Tip of the Week: Avoiding Legal, Financial Difficulties With Ethical Decisions

There are so many facets of pharmacy practice that hinge upon legal and ethical considerations.

In the matter of California State Board of Pharmacy vs Pacifica Pharmacy and Thang Tran, action was taken by the board against a pharmacist accused of poor oversight, and judgment over occurrences at a community pharmacy under his watch. The pharmacist, Thang Q. Tran, owned and operated Pacific Pharmacy, a community pharmacy in Huntington Beach, California.

The board asserts that the inspection of Pacific Pharmacy disclosed expired drugs in its inventory, missing information on prefilled 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,” and claimed that the remaining allegations are minor, and unworthy of discipline. Furthermore, Pacifica argued that the clear and convincing evidence did not establish that Tran knowingly violated the corresponding responsibility statute, that the pharmacy dispensed any controlled substance for anything other than a legitimate medical purpose, or that Tran personally filled any of the prescriptions at issue. In addition, the response to the complaint asserted that Tran and Pacifica stopped filling the prescriptions when notice was given that the prescriptions might not be for a legitimate medical purpose.

According to court documents, prescriptions for controlled substances written by Dr. T, an osteopath whose medical office was located many miles away from Pacifica, and it was asserted that the distance required Tran and Pacifica to make an inquiry whether the prescriptions had been written for legitimate medical purposes, and that 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, who has responsibility for operations, and for 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 operations management and decision-making by the pharmacy owner/manager. Tran did not pursue legitimate inquiry into longstanding questionable prescriptions, he was carrying expired drugs, and was maintaining poor stock and inventory control. These initial problems probably incurred the heightened attention from the board that uncovered the larger problems.

The responsibilities of management transcend their own dispensing, and other behavioral habits 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 medication therapy management and management functions can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. You or your institution can subscribe to AccessPharmacy to access the textbook.

Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California. He is author of Chapter 1: The “Management” in Medication Therapy Management and Management Functions in the textbook Pharmacy Management: Essentials for All Practice Settings, 5e.

REFERENCE

In the Matter of Accusation Against Pacific Pharmacy; Thang Tran. Board of Pharmacy Case No. 3802; OAH No. 2011010644; Precedential Decision No. 2013-01 Made precedential by the Board of Pharmacy effective August 9, 2013. https://www.pharmacy.ca.gov/enforcement/fy1011/ac103802.pdf. Accessed on January 21, 2029.