Wednesday, August 26, 2015

Sternberg v. California State Board of Pharmacy (Cal. Ct. App. - Aug. 26, 2015)

It at first seemed a little harsh to me that the California State Board of Pharmacy revoked Andrew Sternberg's pharmacy license just because he was the pharmacist in charge when someone else stole some drugs from the office.  Seemed harsh to the administrative law judge as well, who recommended merely that Mr. Sternberg be publicly reproved.

But, reading on, I then noticed that the Board stayed this revocation, and merely put Mr. Sternberg on probation for three years.  Probation:  That seems more reasonable.

Still.  The guy's being punished for someone else's theft.  How's that fair?

But then I read more about the facts.  This wasn't just a tiny little theft, or of some insubstantial little drug.  "During a two-year period while he supervised the Target pharmacy—September 1, 2006, to August 31, 2008—Imelda Hurtado, a pharmacy technician, stole at least 216,630 tablets of Norco1 from the pharmacy, with an estimated retail value of up to $1.50 per tablet, or $324,945, and street value of up to $5 per tablet, or $1,083,150."

Dude.  That's a lot of Norcol.  That's a lot of theft.  We might well want the supervisor to, well, supervise a little more in order to prevent these drugs from hitting the street.

Then I read more.  About precisely how the theft was accomplished.  Which, in a way, was a neat little roadmap about how to steal drugs from a pharmacy.  But also highlighted the kinds of things that Mr. Sternberg did -- or, more accurately, failed to do -- to prevent such a theft:

Hurtado accomplished this theft as follows: She would place orders for up to 3,000 tablets (six bottles with 500 tablets per bottle) to be delivered to the pharmacy on a day she was scheduled to work. She did this approximately 85 times, as often as three times a week. When orders arrived, she would take the delivery to a work station farthest away from the pharmacist’s station. She would then remove the six bottles, hide them in the store room, and destroy the packing invoice. When the pharmacist on duty took a lunch break, she would go to the store room, put three bottles in her purse, and take them out to her car. Later in the day, when the pharmacist was on a break, she would take the other three bottles to her car in the same manner. Her theft was discovered when Sternberg found a bottle of Norco in the store room. The Target pharmacy normally did not sell Norco . . . .

The wholesaler (‘supplier’) typically delivered the drug orders to the pharmacy between 12:30 p.m. and 1:00 p.m. Section 4059.5 of the Pharmacy Law requires that a pharmacist sign for and receive all dangerous drugs or devices delivered to a pharmacy. [Sternberg] testified that his policy was that ‘everybody that works in the pharmacy knows that the law prevents anybody from signing for deliveries, except a pharmacist.’ [Sternberg] did not explain how he would enforce that policy, nor was there any evidence presented as to how that would be implemented. With respect to receipt of drug deliveries, when [Sternberg] signed for the delivery of dangerous drugs he would sign a ‘delivery log that is supplied by the supplier’; however, that log only disclosed how many containers were being delivered, not what was in the actual containers. He would then count the number of bottles, and give the tote to a pharmacy technician who he assigned to take care of unpacking the drugs, placing appropriate shelf labels on the bottles, and checking the invoice/packing slip inside the box to assure that the supplier delivered what was ordered. After [Sternberg] signed for the drugs, he ‘never’ looked at the invoices being taken out of the delivery container and did not check the invoices against the drugs he received. [Sternberg] admitted that as the Pharmacist-in-Charge he had the ‘discretion’ to examine the invoices, but chose not to do so. The invoices he received were given to a pharmacy technician, who then placed them in a box under a counter. After the box was filled, it was then transferred to a ‘little storage area’ in the pharmacy. The box was not checked regularly by any pharmacists, but ‘occasionally’ [Sternberg] or another pharmacist would look at those invoices, but only ‘for a specific drug that we had to order for somebody to see if it came in or if it didn’t come in.’ As a result, the missing inventory and invoices were only discovered by chance, and not for at least 18 months."

Wow.  I think we can all agree that this falls far short from "best practices" at a pharmacy.

So, in the end, I can see why Mr. Sternberg received the discipline he did.  If not more.