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<P>In Texas and most states, I believe it's illegal accept unused and expired medicines from customers and reuse the medicines. In certain healthcare setting, nursing homes, hospice, and long-term care facilities, transfer of medicine from one patient to another may be permitted only under the supervision of the attending physicians for both patients. The pharmacist doesn't get involved with this decision. </P>
<P>Generally, it is considered a possible issue of "standard care" when medicine is accepted from one patient and given to another. It is illegal to repackage or redistribut medicines beyond their expiry date for any reason. For safety, most retail pharmacies and clinics will not recycle and reuse donated medicines from a customer. And we all know about the DEA regs on narcotics and first registrants. </P>
<P>Retails pharmacies based on our survey have been accepting unwanted meds for some time, but this practice is not acknowledged or institutionalized widely. In TX, some Walgreens would quietly take customers' unused and expired meds (UEMs) and properly dispose of them as "waste". Recently, a CVS in Houston was discovered to repackage and sale expired meds to customers.</P>
<P>The United Nations WHO strictly prohibits in its Guideline for Donation of Drugs any medicines from individuals for safety reasons. Donation of drugs can be effective and highly useful in certain circumstances, but WHO only reccomends direct donation from healthcare institutions and drug manufacturers.</P>
<P>Here's another interesting whistleblower story at the pharmacy. many of you may remember this case in kansas city: A $2.2 billion verdict was "dispensed" through the civil courts. A popular pharmacist was caught diluting chemo drugs for thousands of cancer patients. The whistleblower was an FBI agent who happened to have Pharm.D.</P>
<P><A href="http://www.nytimes.com/2002/10/11/us/2.2-billion-verdict-for-diluting-drugs.html?ref=robert_r_courtney">http://www.nytimes.com/2002/10/11/us/2.2-billion-verdict-for-diluting-drugs.html?ref=robert_r_courtney</A><BR><BR>Others great stories involved pharmacists giving saline solution instead of the flu vaccine. </P>
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<P>We study these stories with great interest because they do shed some light on the levels of greed, incompetence and down right criminal activity in our healthcare system. We study patient safety and healthcare quality, including the pharmaceutical component of the system. </P>
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<P>Matthew Mireles</P>
<P><BR> </P>
<BLOCKQUOTE style="BORDER-LEFT: #0000ff 2px solid; PADDING-LEFT: 5px; MARGIN-LEFT: 0px">-----Original Message----- <BR>From: Howard Anderson <NDBOPH@BTINET.NET><BR>Sent: Dec 6, 2010 9:48 AM <BR>To: "'Gilliam, Allen'" <GILLIAM@ADEQ.STATE.AR.US>, 'Stevan Gressitt' <GRESSITT@GMAIL.COM>, 'pharmwaste' . <PHARMWASTE@LISTS.DEP.STATE.FL.US><BR>bject: RE: [Pharmwaste] Interestingly large settlement on drug returndiversion <BR><BR><?XML:NAMESPACE PREFIX = [default] http://www.w3.org/TR/REC-html40 NS = "http://www.w3.org/TR/REC-html40" /><ZZZhtml xmlns="http://www.w3.org/TR/REC-html40" xmlns:st1="urn:schemas-microsoft-com:office:smarttags" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:v="urn:schemas-microsoft-com:vml"><ZZZhead><ZZZmeta http-equiv="Content-Type" content="text/html; charset=us-ascii"><ZZZmeta content="Microsoft Word 11 (filtered medium)" name="Generator"><ZZZ!--[if !mso]>
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<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Hi everyone.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Perhaps this whistleblower case caught these people doing something which was not legal in MD and perhaps their controls were not good.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">In <?xml:namespace prefix = st1 /><st1:State w:st="on"><st1:place w:st="on">North Dakota</st1:place></st1:State> we allow returns to the pharmacy and credit to the patient or payer, when the drugs are in punch cards. The lot number integrity must be maintained, of course.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">We also have a very robust prescription drug repository program that gets donations and reuses quite a few drugs when they come back to our participating pharmacies in cards or unit dose, etc.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">I hope a case like this does not throw cold water on our programs to keep these drugs out of the disposal system, by reusing them properly.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Check out our we site for <st1:PersonName w:st="on">info</st1:PersonName>rmation.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Sincerely,<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Howard <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><o:p> </o:p></SPAN></FONT></P>
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<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Howard C. Anderson, Jr.,R.Ph.</SPAN></FONT><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Executive Director</SPAN></FONT><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><st1:place w:st="on"><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">North Dakota</SPAN></FONT></st1:place><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"> Board of Pharmacy</SPAN></FONT><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><st1:Street w:st="on"><st1:address w:st="on"><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">1906 E. Broadway Ave.</SPAN></FONT></st1:address></st1:Street><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><st1:address w:st="on"><st1:Street w:st="on"><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">P.O. Box</SPAN></FONT></st1:Street><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"> 1354</SPAN></FONT></st1:address><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><st1:place w:st="on"><st1:City w:st="on"><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Bismarck</SPAN></FONT></st1:City><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">, <st1:State w:st="on">ND</st1:State> <st1:PostalCode w:st="on">58502-1354</st1:PostalCode></SPAN></FONT></st1:place><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Phone (701) 328-9535</SPAN></FONT><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Fax (701) 328-9536</SPAN></FONT><FONT color=navy><SPAN style="COLOR: navy"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT color=navy size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Web site www.nodakpharmacy.com</SPAN></FONT><o:p></o:p></P></DIV>
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<P class=MsoNormal><B><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt; FONT-WEIGHT: bold">From:</SPAN></FONT></B><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt"> pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <B><SPAN style="FONT-WEIGHT: bold">On Behalf Of </SPAN></B>Gilliam, Allen<BR><B><SPAN style="FONT-WEIGHT: bold">Sent:</SPAN></B> Monday, December 06, 2010 7:33 AM<BR><B><SPAN style="FONT-WEIGHT: bold">To:</SPAN></B> 'Stevan Gressitt'; pharmwaste<BR><B><SPAN style="FONT-WEIGHT: bold">Subject:</SPAN></B> RE: [Pharmwaste] Interestingly large settlement on drug returndiversion</SPAN></FONT><o:p></o:p></P></DIV>
<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"><o:p> </o:p></SPAN></FONT></P>
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<P class=MsoNormal><FONT color=blue size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: blue; FONT-SIZE: 10pt">Good story Stevan! </SPAN></FONT><o:p></o:p></P></DIV>
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<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
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<P class=MsoNormal><FONT color=blue size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: blue; FONT-SIZE: 10pt">That's one down with how many more left, conducting the same practice?</SPAN></FONT><o:p></o:p></P></DIV>
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<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
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<P class=MsoNormal><FONT color=blue size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: blue; FONT-SIZE: 10pt">allen gilliam</SPAN></FONT><o:p></o:p></P></DIV>
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<P class=MsoNormal><FONT color=blue size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: blue; FONT-SIZE: 10pt">adeq state pretreatment coordinator</SPAN></FONT><o:p></o:p></P></DIV>
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<P class=MsoNormal><FONT color=blue size=2 face=Arial><SPAN style="FONT-FAMILY: Arial; COLOR: blue; FONT-SIZE: 10pt">501.682.0625</SPAN></FONT><o:p></o:p></P></DIV>
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<P style="MARGIN-BOTTOM: 12pt" class=MsoNormal><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt">-----Original Message-----<BR><B><SPAN style="FONT-WEIGHT: bold">From:</SPAN></B> pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <B><SPAN style="FONT-WEIGHT: bold">On Behalf Of </SPAN></B>Stevan Gressitt<BR><B><SPAN style="FONT-WEIGHT: bold">Sent:</SPAN></B> Friday, December 03, 2010 5:55 PM<BR><B><SPAN style="FONT-WEIGHT: bold">To:</SPAN></B> pharmwaste<BR><B><SPAN style="FONT-WEIGHT: bold">Subject:</SPAN></B> [Pharmwaste] Interestingly large settlement on drug return diversion</SPAN></FONT><o:p></o:p></P>
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<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"><A href="http://www.prweb.com/releases/2010/12/prweb4859734.htm" target=_blank>http://www.prweb.com/releases/2010/12/prweb4859734.htm</A><o:p></o:p></SPAN></FONT></P></DIV>
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<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></P></DIV>
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<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt">Stevan Gressitt, M.D.<BR>Faculty Associate, University of <st1:place w:st="on"><st1:PlaceName w:st="on">Maine</st1:PlaceName> <st1:PlaceType w:st="on">Center</st1:PlaceType></st1:place> on Aging<BR>Academic Member, Athens Institute for Education and Research<o:p></o:p></SPAN></FONT></P></DIV>
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<P class=MsoNormal><st1:place w:st="on"><st1:City w:st="on"><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt">Athens</SPAN></FONT></st1:City>, <st1:country-region w:st="on">Greece</st1:country-region></st1:place><o:p></o:p></P></DIV>
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<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt">Founding Director, International Institute for Pharmaceutical Safety<BR><st1:PlaceType w:st="on">University</st1:PlaceType> of <st1:PlaceName w:st="on">New England</st1:PlaceName>, <st1:place w:st="on"><st1:PlaceType w:st="on">College</st1:PlaceType> of <st1:PlaceName w:st="on">Pharmacy</st1:PlaceName></st1:place><BR>Department of Pharmaceutical Sciences <BR>Associate Professor of Clinical Psychiatry<BR><st1:place w:st="on"><st1:PlaceType w:st="on">University</st1:PlaceType> of <st1:PlaceName w:st="on">New England</st1:PlaceName></st1:place>, College of Osteopathic Medicine<BR><st1:address w:st="on"><st1:Street w:st="on">716 Stevens Avenue</st1:Street> <BR><st1:City w:st="on">Portland</st1:City>, <st1:State w:st="on">Maine</st1:State> <st1:PostalCode w:st="on">04103</st1:PostalCode></st1:address><BR><A href="mailto:gressitt@gmail.com" target=_blank>gressitt@gmail.com</A> <BR>Cell: 207-441-0291 <o:p></o:p></SPAN></FONT></P></DIV>
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<P class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"><A href="http://www.benzos.une.edu/" target=_blank>www.benzos.une.edu</A> <o:p></o:p></SPAN></FONT></P></DIV>
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<P style="MARGIN-BOTTOM: 12pt" class=MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"><A href="http://www.safemeddisposal.com/" target=_blank>www.safemeddisposal.com</A> <o:p></o:p></SPAN></FONT></P></DIV>
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