When the CRACKS in the system are big enough to KILL PATIENTS !

Emergency insulin could have saved man’s life

http://www.wkyc.com/story/news/health/2015/02/11/emergency-insulin/23276399/

He shouldn’t be dead.

Kevin Houdeshell. Thirty-six-years-old. Diabetic. Good looking boy next door, says sister, Amy Houdeshell.

“That one-in-a-million one a mother would love her daughter to bring home to the family,” she said.

But an expired prescription for insulin was his death sentence.

“He was young, fit, healthy. The pharmacy told him his script had expired, and ‘We’re sorry, but we can’t give you anymore. He tried three times to call his doctor’s office, and four days later he passed away from not having his insulin,” she said.

His family is on a mission now out of unthinkable unnecessary tragedy, joining forces with the Diabetes Partnership of Cleveland to let Northeast Ohio know what Kevin didn’t.

“They have an emergency insulin program,” Amy said. “And if Kevin would have known about that, he would still be alive today”.

Gone barely a year and Kevin Houdeshell’s legacy lives on in a big way that’s gaining momentum and money.

The Houdeshell family has raised almost $20,000 dollars and counting to fund the Diabetes Partnership of Cleveland’s emergency insulin program.

For them, Kevin is the face of many.

“I think of someone that we deal with every day at the Diabetes Partnership of Cleveland — people who need resources. People who need a hand,” says spokeswoman Cheri Collier.

For Kevin, it was an expired prescription, but there are several scenarios in which emergency insulin saves lives.

“People can break a vile of insulin. They may have a change in their insurance status. They may have a high co-pay. So we want to be there to help,” says Collier.

“It’s a life-sustaining drug — insulin. And he needed that to survive and to keep living, and, if you don’t have that, you.die,” Amy Houdeshell tells Channel 3 News reporter Dawn Kendrick. “The bottom line is the pharmacy and the doctor’s office failed.”

Collier explained, “The pharmacist can dispense a small amount. The problem right now is the amount they’re allowed to dispense by law is so small. Maybe there should be a different way the law is interpreted. They’re protecting the pharmacist’s license, I agree, but also we want to protect the clients, the patients, too. We want to help save their lives.

For the Houdeshells, it is an important life-saving message they want to shout from the mountain tops.

“Get educated on diabetes. You can die from this. My brother who was so young and so full of life. He should still be here today,” Amy said.

The Houdeshells are now calling on state legislators to change the laws in order to make it easier to get life-saving maintenance drugs in a pinch.

You can help. The Kevin Houdeshell Memorial Golf Outing is Saturday, June 27. Contact the Diabetes Partnership of Cleveland at 216-591-0800. Any contributions made in Kevin Houdeshell’s name go directly to the emergency insulin fund.


We – as a society – may have sunk to a new low.. a very low low…  Is our healthcare system become so focused on the “rules” .. the “regulations” that a person’s life has been lost because there are those in our system.. who don’t care/understand the consequences of being without many medications.. It is easy to Monday morning Quarterback what this young guy SHOULD HAVE DONE..
We have placed non-professionals and all too often poorly trained non-professionals that have become the “gate keeper” between the healthcare professional and the pt.  Their job is to answer the phone.. pass along the notes.. they don’t know – some probably don’t care about the health of the pt.. their job is to “paper shuffle”
The multi prescriber practice that we go to .. our PCP is a great guy.. the infrastructure/processes of the office varies from “sucks” to totally dysfunctional.  I have had attempts of getting a refill.. the pharmacy will fax twice… no response… I have left voice mail messages  – no response – I have called up the office manager – no response… I will fax and email the office – no response … I finally have to text the PCP .. trying to get xxxx medication refilled.. is there a issue… no response going thru staff … usually within a couple of hours.. the pharmacy gets the refill authorized… I think worse case has been close to 14 days..  If I had waited until I only had a few days meds left and it was a critical med – like insulin – I would have been screwed.
My money would be on that if a pt starting having a angina attack in front of a Pharmacist.. they would not feel comfortable giving the pt a NTG subl tab… nor someone having a severe asthma or allergy reaction in front them..would they reach for a Epi-pen and inject the pt. When SECONDS count… EMT’s are hopefully only MINUTES away.
We are suppose to be part of a healthcare “team”..but when the “team” is composed of professionals, JV’s, amateurs, and novices .. and the patient does what they are suppose to do.. and the professional level never knows what is going on.. some of those “cracks” are big enough to kill pts.

7 Responses

  1. […] When the CRACKS in the system are big enough to KILL PATIENTS ! […]

  2. I am saddened by this situation, but what about the er or urgent care? Seems there must be more to this than is being told. The laws in our state allow a pharmacist to give an emergency refill without authorization if the pts life is in danger. I did just that last week when a diabetic called and said his mail order did not arrive, it was Saturday night, and he had no insulin. I was able to access the mail order “profile” to see that this was indeed the case. It was after hours and I could not call them. We documented all this in our computer, his wife rushed over and we sold her one pen. Do I fear for my job or my license over this? Absolutely not.

  3. As pharmacists we have been conditioned to all of the rules and punishments. Enter the wrong name of the doctor on a prescription and the insurance company takes all the money back on an $8000.00 prescription. Miss documention for one of your annual FWA sessions….get a fine. Accidentally tell your husband what one of his ex-girlfriends got during a heated argument……$1.4 million dollar fine. Is it a wonder this is happening. Granted all of those things are wrong, but do those punishments justified by the crime?

    Remember the days when we were allowed to use our professional judgement? Now we appear to be questioned if we have any professional judgement abilities. Dispense a prescription for a 15 gram tube of triamcinoline cream? What’s the days supply? Six days sounds reasonable, no, wait a second, what area of the body? How many times a day? How many fingertips is that on the dosing charts? I need documentation that a Z-pack is a five day course of therapy from the prescriber and I don’t have the ability to realize it is a five day course myself? The trivial nonsense we are held accountable to that has absolutely nothing to do with benefitting our patients.

    Then there is the matter of authorizing refills. At one time when you saw your physician they would actually give you a prescription. Now it’s have your pharmacist fax me for a refill……which ties up the patient, the pharmacist and the prescriber’s office staff which absolutely makes no sense. And insulin. Remember before the recombinant human insulin when it was less than $15.00 a bottle and you could actually get it without a prescription? And when you called the doctor’s office for a refill or a question you actually spoke with the doctor and it was handled immediately? No faxes, no office staff, no 48 hour delay. It was taken care of. My how far healthcare has come.

    • I can remember when U-40 insulin was $0.99/bottle… U -80 was $1.98/ 10 ml bottle… You still have professional judgement as long as it follows your company’s guidelines, the PBM’s guidelines o any other entity that has given themselves the authority to practice medicine or pharmacy without a license nor a degree. BUT since they control the purse strings or your license.. Who needs a license to control if/when/how medical care is provided.

  4. What pharmacy was he using? In some states, the pharmacists are lawfully permitted to make an emergency fill anywhere between 3, 14, or 30 days if it is essential to sustaining life. Wal-Mart also sells a Relion brand of insulin which can be purchased OTC. There is no reason that this person could not have been helped. Now, I am not an “old guy”, but I would know how to handle this.

  5. How often I would renew the insulin, heart meds and asthma meds one time fill it and pt paid for it. These were items your couldnt break packaging otherwise, id give pills to cover. Then of course keep working on getting the refill OK….often this happened on a weekend or long holiday. I always informed the office of what I did and why and always they were fine with it. I couldnt do it on controls per law but no doctor ever had an issue. And long time ago I asked a compliance officer about it and he said something like that would not be an huge issue with the BOP. What irks me is in multiple physician practices where one doc is on vacation and NO OTHER DOC bothers look at the patients chart to OK a 1x fill. Had that happen once…I gave the patient a week of Lanoxin til his doc got back it was one of my regulars. BTW the patient ripped the practice new one over. There are gray areas in pharmacy,yes too bad no one has the cahoonas to make decisions today except us ‘old guys’

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