I have read all the comments on this post with great interest. Big retailers, independent pharmacies, chain drug stores ..... does it really matter. I never fill a suspicious looking Rx without using the state's Database (KASPER in Kentucky) and calling the prescriber if needed (Normally pulling a KASPER report takes under 20 seconds). I know that any diverted pill can land up in our kids' school bus. There are numerous reports verifying that 30% or more of the kids that pass out high school have tried pain pills, xanax etc at least once (Recreational ...???).

I sure do not want to be the weak link. I believe there should be a serious discussion amongst local pharmacies about sharing such information. I am lucky to have excellent colleagues working in other chain drug stores (Competitors???). We are watchful about any unusual prescriptions and call each other to see a pattern. We might not be as busy as other pharmacies (around 300 rxs in 13 hrs). We also have excellent support from our local law enforcement. They have a Drug Task force.

http://www.lvrj.com/news/pharmacies-not-liable-in-case-80104447.html

The verdict is in !

Here is what the Nevada Supreme court stated on Dec 24, 2009

The Nevada Supreme Court ruled 5-2 Thursday that eight pharmacies in Las Vegas cannot be sued for negligence in the death of a man killed by a motorist under the influence of prescription drugs purchased at their businesses.

Justices decided Nevada's pharmacy laws "are not intended to protect the general public from the type of injury sustained in this case."

Pharmacies do not have a legal duty to protect people injured by their customers, they stated.

"The duty (under state law) is to the person for whom the prescription was written, the pharmacy's customer, if anyone, and not for the general public's protection," stated the court in the majority opinion.

The Justices stated that PHARMACIES do not have a legal duty... So where do PHARMACISTS stand in this equation?

Does this mean that the permit holder (corporate pharmacy) can dictate what we PHARMACISTS can and cannot fill and when. Have they delegated all responsibilities to the employer.. or did the supreme court just exempt corporate pharmacy from any and all liabilities of operating a pharmacy?

This is a pharmacy issue I'm quite familiar with. Where I work (in CA), we don't use a PDMP but we catch people just by a little old fashioned professional scrutiny.

We had a patient once that progressively was prescribed larger and larger quantities of PC via harassing his MDs and switching MDs if they didn't give the patient more refills. It got to the point that he was going through one pint every three days. We decided to call the MD and express concern about the frequency of the PC refills, and the MD suggested we give the patient MORE AT A TIME so that the patient does not have to come in so often. Realizing that the MD was essentially feeding the patient's drug addiction, we as a pharmacy made the professional decision to refuse to refill further refills for that patient. Imagine if we kept filling it, they might have died from respiratory depression or overdose, and who would be to blame?

Admittedly, because I do work in an independent pharmacy, we tend to get patients from the same MDs and we know the MDs in the area that will write narcotics prescriptions for anyone (there are MDs like that) so it's easier to know which prescriptions to refuse. With all of that being said, I think that the pharmacies should have taken the PDMP warning letter more seriously because it was a direct warning, no detective work required.

I'm still not sure whether or not I believe the pharmacists should be held legally responsible for the accident. On one hand, they were warned that the patient could be abusing drugs, but at the same time how does one accurately scrutinize an unusual drug regimen? You'd think to call the MD, but some MDs (like the one I encountered on the phone) do not see a problem with the regimen. There is no 100% sure-fire way of knowing whether or not a patient needs a lot of pain medication for a condition or if the patient is abusing drugs, so is it fair to scrutinize the pharmacist? Shouldn't the MD be under fire?

Reading this makes me wonder, if the accident never occurred, would the affiliated doctors and pharmacists have still gotten in trouble?

And another question. I'm not familiar with how PDMPs work, but if they see that a patient is receiving too many narcotics, do they investigate the prescribing MDs?

Color me curious:

Is the use of a PDMP something that an experienced technician could do? Total honesty: I have no idea if VA even has one, and if they do how I would access it. Because my pharmacy is 24 hours and very high volume, I know for a reasonable certainty that I have "shoppers" who are not using insurance and purchasing controlled substances in greater quantity than they should. But if I wanted to utilize this database, I would have no idea how.

As technicians become licensed and more become nationally certified, the level of professionalism will increase. This is one area where pharmacists can utilize their senior technicians, which in turn will protect the pharmacists and pharmacies from such liability.

The big retailers are in it for the money and will throw RPhs under the bus and protect themselves.