813th Meeting of the North Carolina Board of Pharmacy June 17, 2008
President Wallace Nelson called the meeting to order at 9:00am with Board Members Wallace Nelson, Parker Chesson, Betty Dennis, Stan Haywood, Rebecca Chater and Joey McLaughlin present. Also present were Executive Director Jay Campbell; Board Counsel Clint Pinyan and Alex Elkin; Director of Investigation Karen Matthews; Director of Licensing Rachel Paris; DME Specialist Wendy Watson; NCBOP Investigator Jason Smith; NCBOP Investigator Ken Wilkins. Present as visitors were: Sally Slusher, NCAP; Lori Setzer, CVS; Paul Peterson, PRN; Heidi Barefoot, Target Pharmacy; Marija Mikulslais, Walgreens; Julie Penner, Walgreens, Valerie Rydberg, Walgreens; Charles Stallings, Walgreens; Brenden O’Hara, Walgreens; Franklin Glover, Pharmacist; Vera Glover; Garrett Roach, UNC; Ashley Blankenship, Walgreens/Campbell; Amanda Lucas, Campbell; Bennett Noell, CVS; Roy Van Veld, Walgreens/UNC; Michelle Spain, CVS; Deitra M.Gate; Amy Murray, Kerr Drug; Gray Stewart, Kerr Drug; Jina Jung, Walgreens; Ginny Schaffer, UNC Student; Allison Pecha, UNC student; Shannon Hawkes, Walgreens/Campbell; Tina Lee, Walgreens/Campbell; Cornelius Tollver, Walgreens/Campbell; Andrew Patel, BI-LO; Matthew Pistel, Walgreens; Trish Carrol, Walgreens; Dewanda Little, Healthwise; Ana Dates, Kerr Drug; Luther Stevens, Kerr Drug/Howard; Betsy Ramsay, CVS; George Hearn, CVS; Anthony Pudlo, Kerr Drug;
Ethics Statement & Welcome President Wallace Nelson read the Ethics Statement regarding any conflicts of interest and/or appearances of conflicts of interest of any Board member. There were no conflicts noted by any Member.
President Nelson welcomed all visitors.
Minutes of April 2008 and June 11, 2008 The members received the April 2008 meeting minutes and the June 11, 2008 meeting minutes prior to this meeting for review. It was moved by Mr. McLaughlin and seconded by Mrs. Chater to accept the Minutes as submitted. The motion passed with no dissenting votes.
Disciplinary Hearing – William T. Walker RPh license #05445 William T. Walker, RPh license #05445, appeared before the Board to answer charges that he did not comply with a Consent Order he signed on April 2, 2008 and that the Board accepted on April 15, 2008. Mr. Alex Elkin proceeded with the case and stated that one of the conditions of Mr. Walker’s April 15th Consent Order was that he not serve or act as pharmacist manager of Pharmacy Land pharmacy. Executive Director Jay Campbell was duly sworn and testified that Mr. Walker continued to work at Pharmacy Land pharmacy as Pharmacist Manager until May 29, 2008 in violation of his Consent Order.
After presentation of evidence and testimony from Mr. Walker and Jay Campbell, the Board moved into closed session, on a motion from Dr. Dennis and seconded by Dr. Chesson, to deliberate the matter. When the public session resumed, President Nelson stated that on a motion from Mr. McLaughlin, seconded by Mr. Haywood with no dissenting votes, that the Board would suspended Mr. Walker’s pharmacist license for one year, require that he take and pass the
MPJE exam, get written approval for employment from Board Executive Director, not act as pharmacist manager or as a preceptor, submit continuing education credits to Executive Director, must obtain additional 5 hours of CE including an accredited error reduction class and not violate any other rules or regulation of pharmacy board. A copy of the final decision can be found elsewhere in the Minutes and incorporated by reference herein
Disciplinary Hearing – Tammy Moyer Technician registration #14205 Clint Pinyan proceeded with the case and stated that Ms. Moyer was registered with the Board July 2, 2005 and was employed at Walgreens. In October 2006, Ms. Moyer was arrested for diversion of controlled substance. On January 17, 2007 the board summarily suspended her registration for diverting controlled substances. Ms. Moyer’s request for reinstatement of her registration and the notice for final disciplinary hearing coincided. Ms. Moyer received a notice of the hearing but did not attend. Matthew Pistel, Loss Prevention Supervisor for Walgreens, was duly sworn and testified that Ms. Moyer admitted to diverting controlled substances which she gave to her sister who later sold them. Jason Smith, NC Board of Pharmacy Investigator, was duly sworn and testified that during his interview with Ms. Moyer she stated that she never diverted any controlled substances and refused to sign a voluntary surrender of her registration.
After presentation of evidence and testimony, the Board decided, on a motion from Mr. Haywood and seconded by Mrs. Chater with no dissenting votes, to deny Ms. Moyer’s request for reinstatement and permanently revoke her technician registration. A copy of the final decision can be found elsewhere in the Minutes and is incorporated by reference herein
Consideration of Reciprocity Application – Franklin Glover, VA Mr. Franklin Glover appeared before the Board in consideration of his reciprocity application from Virginia. Mr. Campbell stated that Mr. Glover indicated on his reciprocity questionnaire that in the early 1990’s he had a substance abuse problem and had entered into and completed treatment in Virginia. Mr. Glover’s Virginia pharmacist license was suspended but reinstated after completion of treatment. Mr. Glover spoke of his recovery process. On a motion from Dr. Dennis, seconded by Mrs. Chater with no dissenting votes, the Board approved Mr. Glover’s application for reciprocity.
Consideration of Technician Application – Dewanda Little Ms. Dewanda Little appeared before the Board in consideration of her technician application. Mr. Campbell stated that Ms. Little was honest on her application and admitted to pleading guilty to embezzlement charges, not related to prescription drugs, and has satisfied all obligations of the charges. Ms. Little spoke about her conviction and wanting a second chance. On a motion from Mr. Haywood, seconded by Dr. Dennis with no dissenting votes, the Board approved Ms. Little application for technician.
Open Mike Session NCAP, PRN and BOP committees did not have topics to present to the Board during Open Mike Session.
The Board adjourned for lunch at 12:05am and return to open session at 1:30 pm.
Mandatory Counseling Proposal – Roy Pleasants An ad hoc working group chaired by Roy Pleasants updated the Board on a proposal to require counseling on certain new prescriptions. The group demonstrated the typical time it would take a pharmacist to counsel patients. Mr. Pleasants reviewed an April 2008 survey of North Carolina pharmacists on their views of mandatory counseling. Mr. Pleasants requested direction from the Board on the next steps that would be needed to facilitate the process. Mr. Campbell suggested that they solicit other organizations such as NCAP, RMA and ACP to have their input on the proposal. It was decided that Board members Mr. McLaughlin, Ms. Chater and Dr. Chesson would join the working group and Mr. Campbell would send a letter to each of the above organizations to solicit one person from each organization to join the group.
Consideration of Pharmacist Reinstatement Request – Tristan Jacobsen – license #15290 Tristan Jacobsen appeared before the Board to request reinstatement of his pharmacist license (#15290). Mr. Campbell stated Mr. Jacobsen had voluntarily surrendered his license in October 2007 for noncompliance with his Pharmacist Recovery Network (PRN) contract. Paul Peterson, Executive Director of NCPRN spoke to the Board on Mr. Jacobsen’s behalf and advocated for the reinstatement of his license with conditions. Mr. Jacobsen was duly sworn and spoke of his recovery process and his wish to continue with his pharmacy career.
After presentation of evidence and testimony, the Board moved into closed session, on a motion from Mr. Haywood and seconded by Mr. McLaughlin, to deliberate the matter. When the public session resumed, President Nelson stated that on a motion from Dr. Dennis, seconded by Dr. Chesson with no dissenting votes, that the Board would reinstate Mr. Jacobsen license with conditions. A copy of the reinstatement order can be found elsewhere in the Minutes and is incorporated by reference herein.
Election of Board Officers On a motion from Dr. Dennis, seconded by Ms. Chater with no dissenting votes, the Board elected Stan Haywood as President and Joey McLaughlin as Vice- President for the upcoming Board term. Parker Chesson and Stan Haywood will remain as finance/budget committee members.
Electronic Board Election Rule Amendment Mr. Campbell stated that the election rule would need to be modified to implement a proposed electronic voting system for Board elections. On a motion from Dr. Dennis, seconded by Mr. Haywood with no dissenting votes, the Board agreed to move forward with the necessary rule change.
Inquiry from Margaret Sgritta concerning certified nursing assistant administration of medications at long-term care facilities and the need for patient counseling Margaret Sgritta, consultant pharmacist for long term care facilities, requested guidance from the Board on the need for patient counseling in assisted living facilities. North Carolina Pharmacy 21 N.C.A.C. 46.2504 governs patient counseling requirements in North Carolina. Paragraph (e)(4)
states that "patient counseling, as described in this rule, shall not be required for inpatients of hospitals or other institutions where a nurse or other licensed health care professional administers the medication(s)." So, if a particular assisted living facility is an institution "where a nurse or other licensed health care professional administers" patient medications, then the counseling requirements of Rule .2504 do not apply. Ms Sgritta explained to the Board that, oftentimes the personnel administering medications are "medication technicians" and certain nursing aides, whether nursing aides or medical technicians are “licensed health care professionals”. Mr. Campbell stated that he would make inquiries at the Division of Facilities Services and the Board of Nursing on whether nursing aides and medical technicians are licensed professionals.
Maryland Pharmacists Association Resolution Concerning “As Directed” Prescription Mr. Campbell stated that the Maryland Pharmacist Association is actively educating and encouraging physician not to use “As Directed” on prescriptions.
Florida reciprocity Florida legislature has passed a bill that will eliminate the requirement that a pharmacist have passed the North American Pharmacist Licensure Examination within the previous 12 years as a condition of reciprocity If the Florida governor signs the bill into law the North Carolina Board will revisit allowing reciprocity with Florida at the July 2008 Board meeting.
Financial Update Financial and Administrative Services Director Gail Brantley presented the financial statistics for May 2008.
Investigative Update Director of Investigation Karen Matthew presented the investigative statistics for the month. Ms. Matthew spoke to the Board about the cost saving measures that the Investigation Department is trying to implement, including the use of flex schedules.
Ms. Matthew also complemented Investigator Amy Cook on her cooperation with the FBI on the undercover investigation of a doctor.
Consent Agenda Following a review of the consent agenda, it was moved by Mr. McLaughlin, seconded by Mrs. Chater, to approve the consent agenda as presented. The motion carried with no dissenting votes. The following items were approved.
Prehearing Conference Consent Order
Almands Discount Drug Store – permit #02981 and RPh Michelle Farrington – license #09524 were subjects of a prehearing conference held April 14, 2008, heard by Wallace Nelson, regarding allegations Ms. Farrington, while acting as pharmacist manager, allowed a technician to order controlled substances at which time the technician ordered additional dosages that were diverted by technician; Recommendation : Consent Order of Reprimand toRPh. Farrington and Almands Discount Drug store permit suspended 5 days/ stayed for 1 year with conditions.
RPh. James Harlie Baldwin – license #06987 was subject of a prehearing conference held April 14, 2008, heard by Wallace Nelson, regarding allegations that Mr. Baldwin created 15 unauthorized prescriptions for non-controlled drugs and dispensed those drugs without a valid prescription to members of foster family in dire financial circumstances. Recommendation: 5 day suspension/ stayed 1 year with conditions. RPh. Robert Byron Johnson – license #05833 was subject of a prehearing conference held April 14, 2008, heard by Wallace Nelson, regarding allegations that Mr. Johnson dispensed Norvasc to a patient when the prescribed medication was for Ambien 10mg. Recommendation: 7 day suspension/ stayed 1 year with conditions RPh. Scott Hanson – license #09686 was subject of a prehearing conference held March 24, 2008, heard by Rebecca Chater, regarding allegations that Mr. Hanson dispensed one Fentanyl 75mcg Patch to a patient who had been prescribed a Fentanyl 25mcg by delivering the prescription to the patient’s husband. Recommendation: Consent Order of Reprimand to RPh. Hanson.
RPh. Pushpesh Bhandari – license #12972 and RPh. Paula Michelle DeMaria – license #17385 were subjects of a prehearing conference held April 14, 2008, heard by Wallace Nelson, regarding allegations that while each was acting as pharmacist manager for Eckerd Drugs, Durham NC, they did not conduct a complete controlled substance inventory, which may have detected diversion of controlled substances by technician James Allston. Recommendation: Consent Order of Warning with conditionsfor RPh. Bhandari and RPh. DeMaria.
Tech. Christopher Crowl – registration #08499 was subject of a prehearing conference held October 15, 2007, heard by Joey McLaughlin, regarding allegations of participation in the diversion of medications including controlled substances. Mr. Crowl surrendered his registration on February 7, 2008 and was formally charged by SBI for diversion Mr. Crowl did not attend prehearing conference. Recommendation: Deny request for reinstatement from Mr. Crowl and permanently revoke his registrations with conditions. Airway Medical Supplies, Inc. – DME permit #01358 was subject of a prehearing conference held June 16, 2008, heard by Joey McLaughlin, regarding allegations of Airway Medical Supplies Inc operating 2 DME stores under one permit number which is against Board regulations. Permit had been summarily suspended 1/15/2008. Recommendation: Reinstate permit and 5 months suspension deemed served during summarily suspension w/ conditions.
Increase in Pharmacists to Technician Ratio