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Unlike the previous case, in which pharmacist Russell ignored fraudulent prescriptions, the pharmacist in this case acted responsibly. The facts of this case are as follows.
On Oct. 17, 1995, plaintiff Stuart visited Deborah Meadows, DDS, complaining of a toothache. Meadows prescribed penicillin 500 mg and hydrocodone 7.5mg/acetaminophen 750mg. A pharmacy filled the prescriptions the same day in response to a telephone call believed to originate from the dentist's office. Stuart obtained telephoned refill prescriptions for the hydrocodone on Oct. 20, 25, and 27, 1995. The pharmacist, Julie Edwards, became suspicious on receipt of the Oct. 27 refill that the prescription and refills were unauthorized. She contacted Dr. Meadows' office, which denied authorizing the prescription. Pharmacist Edwards immediately contacted the Dallas Police Department, which assigned a detective to investigate. Stuart was later arrested, but the grand jury declined to indict her. Dr. Meadows later testified that she probably authorized the hydrocodone refills and her office likely misinformed the pharmacist that the refills had not been authorized.
Stuart filed a suit against the Dallas Police Department detective who arrested her pursuant to the valid arrest warrant. This action is beyond the focus of the article. However, the conduct of pharmacist Edwards is worth mentioning.
After receiving one prescription and three telephoned authorizations for hydrocodone within a 10-day period, Edwards properly called the doctor's office for authorization. While these refills seem excessive, it is important to note that the facts of this case do not state the quantities or directions for the hydrocodone prescription. However, this example does illustrate an important DOJ prevention technique: When there is a question concerning any aspect of the prescription order, call the prescriber for verification or clarification. Also, after receiving word from Dr. Meadows' office that the refills were unauthorized, pharmacist Edwards called the authorities. This, too, was the right course of action. Instead of dispensing the medication anyway, Edwards properly refused to refill the prescription.
What result would have occurred had the plaintiff brought this suit against the pharmacist? From the facts of the case, it is very unlikely the court would have ruled for the plaintiff. Edwards used professional judgment in assessing the patient's use of the medication, and when verification was denied from the doctor's office, she acted in good faith in promptly reporting the matter to the Dallas Police Department. Additionally, a pharmacy technician who worked with Edwards corroborated her information by identifying the plaintiff as the person who picked up the refills. Therefore, pharmacist Edwards' actions should serve as a guide for other pharmacists to follow. For more information on prevention techniques, types of fraudulent prescriptions, and characteristics of forged prescriptions, please refer to Fig. 3.
In summary, it is essential for pharmacists to take an active role in combating health-care fraud. This may involve anything from refusing to fill a fraudulent prescription to actually reporting a health-care provider for improper billing practices. The key is for each pharmacist in his/her practice setting to actively communicate with other health-care providers.
References are available upon request.
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