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Ethical Issues and Disciplinary Actions in Ross Medical Pharmacy Fraud Case

Ethical Issues and Disciplinary Actions in Ross Medical Pharmacy Fraud Case

Section 4024 of the Business and Professions Code states that dispensing a drug or a device prescribed by a doctor, a pharmacist, or a nurse should always be within the jurisdiction of their practice. Section 4300 gives the Board the power to revoke or suspend licenses to practice pharmacy. Further, Section 4301 subdivision states that the pharmacist in charge of the pharmacy is responsible for compliance with all state and federal laws that govern the pharmaceutical practice. At the same time, Section 4301 of the Code says that any professional, who gets involved with unlawful activities and holds a license, or one, whose authorization has been acquired by deception or by mistake, shall be predisposed to prosecution. According to Strandberg, the California Code of Regulation, Title 16, Section 1761 states that a pharmacist should not dispense any drug prescription with omissions, irregularity, or uncertainty. If they do, the pharmacist should contact the concerned doctor to ensure the prescription is correct or correct it themselves. Section 125.3 of the Code states that a more reasonable amount used for the investigation and enforcement of the case is payable by the licentiate.

Facts of the Case as Alleged by the Board

According to the Board’s accusation, on September 25, 2013, Ross Medical Pharmacy had paid an amount of $20 to wrongfully use patients’ names and billed their insurance for medical services that they had not received. We tip brought forward that the manager had kept the drugs prescribed by Dr. M.G. after fake visits. Moreover, Ross Medical Pharmacy was deeply involved in this fraudulent scheme. The pharmacy had dispensed fallacious prescriptions. This violates Code section 4301, subdivision, for violating Healthy and Safety Codes section 11153. Between November 28, 2012, and December 17, 2013, Ross Medical Pharmacy failed to adhere to the responsibility of authenticating the legitimacy of prescriptions and evaluating the drug profile and its effects on the patients by dispensing prescriptions with no regard to objective factors. This again contravened Code Section 4301, subdivision and California Code of Regulation, Title 16, section 1761. During the same period between November 28, 2012, and December 17, 2013, the respondents, Ross Medical Pharmacy, recorded a total of 7,730 prescriptions of controlled substances that Dr. M.G. had prescribed and that had no legitimate medical indications. Dr. M.G pleaded guilty to distributing oxycodone illegally and money laundering. She also admitted that she had fallaciously prescribed unnecessary drugs to the patients, which was not in line with the ethics of professional practice. Dr. M.G. was later fired from Southfork Clinic.

Ethical Issues of the Case

The pharmacy was involved in various contraventions of moral principles. These principles should be followed for the perpetuation of professionalism. Thus, the pharmacy violated the ethical principle by taking advantage of the patients through Dr. M.G., who had intentionally prescribed unnecessary drugs without a legitimate medical purpose. This poses a great risk to patients’ health as the drugs might harm them. For instance, the patients had been recommended Alprazolam for muscle spasms and Promethazine with Codeine for cough regardless of their peculiarities. These are harmful medications, and thus, they are controlled substances. The doctor was also involved in a narcotic drug trafficking ring that sold illegal prescription drugs for cash that were later shipped to Texas for sale on the black market. This was for the doctor’s selfish interests since she did not keep the interest of the patients first, as she ought to.

The pharmacy had also failed to fulfill the responsibility of supplying only authorized drug prescriptions when it dispensed the medications prescribed by Dr. M.G. Thus, some controlled substances purchased with cash were suspiciously more expensive than non-controlled substances paid for in cash. More often than not, cash payments are usually preferred when potential drug diversion and abuse are involved. By doing this, the pharmacy contravened the implicit trust of its clients.

Discussion of Mitigating and Aggravating Factors That Influence the Board’s Level of Discipline

In this case, the pharmacy is indirectly involved in illegal activities. It is a separate entity from Dr. M.G, who has alleged to be involved in narcotics trafficking, but since the pharmacy has been engaged in erroneous and unlawful activities, it has faced the law too. The Board could look into why Dr. M.G. had been involved in drug trafficking in the first place. The doctor may have had financial problems, and thus, she took this move in a desperate attempt to meet her needs that she could not meet earlier. Perhaps, the pharmacy itself needed to be made aware of the illegitimate activities within the premise. This means there were few individuals in the pharmacy involved in this scam, not the pharmacy in general. Action should be taken against these specific people who participated in the scam to avoid tarnishing the pharmacy’s name.

On the other hand, the doctor’s involvement with the trafficking of narcotics is against the rules and regulations of the country. Therefore, she should be prosecuted appropriately and strict measures to be taken against her. The fact that these drugs might have been harmful to some of the clients to whom the doctor had prescribed the unnecessary drugs would only be just if the perpetrator were judged accordingly. The pharmacy was involved in a scam that might have put the patient’s health at risk, and thus, the pharmacy must also be revoked its license to dispense drugs to patients.

Prediction of the Outcome of the Case

The Board will likely revoke the license of Ross Medical Pharmacy. Seung-Yul Kim, the head of the pharmacy, should also have her license suspended for allowing illegitimate activities to be run in her pharmacy contrary to the laws of the Board. Seung-Yul Kim should also pay the Board of Pharmacy a sensible amount that they have used to investigate and enforce the case. Dr. M.G should also be prosecuted according to laws and fined an amount equitable with the losses she had brought to the pharmacy and the risk she had caused to her patients’ health.

Takeaways Applicable to My Future Practice

I have mastered from this case that pharmacists and the pharmacies they work in have been entrusted with the responsibility of dispensing drugs that are appropriate for the patients, and these drugs must be medically and pharmacologically beneficial to the patients. Pharmacists must ensure that the right drugs are prescribed and dispensed to the patients. Pharmacists are responsible for ensuring that the rules and regulations pertaining to controlled drugs are followed precisely. If any harm is inflicted on the patients, the pharmacist is responsible for that, and they are liable to prosecution. Pharmacist has a major role in ensuring the safety of their clients. Therefore, they play an important role and have responsibilities in the healthcare system.

📎 References

1. Rickles, N. M., Wertheimer, A. I., & Smith, M. C. (2010). Social and behavioral aspects of pharmaceutical care (2nd ed.). Jones & Bartlett Publishers.
2. Strandberg, K. M. (2011). Essentials of law and ethics for pharmacy technicians, third edition (pharmacy education series) (3d ed.). Boca Raton, FL: CRC Press