mgriffiths Posted April 6, 2018 Share Posted April 6, 2018 I'll try to keep it short and I apologize if it's confusing - the whole thing is still confusing in my mind as well. Skip to bottom for quick summary and my questions if you don't want to read the whole thing. I work in a rural area of Michigan in Family Practice and had a new patient today. He was significantly agitated, diaphoretic, red in face, pupil miosis, and significantly verbose. He states he has long history of ETOH abuse with last drink 2009. He was "self-medicating" his ADHD with ETOH, but since abstaining he has been treated with klonopin and vyvanse combination, also cymbalta but he doesn't remember why he is on cymbalta. In reviewing his controlled substance prescription history his scripts are WAY out of order. For example he was on 40mg Vyvanse that was changed to 60mg Vyvanse 11/2017 and got two prescriptions (11/2017 and 12/2017) filled. Then he filled a 40mg Vyvanse prescription late 12/2017 that was written in 10/2017. Why were those scripts filled out of order? Why was the 10/2017 Vyvanse script not voided due to dose change - is this a fraudulent script? Patient could not answer my questions. During the visit I had no previous medical records other than his words and the state recorded controlled substance prescription history. The provider he was seeing before me was just sanctioned massively (11/2017) by our state medical board and essentially lost his DEA. Of course the patient continued to fill prescriptions this provider wrote prior to losing his DEA in November, with the last being filled 03/2018 (again, those prescriptions were voided the day sanctions went into effect - so fraudulent scripts). I told the patient my concerns and that I would not be prescribing any controlled substances until I had the opportunity to review previous medical records. This royally ticked off the patient and he began to verbally attack me and in the process I learned that he personally owns the pharmacy he uses (in a VERY rural area of Michigan). He is getting his controlled substance prescriptions filled at the pharmacy he owns! He then went on to tell me that he personally knows our state's Attorney General and supposedly our AG and the state pharmacy board are "ok with the situation" (whatever that means). According to him I supposedly don't understand addiction, I have judged him without knowing him, I am making him suffer, etc., etc., etc., all the same things we have all heard who work in primary care (and also those who work in specialties). Guy is obviously strung out and leaves before I am able to complete my exam upset I won't fill his meds. Later in the day I had a few minutes so I called the pharmacy and actually learned the patient is a licensed pharmacist and not only has his pharmacy fill his prescriptions, but he has been personally filling them himself!!!!!! -----TL;DNR: new patient who is a licensed pharmacist, lied to me about being pharmacist, has been personally filling his own controlled substance prescriptions at the pharmacy that he owns My questions: would you report this, and who would you report this to? What is not considered a HIPAA violation? Link to comment Share on other sites More sharing options...
Reality Check 2 Posted April 6, 2018 Share Posted April 6, 2018 IMMEDIATELY report to the state pharmacy board as an impaired and unethical pharmacist. There is no HIPAA here. This is an impaired and dangerous person. Don’t overthink - protect this patient from himself and protect the public from him. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 6, 2018 Administrator Share Posted April 6, 2018 What Reality Check 2 said, but then some. There's entirely possibly a criminal enterprise going on here, between this patient and your predecessor. For good measure, I'd call local PD and tell them what you've just told us. I've found local cops tend to really like it when you can hand them a case on a platter. Link to comment Share on other sites More sharing options...
sas5814 Posted April 6, 2018 Share Posted April 6, 2018 Yea the problem people like this have is they get away with it for a long time so they think they are bullet proof. I'd call the local PD, the pharmacy board, and possibly the medical board in regards to your predecessor. It is possible they have a little criminal enterprise going on.I have seen it before here in Texas. A PA (sadly) was trading narc scripts for sex with a woman who was also doing the pharmacist. It was a weird little story and I never did hear the outcome. Link to comment Share on other sites More sharing options...
thinkertdm Posted April 6, 2018 Share Posted April 6, 2018 59 minutes ago, sas5814 said: Yea the problem people like this have is they get away with it for a long time so they think they are bullet proof. I'd call the local PD, the pharmacy board, and possibly the medical board in regards to your predecessor. It is possible they have a little criminal enterprise going on.I have seen it before here in Texas. A PA (sadly) was trading narc scripts for sex with a woman who was also doing the pharmacist. It was a weird little story and I never did hear the outcome. Presumably scripts for azithromycin and rocephin too. Link to comment Share on other sites More sharing options...
mgriffiths Posted April 6, 2018 Author Share Posted April 6, 2018 Contacted law enforcement and have started the report to licensing board. I have to write out a formal "complaint" and mail it to them. Link to comment Share on other sites More sharing options...
MidwesternTexan Posted April 11, 2018 Share Posted April 11, 2018 'mail' it to them, as in 'snail mail' - it figures Link to comment Share on other sites More sharing options...
CAAdmission Posted April 11, 2018 Share Posted April 11, 2018 On 4/6/2018 at 5:52 PM, mgriffiths said: I have to write out a formal "complaint" and mail it to them. What a jerko system. Does a guy deliver it on horseback too? What happens in a dangerous situation where rapid intervention is needed? Link to comment Share on other sites More sharing options...
CAdamsPAC Posted April 11, 2018 Share Posted April 11, 2018 On 4/6/2018 at 5:52 PM, mgriffiths said: Contacted law enforcement and have started the report to licensing board. I have to write out a formal "complaint" and mail it to them. I can understand the need for a written complaint/report document. What is odd is in the digital age there's not online methodology for submitting the report! It can only blowback on you if you do not proceed with the complaint/report to the various agencies. Link to comment Share on other sites More sharing options...
quietmedic Posted April 12, 2018 Share Posted April 12, 2018 Holy crap! That's nuts...just out of curiosity, is a pharmacist allowed to fill his own scheduled meds? All other illegalities aside... Link to comment Share on other sites More sharing options...
mgriffiths Posted April 12, 2018 Author Share Posted April 12, 2018 1 hour ago, CAdamsPAC said: I can understand the need for a written complaint/report document. What is odd is in the digital age there's not online methodology for submitting the report! It can only blowback on you if you do not proceed with the complaint/report to the various agencies. Totally agree on written complaint, but was surprised I had to fill out a specific form, type up the issue, and then literally mail envelope and stamp... 56 minutes ago, quietmedic said: Holy crap! That's nuts...just out of curiosity, is a pharmacist allowed to fill his own scheduled meds? All other illegalities aside... I'm not sure if a pharmacist filling own scheduled meds is illegal, but at minimum is likely a significant ethics violation. Similar to me writing myself a norco script - not illegal, but ethics violation. Link to comment Share on other sites More sharing options...
CAdamsPAC Posted April 12, 2018 Share Posted April 12, 2018 32 minutes ago, mgriffiths said: Totally agree on written complaint, but was surprised I had to fill out a specific form, type up the issue, and then literally mail envelope and stamp... I'm not sure if a pharmacist filling own scheduled meds is illegal, but at minimum is likely a significant ethics violation. Similar to me writing myself a norco script - not illegal, but ethics violation. Registered mail with return receipt too, I hope! Link to comment Share on other sites More sharing options...
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