As we all know … there is a lot of things going on in both pharmacy and the chronic pain community. Between the number of emails,, phone calls and face book issues.. my unread/unaddressed inbox had gotten out of control… when you have 10-30 emails every day that you keep putting of “until tomorrow” because there are so many hours in a day…  Today after looking that there was over 200 unread/unaddressed emails.. there could be NO MORE “until tomorrow”… so I just wiped everything out.. down to less than 10 as of now…  If you have sent me something and I have not gotten back with you or addressed it… SORRY…  tomorrow is the first day of the rest of my life.. and hopefully I will do a better job of keeping up… on all correspondence…

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Some stuck without medication after doctor is accused in patient deaths

http://www.wdrb.com/story/28006819/some-stuck-without-medication-after-doctor-is-accused-in-patient-deaths#.VNRGBgcb_GR.facebook

LOUISVILLE, Ky. (WDRB) – A Louisville man is out of pain medications and says he can’t get the medicine he needs because his doctor is now charged in the deaths of five people.

“I mean I don’t want to be like this,” said Ricky who asked WDRB not to show his face or use his last name.

For the past five years he has used the same doctor to get his medication.

“I have trouble sitting too long or standing too long or walking or sleeping,” said Ricky.

The opiates, used to treat his persistent back pain, ran out on Saturday.

“This is the first time I’ve ever been through a deal where I’ve needed medical attention and I can’t get it,” he said.

Ricky says his prescription, filled once a month, included hydrocodone and morphine.

“At first you get the shock of seeing your doctor and then you realize oh hell, what am I going to do now,” he said.

About two weeks ago Ricky’s doctor, Jamie Guerrero, was charged in the deaths of five people. The anesthesiologist was also accused of prescribing oxycodone, hydrocodone and methadone to 30 patients without a legitimate medical reason.

Last month he pleaded not guilty and surrendered his DEA license.

Ricky says he’s spoken with several different doctors including his dentist who have told him if he has a real emergency to go to an ER. But he says these doctors can only prescribe certain medication for just a few days.

“I feel myself now like I’m kind of nauseous and stuff and I’ll probably cave to that. That’s probably what will make me go to the ER is if I get really sick,” he said.

The Greater Louisville Medical Society says people can head to its website and click on ‘Physician Finder’.

If Guerrero was their doctor, they will likely be re-screened and re-evaluated. Leaving patients like Ricky wondering how long they might wait for a referral.

“This has been like a long process for me and I’m just gonna be sick and in pain,” said Ricky.

Guerrero remains free on a $50,000 bond. He’s due back in court on March 31.

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http://youtu.be/0TAUPBEn7Z0

Tim Webb risked his job and broke the rules to save the life of 17-month-old boy.

The 911 dispatcher at Virginia’s Galax Police Department recently received a frantic call from Melissa Grable, describing how her young son Aidan had suddenly become lifeless during a nap, reports Fox2 Now.

The boy, who was previously feeling ill, had suffered a seizure and stopped breathing. Sensing they only had minutes to act, the distraught mom begged Webb for directions on what to do.

The dispatcher asked if anyone on the other end knew CPR. When Grable said no, Webb was left with a tough decision.

Webb himself knows CPR, but the Galax Police Department does not have an emergency medical dispatch certification from a reputable source like https://cprcertificationnow.com/collections/cpr-and-first-aid-certifications. This means dispatchers are prohibited from giving CPR directions over the phone.

Of course, a WAGS pharmacist foiled a armed robbery 4 years ago by using his legally licensed firearm while on duty .. a violation of company to carry any defensive “weapon” and got himself fired..

http://abcnews.go.com/business/fired-walgreens-gun-toting-michigan-pharmacist-filled-robbers/story?id=13705438

World News Videos | ABC World News

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I got a phone call today from a young PharmD. This RPh had apparently working for one of the “BIG BOYS” as a floater for over a year and getting abt 30 hrs/wk.. A several months ago.. was offered the PIC position at a store and 40 hrs full time.  Of course, as a floater, the RPh was familiar with the company’s computer system but was not familiar with the company’s PIC procedures… This RPh had to rush thru some 70+ training modules and on top of that… two Pharmacists and two senior techs had all left just as this Rph took over as PIC.

After a few months of being PIC, this RPh asked to allow to be stepped down from being PIC.. staffing levels did not permit the RPh to keep up with all the administrative requirements. Likewise, this store was located in a well to do, older community and the store’s phone system seemingly rang off the wall because these pts were expecting “service” … calling in their Rx numbers by phone.. the typical way pharmacy functioned in the mid-late 20th century.

I speaking with this RPh.. it seemed that the RPh was more focused on doing the job well/correctly than just getting the tasks done as quickly as possible.

Recently, the RPH was called into the office to find several from upper level management and loss prevention.. From my understanding of the gist of the meeting is that this Rph was accused of not reporting med errors into the pharmacy software system. Which the Rph denied… apparently mistakes are so common in their system… that a Rph who was so conscientious that med errors didn’t happen in the numbers that this company expects.  So apparently in their mind.. if they are not getting reports of errors the Rph is sweeping them under the rug.

I guess if a Rph doesn’t report med errors that are happening.. then the corporation doesn’t have proof as to the RPh admitting making the errors… proof that the RPh has violated the practice act and proof that the Rph has violated the company’s P&P. Which could mean that the company may end up with some financially liability being blind-sided by a lawsuit over a error that they are not aware of .

Apparently there was a number of questions on some sort of form and several pages.. that the Rph had provided and they required the Rph to initial and sign each page.. after all the signing was completed.. the Rph asked for copies of the paperwork and was told NO!..

FIRST TEACHABLE MOMENT … under such circumstances.. ask all the corporate witnesses to sign/initial the paperwork… make a copy for you… hand you the copies and at that point in time.. you will sign them.. THEY SAY NO… YOU SAY NO !

SECOND TEACHABLE MOMENT … ask to record the conversation with your smart phone… or

http://www.hsn.com/products/swann-hd-pencam-mini-720p-video-camera-and-recorder/6746299?query=6746299&isSuggested=True

This is a FUNCTIONING INK PEN  🙂  abt $100… always keep in your pocket ?

If recording is permitted then something is probably up… you may be taking a knife to a gun fight.. It might be in your best interest to hire any attorney to sit in on this meeting as a future date that is agreeable to all.

Well the outcome of this meeting was … they were not sure what the conclusion should be.. the circumstances were unique – a Pharmacist not making med errors ?

The Rph was “suspended” until a decision was made… when asked when a decision would be made… the group was not sure .. may take some time..

Abruptly calling such a meeting where you are out numbered .. agenda is not clear …is designed to throw you off your game.. You will never win a game where you don’t know what game you are playing nor the rules of the game.. by the time you “catch on”.. you are so many point behind.. there is no way you are going to win…

THIRD TEACHABLE MOMENT… ever had a supervisor call you on the phone or pull you aside for a “conversation”.. a one-on-one private conversation.. a very  useful tool to give the supervisor plausible deniability when whatever you are told.. comes back to haunt them.  One-on-one conversations gives the “other side” the ability to claim that “that is not what I said”, “that is not what I heard”, “I don’t remember saying that”, “I don’t remember hearing that”, “there must have been some sort of misunderstanding”

You deal with this sort of corporate CYA.. when you have such conversations… where you are told to do something that you consider possibly unethical, immoral, illegal or makes you personally  uncomfortable..  Simply send a email to the person you had the conversation with… such as … Just to make sure that I am complete clear of our (phone ) conversation on mm/dd/yyyy at abt 00:00 …  and lay out your understanding of the conversation… send it high priority and read receipt … BCC a copy to your home computer and/or your phone to verify that it went out… regardless of what the other party does… doesn’t open the mail… doesn’t acknowledge receiving the email.. there is a “paper trail” of it being sent…

Close the email out with some sort of statement  “unless I hear from you otherwise or to the contrary , I will presume that my understanding of our conversation is correct and accurate.”

Your employer keeps a personnel file on you… shouldn’t you keep a corporate file on them and your supervisor? Copies or screen shots of questionable edicts. It is better to have a file that may end up being 80% junk.. than 100% empty.. if you have to defend yourself over something that you did or was told to do.

One large pharmacy/healthcare corporation asked all of their employees to sign an agreement to wave their rights to sue their employer and agreed to some sort of mandatory mediation to solve any employee/employer conflict.

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AG Indiana Greg Zoeller

Do you know what happens when the state removes a MANDATORY urine testing program … watch for them to institute VOLUNTARY GUIDELINES…and prescribers not following those guidelines will be hassled for not following “best practices” another BITTER PILL for the residents of Indiana

http://aclu-in.org/list-of-all-current-litigation/261-list-of-all-litigation-november-11-2014

Wierciak v. The Individual Members of the Medical Licensing Board of Indiana (U.S. Dist. Ct. — So. Dist. of Indiana) [Filed 1/14]

A new rule requires that all patients taking certain levels of opioid medication for 3 months or more must agree to be drug tested at least once a year. This class action challenges the rule as violating the Fourth Amendment. The Medical Licensing Board is issuing a proposed regulation that will remove the State-mandated requirement that patients take the drug tests.

ATTORNEY(S): Kenneth J. Falk, Gavin M. Rose

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Kouts nurse practitioners accused of illegally issuing prescriptions

http://www.nwitimes.com/news/local/porter/article_de615077-0216-595b-8ce8-22f61f8502d6.html

VALPARAISO | Two nurse practitioners from Kouts Family Health Care face numerous criminal charges based on allegations of unlawfully issuing prescriptions and not being properly licensed, according to their defense attorney.

“This has now culminated with a classically over-charged accusation and the issuance of arrest warrants for two responsible professionals who are credits to both their community and calling as nurse practitioners,” attorney Scott King said in a prepared statement.

He said he provided investigators with documents showing his clients are “dedicated, compassionate health care providers with more than 50 years combined experience” helping “people who would otherwise lack reasonable access to adequate healthcare.

“The bottom line is that they have done nothing illegal and have been wrongfully accused,” King said.

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Try to wrap your head around this.. it is a known fact that 85% of the people who suffer from civil forfeitures are never charged.. never found guilty.. and many/most get pennies on the dollar back.. if anything at all..  Our justice dept using that money to pay confident informants – usually crooks or “bad guys” themselves to help law enforcement to find other assets to seize under asset forfeiture program.. Maybe they should rename it as the stool pigeon payment program ?

Federal agencies’ payments to confidential informants increase

http://www.post-gazette.com/news/nation/2015/02/05/Federal-agencies-payments-to-confidential-informants-increase/stories/201502050147

The bulk of the disclosed awards went to whistleblowers. Their more shadowy cousins, confidential informants, got tens of millions, including  $28.8 million in payments from a single Department of Justice fund, according to a report sent to Congress on Jan. 29. The informant payments came out of the Asset Forfeiture Program, which last year received $4.47 billion through the seizure of proceeds or tools of crimes.

The award payments “provide a tremendous incentive to individuals to assist [the Drug Enforcement Administration] in investigations of drug traffickers that result in the seizure and forfeiture of drug-related assets,” according to an Obama administration budget statement. The program also helped the FBI to fight “criminal schemes in white collar crime, organized crime, and narcotics trafficking,” the administration contends. Informants whose work led directly to seizures got $16.8 million from the program, while $12 million went to sources whose work didn’t lead directly to criminal assets. The total of $28.8 million continued a steady upward trend from $22.4 million five years earlier.

Defense attorneys sometimes argue that tying informant pay to seizures perverts the process.

“Now [informants are] being paid on a percentage basis, and the work is now more profit-driven than it is driven for the sake of uncovering criminal conduct,” said Downtown-based defense attorney Mark Sindler, who has defended several clients accused by federal informants. “That’s morally problematic.”

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The email from below was a follow up to a email that was sent to me via National Pain Report

This poor gentleman travels for a living.. IMO.. he is being batted back and forth like a tennis match.. the pharmacist near his home won’t fill a Rx a couple of days early so that he had his needed medication while working on the road.. and the pharmacist while on the road won’t fill his necessary medication because he does not live locally …

When this issue was published on NPR.. it got 87 comments..  mostly about that “corresponding responsibility” crap.. and tens of thousands of page views…

When I was very young, my Dad use to try to sucker me into a bet.. “heads I win.. tails you lose “..

This time.. this fellow lost a night’s sleep and a day’s work/pay over this BS.. in a court of law .. that is called financial damages..

Okay.. you who are on the firing line every day.. since I have been retired for a year.. I am out of  touch – according to some.. what advice would you give this fellow ?? Some have previously stated that the pharmacist shouldn’t be sued for throwing the pt into elevated pain, withdrawal, denial of service , pt abuse…  I will make sure that this fellow gets all of your “real life” guidance in how he should manage is medication and his chronic disease issues.

Filed under: General Problems | 2 Comments »

Terminally ill cancer patients denied prescription drugs at the pharmacy

Pharmacies cite pressure from DEA to crack down on pain killers

watch video on website.. could not embed in this post

http://www.wesh.com/news/terminally-ill-cancer-patients-denied-prescription-drugs-at-the-pharmacy/31097790?utm_source=Social&utm_medium=FBPAGE&utm_campaign=wesh+2+news

ORLANDO, Fla. —“Who in their right mind would not prescribe drugs to somebody who’s terminal?” asks Darlene Patsos.

Two weeks ago, Patsos was diagnosed with stage 4 lung cancer.

“Every time I go in there, it’s a different excuse,” she said of the pharmacy.

Doctors told her the cancer is inoperable and will take her life.

“It’s in my bones, probably in my brain. It’s throughout my body,” she said.

To ease her pain, doctors prescribed oxycodone, but pharmacist after pharmacist refused to fill it.

“I get the third degree every time I try to get the drugs,” she said. “I feel like they view me as a drug addict.”

Patsos says she was even told to “pharmacy shop” — go from pharmacy to pharmacy until she finds someone who will fill it. She ultimately did find a pharmacy, but it’s a 40-mile round-trip drive from her home.

For the last week, WESH 2 has been investigating why people with legitimate prescriptions for pain killers are getting denied at the pharmacy.

Special report: Pharmacies denying legitimate prescriptions

We’re now hearing from cancer patients who say they’re routinely being denied doctor-prescribed medication and made to feel like drug addicts.

Cancer patient: Pharmacies look at me like a drug addict

Another woman with stage 4 breast cancer wrote WESH 2, saying, “I took my last prescription to 13 pharmacies over a period of three weeks before I finally found someone who would fill it.”

“It’s a deeply concerning problem where we have legit patients being wrongfully denied of their medications on an increasingly frequent basis,” said Dr. Avi Bhandari.

Bhandari said the prescriptions he prescribes are being denied daily.

“We know as physicians that our patients are not getting the health care outcomes that we desire for them,” he said.

Last week, WESH 2 Investigates spoke with one pharmacist who cited pressure from the Drug Enforcement Administration to crack down on certain painkillers.

Bhandari said drug stores are following inconsistent policies when it comes to dispensing medication in an effort to determine who needs it and who doesn’t.

“They’re forced to basically determine medical necessity, and there isn’t much clarity or consistency in those checklists,” he said.

According to the Florida Society of Physical Medicine Rehabilitation, at least three people committed suicide last year after being denied pain medicine.

The DEA has agreed to an interview with WESH 2 next week.

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http://helenair.com/search/?k=%22best+of+helena%22&t=&l=20&d=&d1=&d2=&f=html&s=start_time&sd=desc&sHeading=Best+Of+Helena&app%5B0%5D=editorial&o=0

At the IR, we’re excited to help our readers honor these great winners in all 97 categories. They make Helena a great place to work and live. Please join us in congratulating them for their hard work and effort.

Helena is the capital of Montana, abt 30 K population… according to www.yp.com.. there is 9 pharmacies (7 chains/2 indys).. what I find interesting out of the 97 categories .. apparently NO PHARMACIES/PHARMACISTS were voted as the “BEST OF HELENA” For years there was a survey conducted – by Schering I think – that did a “most respected profession” and Pharmacists always were FIRST PLACE… last year Reader’s Digest did a similar survey and pharmacists were FOURTH…

From this survey.. it would appear that the people in Helena, MT.. can’t find even ONE PHARMACY/PHARMACIST they are comfortable voting as the “best of”.

Maybe the INDEPENDENT RECORD needs to have a survey “The WORSE of HELENA” so people in Helena will know who to avoid to patronize.   Might even have several pharmacies/pharmacist TIE to be on that list ?

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