents in a later court case.

Conway mostly talked about her family history, childhood abuse and previous medication. She told Bellinger she had taken medicine for depression years earlier but hadn’t taken anything since. He told her he empathized with her and promised to bring her a book on bipolar disorder.

Bellinger had practiced family and emergency medicine since receiving his medical degree in 1985 from Michigan State University. He worked at several hospitals and urgent care clinics in Michigan before taking a job at the Sparrow clinic.

Minutes after their consultation, Bellinger approached Conway at her desk and handed her two prescriptions: one for Lamictal, the other for Depakote, according to medical records and her legal deposition. Both drugs are used to treat epilepsy and bipolar disorder. Lamictal carries the FDA’s strongest label, a “black box” warning, which highlights the potential danger of combining Lamictal and Depakote.

Research on the ability of doctors to identify harmful drug pairs shows that although many physicians consider the issue when they write prescriptions, their specific knowledge about drug interactions is generally poor.

In one 2008 study, researchers asked 950 prescribers to classify various drug combinations by severity of risk. More than a third of the prescribers answered “not sure” for half of those pairs. Less than 25 percent of the prescribers correctly recognized that three of the drug pairs should not be taken together.

Training on specific drug interactions in medical schools is lacking because of time constraints and the vast number of hazardous combinations, said Dr. Alfred George, chair of the pharmacology department at Northwestern University’s Feinberg School of Medicine. Doctors also are not required to demonstrate knowledge of drug interactions to state licensing boards or when seeking hospital credentials, he said.

“New drugs are hitting the market every day, and clinicians rarely have time to read all the literature on the drugs they prescribe,” George said.

Adding to the problem, no list of medications automatically follows patients from one medical provider to another. One physician may not know what another doctor has prescribed.

The label for Lamictal warns that the drug’s concentration level in the body more than doubles when taken with Depakote. To lower the risk of a deadly reaction, the label advises doctors to decrease the normal starting dose of Lamictal by half when it is combined with Depakote.

Physicians may read such warnings but make prescribing decisions at their own discretion. Bellinger gave Conway a prescription for the full dose of Lamictal.

In depositions, Bellinger said his diagnosis of bipolar disorder was based on multiple conversations with Conway over a period of months and that his prescriptions were in line with successful treatment plans for other patients. He said he was familiar with the black box warning but assessing the combined risk of the two drugs was difficult because Lamictal also can cause a dangerous skin rash when taken alone.

Citing language on the drug label, Bellinger said the extent to which Depakote potentially increases the risk is unclear. He believed the possible risk posed by giving Conway the full dose of Lamictal was outweighed by the danger of giving her a dose that was too low to relieve her symptoms.

In her deposition, Conway said Bellinger made a prediction as he handed over the prescriptions: She would feel better by the next day.

No warnings

Conway faxed the prescriptions to her usual pharmacy at Sparrow Hospital in nearby Lansing, part of the same health system as the urgent care clinic. Her husband, Tim Conway, worked there transporting patients and picked up her prescriptions the next day.

No one at the pharmacy called his attention to the potentially lethal drug pair, he said in an interview. No one mentioned that the dose of Lamictal exceeded the guidelines for taking it with Depakote. And no one talked to him about a rash.

“There were no special warnings — nothing,” he said.

Pharmacists serve as the last line of defense against bad drug combinations. Those who see a potentially unsafe pairing can ask questions of the patient, consult with the physician and ultimately withhold the medications.

“If a patient has a significant drug interaction that the pharmacist should’ve been aware of and didn’t catch, then their license could be affected,” said Carmen Catizone, executive director of the pharmacy group.

Yet pharmacists who are busy, distracted or inundated with alerts may fail to intercept potential drug interactions.

Sophisticated software systems automatically screen prescriptions for risky drug combinations and alert pharmacists about the danger. But more than a decade of research shows those systems fail to fully protect patients.

The safety checks produce a flood of alerts about a range of potential dangers, including drug interactions that cause only minor side effects. Pharmacists must contend with so many alerts that they can become desensitized to even the most serious warnings and dismiss them. One study found that pharmacists overrode more than 90 percent of alerts, including warnings about some risky drug interactions.

Heavy workloads for pharmacists also pose a threat. A 2007 study by University of Arizona researchers found that the risk of dispensing two drugs that could interact rose about 3 percent for each additional prescription filled by a pharmacist in an average hour.

The pharmacist who filled Conway’s prescriptions, Ryan Hamelin, later testified in a deposition that he handled as many as 80 orders on a busy shift. He signed off on her medications at 6:51 a.m., nine minutes before his overnight shift ended.

When a technician entered the two prescriptions into a pharmacy computer, a red screen appeared with a warning that required a pharmacist’s review, Hamelin said. The alert noted a potential overlap between the medications, which are both used to treat the same illnesses, but it did not call attention to the drug interaction, he said.

Hamelin, who had received his doctor of pharmacy degree a year earlier, said he had seen such drugs paired together previously. He also said he was aware of the drug interaction and the black box warning on Lamictal.

But it seemed to him that the doctor had used some discretion when writing the prescriptions, as Bellinger had prescribed initial doses that increased over time. Hamelin trusted the prescriber’s judgment, he said.

Hamelin said he did not see a need to warn Conway personally about the drug pair. Package inserts that advise patients about drug risks typically satisfy a pharmacist’s obligation to warn about such dangers, he said.

Hamelin approved the scripts and left work.

‘This is not right’

That day, Conway began taking the two drugs. She felt better almost immediately.

But two weeks later, she felt a tickle in her throat and pain inside her ears. She had a cough and bloodshot eyes. Then she woke up with her eyes matted shut with thick gunk. Conway went to work early to get medication for what she assumed was pinkeye.

At the urgent care clinic, Conway told the medical staff about taking Lamictal and Depakote, according to her deposition. She described her symptoms, including chest pains she suffered for a day or so before the episodes stopped.

No one realized that the seemingly unconnected symptoms foretold an agonizing condition called Stevens-Johnson syndrome in which the immune system attacks the patient’s skin and mucous membranes.

The cells in the lining of Conway’s eyes, mouth and lungs were self-destructing. It was as if some switch in her body had been flipped and nothing could shut it off.

Exactly how the disease develops is not fully understood, but it is most often triggered by medications. Numerous drugs including Lamictal have been linked to the condition when taken on their own. There is no cure; the best treatment is to stop taking the drugs that caused it.

Had Conway’s condition been diagnosed, she would ideally have been sent to a hospital burn unit, which is best suited to treat the massive loss of skin as the disease progresses, said Jean McCawley, director of the Stevens Johnson Syndrome Foundation, a patient advocacy group.

Instead, Conway’s chest pains became the main concern. A doctor at the clinic ordered X-rays and an electrocardiogram to test for possible heart problems. Both showed normal results. To be cautious, Conway was sent by ambulance to nearby Sparrow Hospital for more comprehensive heart tests, medical records show.

Conway told the hospital intake nurse that she was taking Lamictal and Depakote. Because Conway’s eyes were too inflamed for her to see, the nurse pulled the pill bottles from Conway’s purse and noted the medications in a hospital record.

The second round of heart tests showed no abnormalities, and Conway was released from the hospital with a suspected strained chest muscle, records show. Her husband came to the emergency room to take her home.

After receiving her discharge papers, Conway went to a bathroom to change out of her hospital gown. She glanced at herself in the mirror before getting dressed. On her way out, she caught another glimpse and stopped to stare. Bright red spots had popped up on her face and neck. It looked like someone had thrown red pepper on her.

Conway flagged down a nurse and pointed to her face. “This is not right,” Conway said, according to her deposition.

“Wow,” the nurse said.

The nurse retrieved a doctor, who examined Conway. But no one connected the outbreak to the two new medications she had reported to nurses and doctors twice that day.

The nurse gave Conway a shot of Benadryl and sent her home.

Deadly diagnosis

Spotting the signs of a dangerous mix of medications can be critical to saving a patient’s life. But because the interactions often cause common symptoms, such as low blood pressure or confusion, health care providers can easily miss the clues.

“Drug interactions hurt and kill like nobody has any idea,” said David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto.

Juurlink has treated patients who arrived at the emergency room after taking an antibiotic with certain types of blood pressure medication, which can cause a deadly spike in the level of potassium in the blood. Such a death likely would be attributed to heart disease and old age instead of a drug interaction, he said.

After Conway got the Benadryl shot she went home and went to sleep. She woke up at 4 a.m. with painful blisters in her mouth. Her skin rash was turning into red welts. Conway drove herself to the clinic where she worked and was examined by Dr. Kellie Donahue.

The doctor asked Conway about her symptoms and any medication she’d been taking. When Conway told her about the Lamictal and Depakote, Donahue stopped taking notes and looked up at her.

“I think you have Stevens-Johnson syndrome,” she said, according to Conway’s deposition.

Donahue, the first medical professional to notice the dangerous drug mix, explained to Conway that she was suffering from a serious skin rash caused by medications.

But even Donahue didn’t realize how severe the rash would become.

After telling Conway to stop taking the drugs, which Conway had done when the chest pains began, Donahue gave her a steroid shot and sent her home.

Conway took a short nap and woke up with blisters spreading into her throat. She called Donahue, who instructed her to go to the hospital immediately.

Her first night in the hospital, Conway sat up in bed until dawn researching Stevens-Johnson syndrome on her laptop computer. She’d never heard of the disease. The more she learned, the more alarmed she became. She discovered that, in its most extreme form, many victims die. The biggest risks stem from infections.

In the next days, Conway’s blisters spread and erupted. Swallowing food was too painful. She couldn’t stop coughing and complained that she was struggling to breathe.

Her skin began to peel off in sheets, leaving angry patches of exposed flesh that turned black and bloody.

Worried about infection, her husband laid down a trail of towels so she didn’t have to walk to the bathroom on the hospital floor. He spent the nights at her bedside in a chair. He didn’t know what to tell the kids, especially the three youngest. He didn’t want them to visit their mother — her wounds looked too gruesome. He did not disclose his biggest fear, that she might not come home.

Conway sporadically roused herself from a stupor of morphine, but mostly she was in too much pain to speak or open her eyes.

On Conway’s 10th day at the hospital, nurse Kathy Sandoval was assigned to treat her. The nurse had treated one other Stevens-Johnson victim years earlier, but when she walked into the room, she had never seen anything that compared to how Conway looked that day, Sandoval recalled in an interview.

From head to toe, only patches of skin could be seen. “It was red, open, exposed,” Sandoval said. “She wasn’t gushing blood, but there was blood everywhere.”

Sandoval was afraid to touch Conway.

“She looked like she’d been in a fire,” Sandoval said.

She knew how lethal the condition could be and worried that the sloughing tissue in Conway’s lungs and throat might block her airway. Sandoval hovered over Conway’s bed watching for signs of distress.

That night, at Sandoval’s insistence, Conway was transferred in unstable condition from Sparrow to an intensive care burn unit at the University of Michigan Medical Center, records show.

At that point, about 70 percent of Conway’s skin had blistered or peeled off. She could barely communicate.

The next day, an ophthalmologist tried to examine the damage in her eyes, but Conway was in too much pain to cooperate. In the doctor’s notes from that day, he wrote that Conway told him she didn’t expect to survive.

Fighting to live

Medical records document the flurry of activity that surrounded Conway at the Ann Arbor hospital. Nurses checked her vital signs at regular intervals. Doctors inserted a feeding tube. The wound care was constant. Every hour, nurses pried open her eyelids to apply drops of medicine.

“They’re just trying to keep the patient alive at that point,” said McCawley of the Stevens-Johnson advocacy group. “Patients are usually monitored 24/7 with the most intensive care they can give them. … The reaction has to run its course.”

On Conway’s third day at the hospital, her condition improved slightly. She was able to sit up on her own and was taken off contact isolation, which meant that staff no longer had to wear gowns and gloves to enter her room.

Over the next few days, the rash stopped spreading and parts of her skin began to grow back.

In an attempt to save her eyesight, doctors grafted amniotic membrane onto her eyes to help them heal. She continued to gain strength and looked better.

Medication was more effective in easing her extreme pain. The lesions on her face were clearing. Doctors removed her feeding tube and she was able to swallow soft food.

After nearly three weeks, Conway returned home with her eyes stitched shut so they could heal from surgery. Wounds were still red and visible on her face and neck. Her twins were too scared of her appearance to sit on her lap, so her husband turned off the lights in the living room and they sat with her on the couch.

She held their hands in the dark, tracing the outlines of their small fingers. Unable to see, she learned to distinguish the boys by the shape of their fingernails.

Conway spent the next two months unable to open her eyes and later received training on how to walk with the help of a long white cane. In the years since, she has slowly regained her strength, taking long walks and working on home repair projects with her husband.

But the trauma left Conway legally blind. In her left eye she can see only shadows and light. By holding a computer tablet close to her right eye and magnifying the text, she can read in limited amounts.

She can’t drive a car or watch the kids at sports events or read a paperback book.

She also suffers stabbing pains in her eyes from nerve damage, leaving her unable to get out of bed on her worst days. She must frequently apply medicated eyedrops because her tear ducts were destroyed. She fights a constant cough caused by her lung injuries. The family now lives in Florida where the high humidity provides some relief for her eyes.

Conway said her approach to taking medication has changed.

“The general public trusts that what their doctors give them is OK,” she said. “They don’t question it, but they should question it — every time.”

In 2012, Conway filed a lawsuit against Bellinger and Sparrow Health System that was settled in 2014 under confidential terms. She and her husband talked about her ordeal in several interviews but declined to disclose the names of the defendants, whom the Tribune identified through court records.

Her attorney, Andrea Dalton, said she has handled more than a dozen lawsuits for other patients, many of them children, who suffered from Stevens-Johnson syndrome after taking the same drug combination as Conway. The cases fit a pattern of errors, Dalton said.

“It starts with a hospital or physician error, then there’s a pharmacy error and diagnostic errors, and that becomes the perfect storm,” she said. “At the end of this is someone who has to live with it for the rest of their life.”

Citing a confidentiality agreement, Bellinger’s attorney declined to comment on the case. An attorney for Sparrow Health System said Hamelin, the pharmacist, turned down requests for interviews. The health system released a brief statement saying: “Sparrow cannot discuss specifics of this case due to the nature of the settlement agreement. But the safety and security of patients is always our top priority.”

Bellinger stopped prescribing the two drugs together after Conway became ill, he said in a deposition. It wasn’t worth the risk, he decided.

The case did not appear to change anything for Hamelin, the pharmacist who handled the prescriptions. He testified he would not have a problem filling the same order again.

4 dozen prison guards in Georgia arrested on bribery, drug charges

4 dozen prison guards in Georgia arrested on bribery, drug charges

http://www.wsoctv.com/news/news/national/4-dozen-prison-guards-georgia-arrested-bribery-dru/nqNcG/

The Atlanta Journal-Constitution

Arrests were being made across the state Thursday morning as about four dozen current and former state prison guards were told they face drug smuggling and bribery charges.

The charges are outlined in six federal indictments, which have recently been unsealed, the Atlanta Journal-Constitution reported. The U.S. Attorney’s Office in Atlanta plans an afternoon press conference to announce the charges.

>>Read more trending stories

The indictments are part of a continuing crackdown to rid the state prison system of drugs, corruption and contraband cell phones which are being used by inmates to commit crimes outside the prison walls.

The new indictments allege corruption by guards from Phillips, Macon, Dooly, Hancock, Pulaski and Baldwin state prisons. Five of the guards being charged were members of Hancock State Prison’s tactical team, which works to rid the prison of contraband.

According to the indictments, the guards allegedly smuggled in multiple kilograms of methamphetamine and cocaine in exchange for thousands of dollars in bribes. The guards will be making their first appearances in federal court throughout the day.

Woman claims wrong prescription allegedly caused heart attack

Woman claims wrong prescription allegedly caused heart attack

http://louisianarecord.com/stories/510662918-woman-claims-wrong-prescription-allegedly-caused-heart-attack

NEW ORLEANS – A St. Tammany Parish woman who allegedly suffered a heart attack after her prescription was incorrectly filled is suing the pharmacist and pharmacy for damages.

Barbara Ory filed a lawsuit Feb. 4 in the U.S. District Court for the Eastern District of Louisiana against Louisiana CVS Pharmacy LLC, CVS Pharmacy Inc. and Thuy Nguyen, citing negligence.

Ory claims that on Feb. 4, 2015, she filled a prescription for what she believed to be Valsartan tablets from a CVS Pharmacy located on Highway 22 in Mandeville. She allegedly began taking the medication on that day and claims that her blood pressure became erratic. On May 22, 2015, she was allegedly admitted to St. Tammany Parish Hospital’s emergency room with a blood pressure of 215/110.

During the hospitalization, Ory allegedly discovered that the medication she was taking was Valacyclovir, a generic form of Valtrex, instead of Valsartan. Ory claims she required frequent follow-ups to her cardiologist to regain control of her blood pressure. On Oct. 30, 2015, Ory allegedly suffered a heart attack which required a three-day emergency stay at St. Tammany Parish Hospital. Plaintiff claims that her afflictions were the result of the alleged negligence of defendant Nguyen, who allegedly failed to properly supervise and monitor the filling of the prescription.

She is suing for damages relating to her injuries and medical expenses, court costs and attorney fees, and any other relief deemed proper by the court. She is demanding a jury trial and is represented by Robert J. David and M. Palmer Lambert from Gainsburgh, Benjamin, David, Meunier & Warshauer LLC in New Orleans.

U.S. District Court for the Eastern District of Louisiana Case number 2:16-cv-01008-MLCF-DEK

DEA want legit pts to get their needed medications ?

IMS Health Webinar: DEA and the Hospital Setting – Addressing the Changing Landscape

http://www.imshealth.com/en/about-us/news/events/dea-and-the-hospital-setting

The DEA claims that they want legit pts to get their needed pain medication.. yet … here is a webinar that is being presented on how the DEA is affecting hospital operations. If there is ever a setting where pts are in need of pain meds.. it should be a hospital.. yet is the DEA again stating one thing publicly and something totally different to its registrants ?

24 Feb 2016 , 11 AM EST

Webinar

IMS Health will host a panel of industry experts who will discuss how increased U.S. Drug Enforcement Administration activity and regulatory requirements are affecting hospital operations. Learn what to expect from the DEA over the next year, as well as operational considerations to ensure that your compliance programs don’t negatively impact priorities. 

To register, visit our website

medical license wasn’t affected but his ability to accept Medicaid and Medicare is currently suspended

Charges dropped against doctor accused of cocaine possession

http://www.mypanhandle.com/news/charges-dropped-against-doctor-accused-of-cocaine-possession

The charges against a Panama City doctor accused of possessing cocaine were dropped Wednesday.

Results from the Florida Department of Law Enforcement revealed the off-white substance was not an illegal drug.

Panama City Police arrested Dr. Bryce Jackson in late November.

Police reports say an officer pulled him over after he made a quick stop at the Marie Motel and then pulled out and drove the wrong way on a one-way street.

A dog was called in who alerted officers of drugs inside a substance found on the floor mat tested positive in a field test for cocaine.

Jackson’s Attorney Waylon Graham said the dried substance had to be scrapped off the mat.

“Those field tests that cops do in the field are very inaccurate, very, very inaccurate, and about half of the time, it will identify a drug when there is no drug so this is actually somewhat common, but here it just happened to be very, very fortunate for Dr. Jackson, but you just cannot put a lot of stock in those field tests,” Graham said.

Graham added that Doctor Jackson’s medical license wasn’t affected but his ability to accept Medicaid and Medicare is currently suspended.

He says Jackson has a civil attorney in Tallahassee who is working to restore that ability.

We will have more on this story tonight at 10. 

 

DEA Investigators say a former Bullitt Co. Deputy has ties to a Mexican drug cartel

DEA Investigators say a former Bullitt Co. Deputy has ties to a Mexican drug cartel

http://www.wdrb.com/story/31176353/dea-investigators-say-a-former-bullitt-co-deputy-has-ties-to-a-mexican-drug-cartel

LOUISVILLE, Ky. (WDRB) — Investigators say a former Bullitt County Special Deputy has ties to a Mexican Cartel. WDRB traveled to the center of drug operations to investigate how authorities caught up with him and the other local men tied to the investigation.

The Drug Enforcement Agency says the Sinaloa Cartel transports narcotics across the country from southern California using a network of cars and trucks — and sometimes planes — to get the drugs to their destinations.

“The purity levels are higher coming up from Mexico area,” Riverside DEA Asst. Special Agent in Charge Frank Pepper said.

A DEA map shows the Sinaloa Cartel is working in Louisville, Lexington and London, Kentucky.

Tim Massino with the Los Aangeles Drug Enforcement Agency explained why southern California is such a hot bed for drug activity.

“Probably the one reason is its proximity to the border. We are probably 1.5 to 2 hours [from it],” he said. He added the interstate system and rural, desert areas allow easy transportation and storage.

But Pepper says people in Kentuckiana should be concerned.

“Due to the fact that this area brings it in, warehouses it for a temporary time, in what we call stash houses or stash warehouses temporarily, then it’s distributed back east to Kentucky,” he said.

Federal prosecutors say Chris Mattingly, a former Bullitt County Special Deputy, is a major drug trafficker with connections to a Mexican cartel. Sources say it’s the Sinaloa Cartel. 

Mattingly is behind bars at the Oldham County Jail. He was indicted last September for conspiracy to distribute 1000 kilograms or more of marijuana. That’s about 2,200 pounds, which has a local street value of more than $2.5 million.

But investigators say Mattingly has been working with others. It’s an investigation that has been going on for years.

In May of 2014, at an intersection in Perris, California, investigators pulled over Ronnie Shewmaker of Bullitt County. They say inside his Chevy Malibu with Kentucky plates, they found about $420,000 in cash. They say he also has ties to Chris Mattingly.

A document shows Shewmaker was booked for being under the influence of a controlled substance. The Riverside County District Attorney’s Office says the charge was never filed, but tells WDRB the case may have been submitted to federal authorities instead.

Investigators say his arrest in Perris is close to an area known for stash houses. It’s a remote area that’s difficult for law enforcement to surveil.

The DEA in Los Angeles couldn’t speak specifically about Mattingly’s case because it’s a pending investigation, but Pepper says when one of their connections is arrested, it affects the cartel. 

“It forces them to evaluate who they are going to deal with and it puts a temporary stop on trafficking in that particular area,” he said.

Investigators say they learned about Mattingly through on a wiretap with a drug cartel member in Riverside, in which Mattingly told the drug trafficker about a delivery of money for marijuana. 

“We’re intercepting drug trafficking. We’re not intercepting the everyday citizen,” Massino said.

Attorneys say the Mattingly case also involves about 70 gigabytes of video and audio. But Mattingly’s attorneys question the legality of these Riverside wiretaps. The DEA says drug traffickers try to make it hard for investigators by using burner phones they trash quickly.

“They go through a number of phones on a monthly basis,” Massino said. 

While some defense attorneys are against the wiretaps from the government, Pepper says they can be a very important part of cases against traffickers.  

“I would say to them the government has a tremendous burden with the court system to show that there is probable cause to believe their clients have been trafficking narcotics and committing crimes against the community,” he said.

Police went to Mattingly’s Used Cars in Breckinridge County, Ky., where prosecutors say a Mexican man opened a car door and took out a cooler with $60,000 in cash. 

In March of 2015, investigators searched Mattingly’s farm in Breckenridge County and say they found $20,000 in cash and guns with night vision. 

Mattingly hasn’t been a special deputy in Bullitt County for a while though. He had his badge pulled after he showed to investigators when he was pulled over in 2014 in Louisville for possession of marijuana and steroids.

The case was later dismissed.

Federal prosecutors say there may be additional charges against Mattingly — and other suspects — that involve Meth.

While several investigations continue into Mexican Drug Cartels, the DEA is standing by its decision for court approved wiretaps.

They point to the results.

“In many cases, it’s the only way we can identify who the real culprits are and make the connections between organizations,” Massino said.

Ronnie Shewmaker could not be reached for comment on this story. 

Previous: A look at the Mexican drug cartel pipeline from southern California to Kentucky

Per 3rd Yr PharmD candidate: Only a small minority of pharmacists refuse to dispense medications

Soon, pharmacists will offer more help to patients

http://www.modbee.com/opinion/opn-columns-blogs/article59390669.html

Since Oct. 1, California and Oregon have been in the process of implementing a law allowing women to obtain birth control directly from pharmacists. This law is taking effect during a controversial time for pharmacists.

In Cosmopolitan magazine last year, writer Haley Potiker detailed being denied the abortion pill by a CVS pharmacist. Potiker called the pharmacist’s behavior cold, quoting her saying, “There’s nothing I can do” and walking away “without a word.”

The pharmacist, Potiker explains, “didn’t feel like giving (me) the medication” despite a doctor’s prescription that included a warning that failing to take it in time would be risky.

There have been many similar documented instances of women being “reprimanded” by pharmacists for requesting oral contraceptives. It happened to me.

I attended Beyer High School. At 16, I was diagnosed with polycystic ovary syndrome and my pediatrician prescribed Yaz, both a birth-control pill and the main treatment for my condition. I will never forget when my mother tried to get the prescription filled and the pharmacist asked, “Do you even know what this is for?” then, “Why are you trying to get this for your daughter?”

At the time, I never considered that I might one day be in that pharmacist’s shoes.

Some people outside the health-care community are encouraging a few pharmacists to refuse to fill certain prescriptions. This is not good for future interactions between pharmacists and patients.

The National Women’s Law Center, which advocates for women’s rights, has written a “Pharmacy Refusals 101” guide in which it advises women to “file a complaint with the state’s pharmacy board to get sanctions against the pharmacist or pharmacy.”

Others have recommended not returning to the pharmacy and telling the community of such negative experiences. In reality, few patients seek media attention or other remedies.

Actually, judgment calls by pharmacists can be extremely useful in many instances – from preventing life-threatening medication errors to fighting the battle against prescription drug abuse. Only a small minority of pharmacists refuse to dispense medications for religious or moral reasons.

As a member of the pharmacy community, it is disheartening whenever a pharmacist is portrayed as not exhibiting commitment or compassion or violating the codes of ethics and evidence-based practices that govern our profession. To get our white coats, all pharmacists take an oath to embrace and advocate changes that improve patient care.

In Gallup polls, pharmacists have been ranked among the nation’s most trusted professionals – ahead of doctors and behind only nurses. Honesty and adherence to the highest ethical and moral standards have always been a cornerstone of our profession. In recent years, one of our highest priorities has been patient-centered care.

The future of community pharmacies encompasses medication therapy management, which optimizes drug therapy and improves therapeutic outcomes.

Despite our training, expertise and trustworthiness, pharmacists are not recognized as health-care providers under federal law. The American Pharmacists Association is campaigning to gain “provider” status, allowing pharmacists to prescribe medications in some cases.

Pharmacists possess the training and knowledge to support women’s health through education and providing medication, particularly in areas where access to primary health care is limited. Pharmacists are often the first health-care professionals to whom people turn for advice. Because they’re available in retail establishments, pharmacists have a higher degree of accessibility. Our training on reproductive issues, safety and proper use of contraceptives is comprehensive, and our communication skills have been honed for quick and convenient intervention.

Under the FDA’s watchful eye since 2006, pharmacists have been successfully providing emergency contraceptives and crucial counseling. With new laws, pharmacists will be able to provide services once restricted to doctors’ offices without increased costs to consumers.

Oregon and California pharmacists will have to complete supplemental training. Though care might be more generalized, it will meet the needs of a vast majority. Our basic protocol will dictate that those requiring specialized care and screenings will be referred to gynecologists. As medication experts on a community’s front lines, pharmacists have the ability to educate on health issues and to clarify commonly misunderstood medical terms.

One area of concern is abortion, one of the most commonly performed medical procedures in America. A “medical” abortion uses medications instead of surgery and is only available during the first nine weeks of pregnancy. The “abortion pill” is a two-step medication regimen.

At Planned Parenthood centers, the first medication is administered on-site. For the second medication, patients are given a prescription to be filled at a pharmacy. It must be taken from 24 to 48 hours after the first.

The “abortion pill” is different from “emergency contraception.” Emergency contraception is a broad term for medications that might prevent pregnancy by either preventing ovulation, preventing an egg from being fertilized, or preventing a fertilized egg from attaching to the uterine wall. Such medication is often called the “morning-after” pill – but that can be misleading.

Any pharmacist will tell you the morning after, or Plan B, pill should be taken immediately after unprotected sex or the failure of other birth-control measures; waiting until the “morning after” can be too late. Emergency contraception is not only available as a pill; it also can occur with an IUD containing copper, which is an effective emergency and long-term contraceptive.

It is estimated there are 6.6 million unintended pregnancies annually. The abortions that often follow are preventable and costly. The economic impact of abortion since 1970 has been estimated at $35 trillion to $70 trillion. Pharmacists can make an enormous economic and social impact by making contraception and health education more accessible.

Regardless of personal opinions on unplanned pregnancy, reducing the abortion rate is worthy of our attention and efforts. Women should not have to resort to invasive or inconvenient options.

Pharmacists and patients will soon be able to work hand-in-hand to achieve desirable goals for women’s health. This is a strong relationship that will stand the test of time as pharmacists make judgment calls to help and protect Americans.

Even when put in the shoes of that Modesto pharmacist, we are ultimately committed to what is in the patient’s best interests.

Siona Eivazian is in her third year of the doctor of pharmacy/master of health services administration program in Florida.

Pharmacist Explains Prescription-Filling Process- piece of cake ?

Pharmacist Explains Prescription-Filling Process

This comes after a Marianna mother claimed another pharmacy’s negligence injured her daughter.

Source: Pharmacist Explains Prescription-Filling Process   VIDEO LINK

http://www.arkansasmatters.com/news/local-news/pharmacist-explains-prescription-filling-process

Does anyone recognize this work environment ?… no drive thru, no ringing phones, no interruptions, no dozens of basket stacked up ?

LITTLE ROCK, Ark. – Questions continue to roll in after a Marianna mother claimed a pharmacy’s negligence injured her daughter. 

The prescription bag showed the four-year-old girl’s information, but the bottle and pills belonged to another patient.

Many asked on Facebook how the pharmacy and mother did not notice.  

After a Little Rock pharmacist showed KARK 4 News the prescription-filling process Monday, it seemed it would be difficult for a mistake to make it to a customer.  

“Whatever you do, it’s all on you basically,” said Tamela McGraw, an intern at Freiderica Pharmacy and Compounding. “Double, triple check everything. That’s always reinforced to say that the pharmacist is the last line before the drug goes over the counter because they have to check it.”
 
McGraw demonstrated once the pharmacy receives a prescription from a doctor, a pharmacy technician enters the doctor, patient and drug information, and the pharmacist approves it. 
 
The tech can then fill the prescription, which the pharmacist must also approve. 
 
The pills then move from a basket to a bag, ready for the patient. 
 
McGraw said it is a five minute to hour-long process she goes through with every prescription. 
 
However, mistakes can happen, like possibly putting pills into the wrong bag. 
 
“It really depends on the workflow that day and how many people are getting their prescriptions filled at that certain pharmacy,” McGraw said. 
 
The consequences could be deadly. 
 
“Especially since some medications are toxic to some patients,” McGraw said. 
 
For that reason, the people behind the counter cannot be the only ones who have eyes on the prescriptions. 
 
McGraw said it is also the patient’s responsibility. 
 
“Take your time, open the bag, look at it, even ask the pharmacist or technician what’s inside,” she said. “Then you won’t have to worry about getting someone else’s medication.”
 
KARK 4 News has still not heard from the Fred’s Pharmacy corporate office, the pharmacy in question from Friday’s story, after multiple attempts at communication.

There are no DO-OVERS

stevemailbox

Hello everyone! Well, we made it past Monday! I hope you are all doing ok (for those of you who are pain sufferers, I pray that your pain is tolerable). I have another important question for you to answer. You all remember that I had to renew my driver’s license back on the 11th of Jan. I tried to do it online and answered a question incorrectly because I read it wrong and was trying to be honest. It said do you have any disabilities, conditions, medications that could affect your ability to drive. I answered yes, thinking I am being honest about my spinal cord injury. Well, I got this lady at the DMV who gave me a hard time and wouldn’t let me change the answer. My disability does not interfere with my driving ability unless it has to do with getting my wheelchair in the car, etc. She made me (for the first time ever…Ca never did this), to get a doctor’s certification. The doc I used was my primary care who is closer to home and not in Vegas. Well, he filled it out and answered all of the boxes that I was able to drive. The DMV and everyone else thought everything was filled out ok and I got my license renewed. The day my license came in the mail, so did a letter from Carson City asking me to surrender my license. The local DMV and everyone involved missed something that the doc wrote out and that was my ability to drive with my disability. He said no. He wrote this in on a second sheet. When we asked him to fix it, he said no. Well, I have an appointment at the end of the month to see my pain doctor in Vegas. I will have them do the paperwork because they have known me longer. Even though there is an appointment scheduled, I had to surrender (voluntarily) my driver’s license yesterday! I have never had an accident and 2 tickets in my life since I started driving at 16 years old. They would not wait until the end of the month when the forms hopefully will clear me to drive. If I feel medicated or unable to drive, I don’t. I just wanted to have it in case there was an emergency! Ass hats! This is a crock! Has this happened to any of you?

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