The Pharmacy Chick

Flying the coup in retail

Doofus-o-mania..must be the water!

Filed under: Uncategorized — pharmacychick at 5:25 pm on Wednesday, March 30, 2011

When it rains it pours.  Doofuses among us run rampant.  This one, we can file under “fool me once, shame on YOU, fool me twice, shame on me”. 

Its Monday afternoon and I am returning from my all-too-short lunch and I see one of my long timers (we will call him Wigged out…Wiggie for short) sitting in the wait room.  Tho he has never been a FAV of mine, (too many narcs..too many docs- not a good combo), he has at least always been pleasant when he is sober.  This day he picked up a nice cocktail of genericVicodin and Diazepam.  (Note..I didn’t spell it has never been nor ever will be spelled that way.  learn to spell it correctly all ye who prescribe).  He picked up the rx and went on his merry way. I was not involved in the filling, dispensing or counseling of this patient. I did however, say hello as I walked by.

A couple of hours later, the phone rings and its Wiggie.  The tech takes the call and passes it to me. “You better take this one, he thinks we made a mistake”.  He proceeds to tell me that the tablets inside the bottle do not match the descriptor on the side.  “These are yellow and it says they should be blue”.  My first thought was damn, he got 5mg instead of 10mg…We were slammed so I asked him to return the product and I will replace it.  Shortly thereafter he returns and I open the bottle and sure enough there are yellow tabs inside.  I set them aside, replace the drug, make appropriate apologies,  document the discussion and leave it for MyManFriday who was the filling pharmacist.  I wrote a post it note  “Diaz 5mg? make sure all rx scanned  for accuracy”.

Since it was a very busy monday, I set it aside and didn’t do anything else with it.  I’ll talk to Man Friday tomorrow…

Most of tuesday passes when the phone rings and its Friday on the line.  “The tablets inside that bottle that Wiggie returned aren’t Diazepam 5.  they are cyclobenzaprine by WHAZZIT labs,  a product WE DONT CARRY. 

Well well well, we have a new game on.  Wiggie has moved from routine drug seeking to faking rx errors to obtain more diazepam.  Game over BUCKO.

We left him a message to call us (knowing darn well he wouldn’t be THAT stupid). Then called the prescriber, cancelled any rx’s he had on file and marked his profile as terminated.  We figured we had seen the last of Wiggie.

Well he was indeed THAT stupid.  He called on wednesday and attempted the same ruse… with the same rx!!!  When informed that not only had we fixed the “error” but we were on to his scam because what he returned was something we dont stock.  He hung up on Man Friday.

But to take the cake…drumroll please……He called on Thursday and wanted to fill some rx’s he had on hold.  In the sweetest voice I could muster I said “Wiggie, you can’t fill prescriptions here anymore.  ”

He had the audacity to ask WHY.

Well Wiggie, all the docs know what you did.  And so do the pharmacies around us.  Good luck with your next venture.



Comment by wiser

March 30, 2011 @ 6:19 pm

pc- in a world where folk intentionally hurt themselves to get meds, and count on transcription to lag just enough to let them fool the next urgent care prescriber, this is not a surprise, and good to know. it is similar to the ruse claim that the prescription was written wrong, or was not signed, so please give me another.

Comment by Dr. Grumpy

March 30, 2011 @ 6:23 pm

Aw, at least give the man extra credit for persistence!

Comment by RxBoy

March 30, 2011 @ 8:29 pm

I hope the pharmacist who filled that rx has the ability to press charges against this guy. What if he hadn’t been caught? Would your pharmacist have faced disciplinary action?

At my store a few years back one of our pharmacists got in trouble for just this type of thing. He had approved a prescription for some hydrocodone-apap tablets and it was sold out. The patient came in and picked it up and then when they got home switched it out with some metoprolol tablets and then brought it back in saying that this was what was in the bottle.

Well, the pharmacist was blamed for the error and he was written up and disciplined for the error. A few days later, a family member who found out what this patient did came in and told us about it. When the guy was confronted he admitted that he had switched out the tablets in order to get another bottle of the hydrocodone.

I hope there is legal recourse for a pharmacist when the are falsely accused of something like this. If a patient comes in and says they were given the wrong thing, the assumption is that the pharmacist made the error and who is to prove otherwise? That’s a scary thing to think about. A drugseeker could potentially cause a pharmacist to loose their license.I agree with you, this really is a crime against the filling pharmacist, accusing him of misfilling a prescription when it was done correctly.

Comment by phx

March 30, 2011 @ 10:22 pm

You know where I work, they don’t really discipline you for errors- you just document in the computer system, correct the error, contact prescribes if any meds taken, and apologize for what happened. Now, if they notice a trend in a particular pharmacist & error rate – they may get talked to/transferred to a slower store, but I never have heard of anyone being written up for an error. That is even when an error becomes a complaint to the board of pharmacy. It’s kind of funny how some people are the nicest people when a blatant error was made and other people get angry if the Dr.s name is wrong! As for the good ol switcheroo-I’ve had that one pulled-but it was a little more deceptive- pt had 2 rx’s said both were ibu-no way to prove it!

Comment by Guzzo

March 31, 2011 @ 3:43 am

I worked for a smart mail-order pharmacy that had all the bells-and whistles technology. They had an automated filler that took pictures of the drugs inside each vial as they were filled.

Now, if only someone in retail could come up with an easy was to photograph each drug that was dispensed and store it with the Rx in a database.

Comment by Tracy

March 31, 2011 @ 4:55 am

We had a pain clinic call us to ask for the description of embeda b/c the pt had returned because “it didn’t work, made her nauseous, whatever”. She wanted to go back to her oxycontin. While he Rph was on the phone getting the description from he nurse, she goes over to the shelves, pulls the fluoride 0.5mg, gets a funny look on her face, and says “um. That’s not embeda. That’s fluoride. It smells like grape, right? Yeah. ” Needless to say we have not seen or heard from this patient again. Thankfully she didn’t blame us. (There is NO WAY she got fluoride in place of embeda and we were ready to fight that fight).
I also took a phone call once from a pt who thought she might have gotten the wrong thing bc her vicodin didn’t look right. I took the description, popped it into the handy drug identifier and “tylenol arthritis “. She didn’t blame us but thought someone in her family had made the trade.
Most often we get accused of “shorting me on my __” (insert somas vicoden oxycontin morphine tramadols here). We started circling and initiating the dispensed qty on anything controlled (i consider soma and tramadol honorary controlled drugs, so they get the special treatment too). For about 4 months after we started doing that we got so many hopeful calls about being shorted, only to get told that “nope, that’s my initials saying i double counted it for you” recently we got a call where i forgot the initial and they said they were shorted. When the Rph said that we double counted it, their response was “well you didn’t initial it.” Sheesh.

Comment by chris

March 31, 2011 @ 5:32 am

Had an error a couple of years back, not drug seeking, more a case of compensation seeking. Claimed I had given him the wrong drugs and put him in hospital. His friend a ‘nurse’ wrote me a letter listing his symptoms and told me that the doctor told him to sue because he nearly died.

I was quite worried by this potential error but then as I investigated the error, phoning the hospital etc. a few incositencies came up.

1. GP not aware of patient being unwell in past few months
2. Has not been booked into and NHS hospital in the last 4 years
3. The ‘incorrect item’ that he recieved looked like the label had been peeled and restuck
4. the ‘incorrect item’ was a medication that he had been taking 3/4 years ago and was over 2 years out of date
5. The side effects listed by the nurse were in the exact same order as in the BNF, including some contradictory ones ie. bradycardia and tachycardia
6. No record of his nurse on the nursing register

I later found out that this guy has done this wort of thing before and been charged for fraud. I am awaiting my companies action on this individual.well I have the original bottle, so If I had to I would have it analyzed for drug residue. I’d bet I would find Diazepam residue in the bottle. we filled it correct. the back count done after the fact showed we were spot on, until I released the “correction” to the patient. then we bacame 25 short. precisely the amount he got.

Comment by Jade

March 31, 2011 @ 8:11 am

My deal (I work in a hospital) is that we do drug IDs right then and there. Micromedex has a great Identidex drug ID program we keep available at the computer terminal. We have nursing trained when the patient comes in with their own prescription drugs to not give it until pharmacy okays what’s in the prescription vial.

When I work retail we tell the patient, ‘hold on, let me check into it’. We don’t ‘correct’ anything or fill anything for anyone until we figure it out in real time. We like direct confrontation, too.

In the hospital, most of the time the issue is that the patient ‘needed’ to put their medications in a second bottle to carry with them to have in their purse or whatever and the label bears little or no resemblance to what’s in the bottle. That’s why it is very important for me to find out where the drug was filled and what’s in the pharmacy file (in case the patient’s order was change between the original labeling and what the patient put in the bottle.)

I have had patient’s put their VA supply of digoxin 0.125 mg into a bottle of digoxin 0.25 mg–I can tell because the label on the vial indicates it was filled several years prior, but obviously there’s a ‘new’ supply in the bottle.

It helps immensely when I can call the pharmacy and verify what the latest order on file especially with patients that are a ‘no doc’ i.e. they are admitted through E.R. into the hospital without a local prescriber on staff, so there’s not the best of records available on the patient. I consider it part of my job as a pharmacist in the hospital to be able to work with the physician on staff to get the right medications to the patient.

This is a pet peeve of mine with all the mail-out pharmacies around that refuse to talk to licensed pharmacists!! Because, the mail-outs are either not available 24/7 or staffed by techs or political science grads who are afraid of HIPAA because they don’t understand HIPAA–that of all the people in the world who need to know patient information, it IS the pharmacist who is assuming pharmaceutical care of the patient.

At least the VA has patient information available 24/7. Most chains have central access to patient information also. If the local Walgreens, CVS or Wal-mart is not open, I can call a 24 hour one even in a different town and get the information from another shop.

Comment by Impatient

March 31, 2011 @ 6:17 pm

Great job! I can’t understand addiction…I take drugs just to feel normal; others would take them to get a buzz.

Comment by hany

June 23, 2011 @ 8:29 pm

I truly despise drug seekers, not cause they enjoy buzzez, because they are so selfish and are willing to wreck and disrespect everyone in there path for there buzz…some people say its the drugs, I don’t blame the drugs I blame them and only them.

I pray to God to heal any addict out there, however if you are an addict reading this, you must decide to pray for that to start with…it won’t just dawn on you that what you are doing is extremely selfish.

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