Pharmacy Mgmt Tip of the Week will take one more trip for now down the lane of pharmacists’ and pharmacy managers’ legal liability and the need to ethically carry out responsibilities in accordance with state board of pharmacy rules and regulations.
In the matter of California State Board of Pharmacy vs Pacifica Pharmacy and Thang Tran, details are provided of action taken by the Board against a pharmacist with poor oversight and judgment over occurrences at a community pharmacy under his watch.1 The pharmacist, Thang Q. Tran, owned and operated Pacific Pharmacy, a community pharmacy in Huntington Beach, CA. The board asserts that the inspection of Pacific Pharmacy disclosed expired drugs in its inventory, missing information on pre-filled medication containers, and a discrepancy in the inventory. It also asserted that Pacifica and Tran dispensed numerous prescriptions for controlled substances without determining whether any prescription was written for a legitimate medical purpose. Pacifica asserted that a pharmacy cannot be liable under the corresponding liability statute because that statue applies only to a “pharmacist who fills the prescription.” Pacifica claimed that the remaining allegations are de minimus and unworthy of discipline. The board argued that the clear and convincing evidence did not establish that Tran knowingly violated the corresponding responsibility statute or that Pacifica dispensed any controlled substance for anything other than a legitimate medical purpose or that Tran personally filled any of he prescriptions at issue. The board asserted further that Tran and Pacifica stopped filling the prescriptions when notice was given that the prescriptions might not be for a legitimate medical purpose. The many red flags surrounding the prescriptions for OxyContin and other drugs were written by Dr. T, whose medical office was located many miles away from Pacifica and that this required Tran and Pacifica to make some inquiry whether the prescriptions had been written for legitimate medical purposes, and there was clear and convincing evidence of their lack in doing so. It was ruled that the only measure to protect the public was the outright revocation of Tran’s license and Pacifica’s permit.
The results of the board action taken underscore certain legal and procedural liabilities for the owner/manager pharmacist such that they have responsibility for operations and complying with law and standards even for prescriptions they might not have personally dispensed. In this case, the Board did not infer or even inquire as to who filled the prescriptions. The case also speaks to some poor operations management and ethical decision-making by the pharmacy owner/manager (Tran). Not only did Tran not pursue legitimate inquiry into longstanding questionable prescriptions, but he also was carrying expired drugs and maintaining poor stock and inventory control. These initial problems might have brought further attention to the larger problems uncovered by the board upon inspection. The responsibilities of management transcend the manager’s own dispensing behaviors while on duty. This case underscores the need for the manager to apply ethical decision making to all matters of effective and efficient pharmacy operations.
Additional information about Ethical Decision Making and Ensuring Quality in Pharmacy Operations can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.
1In the Matter Against Pacifica Pharmacy Corp.; Thang Tran. https://www.pharmacy.ca.gov/enforcement/fy1011/ac103802.pdf