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New Details Released on Drug Enforcement Administration’s Investigation of Central Florida Pain Management Clinic

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Drug Enforcement Administration’s (DEA) investigation into a Longwood, Florida, pain management clinic continues. More details are being revealed about the case. DEA agents along with local police and sheriffs’ deputies raided the pain management clinic on June 14, 2013. Agents believe the evidence they have gathered suggests the clinic was operating as a “pill mill,” according to the Orlando Sentinel. Officials allegedly seized evidence at the clinic associated with at least ten (10) doctors and other clinic employees. No one has been arrested yet, but documents filed in federal court in Orlando suggest charges could be coming.

I previously blogged about this raid. Click here to read that blog.

Details of the Investigation.

According to the Orlando Sentinel, the DEA began surveying the alleged pill mill in January 2011, while investigating a doctor shopper. From July 2011 through May 2013, agents monitored the clinic. During the investigation, agents observed long lines outside the clinic, out-of-state license plates and groups of “patients” arriving at the clinic together. All of this behavior, according to authorities, is associated with pain clinics.

More concrete evidence against the pain management clinic, according to police officials, includes:

– Patients stating that employees discussed selling pain pills and fake MRIs;

– DEA agents observing drug deals made by patients coming from the clinic, in the vicinity of the clinic;

– Used needles were found in nearby parking lots; and

– Two of the clinic’s patients allegedly died from overdoses during the investigation.

Pain Management Clinic Physicians Made Millions.

It’s reported that the pain management clinic hired ten (10) doctors to write illegal prescriptions and employed others to falsify documents. For their willingness to participate in the illegal activity, the physicians allegedly made millions of dollars.

According to the Orlando Sentinel, the bank accounts of the clinic managers were analyzed as part of the investigation. From 2011 to 2013, more than $5.5 million in cash was deposited into the bank accounts of the clinic managers and physicians.

To read the entire article from the Orlando Sentinel, click here.

Keep in mind, at this point, these are just allegations made against the clinic and its employees and nothing has been proven by the state or federal government.

Be Mindful of the Prescription Drug Monitoring Database.

DEA agents used Florida’s prescription drug monitoring database to find out what types of pills and how many pills physicians at the Longwood pain clinic were prescribing. The prescription database was not intended to be used for criminal prosecution or law enforcement purposes. Yet it is routinely being used to prosecute physicians, pharmacists and pharmacies among others.

If You are a Health Care Professional Involved with Pain Management, Keep These Tips Handy.

The raid on the Longwood clinic is just one of the many we’ve recently seen in Florida. DEA agents and local law enforcement officials are not slowing down in their fight against illegal pill mills, and illegal prescribing and dispensing practices. I have represented a number of physicians who have been accused of “overprescribing.” Some of these were criminal investigations by local law enforcement authorities, such as a county sheriff’s office. Some were investigations by the DEA. Some were investigations by the state licensing agency, such as the Florida Department of Health (DOH).

It is important physicians know how to protect themselves and their licenses from drug-seeking patients. Click here to read tips I give to physicians I advise on this issue.

Contact Health Law Attorneys Experienced with DEA Cases and Licensing Actions.

The Health Law Firm represents physicians, pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies.
If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think about all of these raids on pharmacies and pain clinics? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “Rx for Danger: Pain Clinic Owners Made Millions, Hired 10 Doctors to Write Illegal Scripts, Feds Say.” Orlando Sentinel. (June 24, 2013). From: http://www.orlandosentinel.com/health/os-professional-pain-care-longwood-20130624,0,1172890.story

Indest, George. “Drug Enforcement Administration Agents Raid Central Florida Pain Management Clinic.” The Health Law Fir. (June 17, 2013). From: http://thehealthlawfirmblog.wordpress.com/2013/06/17/drug-enforcement-administration-agents-raid-central-florida-pain-management-clinic/

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

More Than 20 Arrest Warrants Issued by Polk County Sheriff’s Office in Connection to Pill Mill Investigation

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Polk County Sheriff’s Office issued 25 arrest warrants in connection to an ongoing pill mill investigation involving a medical clinic in Winter Haven, Florida. On September 19, 2012, the sheriff’s office announced that ten suspects in the case have been arrested, and 15 suspects with arrest warrants remain at large.

Click here to see the press release from the Polk County Sheriff’s Office.
Authorities Used the Prescription Drug Monitoring Program to find Suspects.

Last year the state launched the Prescription Drug Monitoring Program, which requires doctors and pharmacists who dispense controlled substances to report the information to a statewide database.

According to the Polk County Sheriff’s Office, the database was used to round up those associated with the Winter Haven medical clinic.

In an article in the News Chief, deputies said 13 of the suspects were allegedly acting as “smurfs” (people hired by a drug ring to take fake prescriptions to be filled, then turning the pills over to the ring). Another 12 people were accused of “doctor shopping,” which is the practice of going to multiple doctors to get many prescriptions for narcotics.

To read the entire article from the News Chief, click here.

This case was investigated by the Polk County Sheriff’s Office, the Florida Department of Law Enforcement (FDLF), the Florida Department of Health (DOH) and the Attorney General’s (AG) Office.

“These people are giving the smurfs a bad name,” Papa Smurf stated. “We should be happy that law enforcement is doing a good job rounding up the read ‘bad guys,’”added Brainy Smurf.
Legal Tips for Physicians to Manage Pain Patients.

Doctors, pharmacists and all healthcare professionals who are involved in schemes relating to overprescribing or trafficking in narcotics may be targeted by many different agencies.

We have represented physicians who have been the subjects of Drug Enforcement Administration (DEA) investigations. The DEA will often use undercover agents and informants to pose as patients, wired for audio recording. The DEA will often work with local law enforcement authorities and the Department of Health (DOH).

Other investigations and arrests may be initiated by a statewide prosecutor’s office, which is under the Attorney General (AG). Still others have been initiated by the Medicaid Fraud Control Unit (MFCU) where Medicaid funds are used.

Click here to see an article on our website with tips for to help manage pain patients.

Give us your thoughts on this story below.

Contact Health Law Attorneys Experienced in Representing Health Care Providers in DOH Cases.

The Health Law Firm represents pharmacists, pharmacies, physicians, nurses, and other health care providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies.

If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Sources:

Parody, Clifford. “25 Warrants Issued in Ongoing Pill Mill Case.” News Chief. (September 20, 2012). From: http://www.newschief.com/article/20120920/NEWS/209205012

Pavuk, Amy. “25 Arrest Warrants Issued in Pill-Mill Probe.” Orlando Sentinel. (September 19, 2012). From: http://articles.orlandosentinel.com/2012-09-19/news/os-polk-pill-mill-arrests-20120919_1_pill-mill-probe-arrest-warrants-fraudulent-prescriptions

Eleazer, Carrie. “25 Arrest Warrants Issued in Connection to On-Going Pill Mill Investigation.” Polk County Sheriff’s Office. (September 19, 2012). From: http://www.polksheriff.org/NewsRoom/News%20Releases/Pages/09-19-2012.aspx
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.Copyright © 1996-2012 The Health Law Firm. All rights reserved.

By The Health Law Firm|2024-03-14T10:00:36-04:00June 1, 2018|Categories: Department of Health, In the Know, In the News, Pain Management, Pharmaceutical Drugs, The Health Law Firm Blog|Tags: controlled substances, doctor, Florida prescription drug abuse, Florida prescription drug crackdown, nurse, overprescribing, pain clinics, pain management, pharmacies, pharmacists, physician, pill mill, pill mill laws, prescription drug trafficking|3 Comments

Will Florida Board of Medicine Follow Board of Pharmacy’s Lead and Recommend PRN Evaluations for Applicants Before Application is Considered?

By Lance Leider, J.D., The Health Law Firm

At the February 12, 2014, Florida Board of Pharmacy meeting, some board members expressed frustration with the fact that applicants for licensure with prior mental health or substance abuse related issues had not been evaluated by the Professionals Resource Network (PRN) prior to the consideration of their applications by the Board. The applications were scheduled for consideration, but applicants were told to come back after they had PRN evaluations. This recommendation by the Board of Pharmacy could have potentially serious consequences for applicants.

So far, the Board of Pharmacy is the only Board we are aware of to make such a recommendation. We are waiting to see if the Board of Medicine or other professional boards follows suit.

No Statutory Requirement to Get Preemptive PRN Evaluation.

The Board of Pharmacy’s recommendation that any applicants with “positive health history responses” seek out a PRN evaluation prior to submitting the application is not a course of action we would recommend for nurses, doctors, pharmacists or any healthcare provider. There is no statutory requirement that an applicant with past or present drug or alcohol issues be evaluated by PRN prior to submitting an application to any professional board.

Issues with Submitting to Preemptive PRN Evaluation.

Submitting to a PRN evaluation places the applicant at the mercy of the organization and its appointed evaluator. If an applicant is deemed by PRN to require monitoring there is likely no way that a license of any kind will ever be issued without the blessing of PRN.

Typically PRN monitoring contracts last for five years. They require, among many other things: daily check-ins for drug and alcohol screens; frequent mental or substance abuse evaluations; weekly support meetings; possible restrictions on practice type and location; psychiatric following; total abstinence from all non-approved medications; total abstinence from alcohol; and notification of present and future employment.

In a word, PRN contracts are onerous.

Submitting to a PRN evaluation before your application is considered by the Board may serve to effectively waive your right to individual consideration of your application. If PRN says you need to be monitored, there is likely no way that the Board of Medicine will grant you a license that is not conditional on your participation in the program.

Your license will likely be listed as “Active/Obligations” instead of “Clear/Active.” This means that any member of the public, coworker, employer, insurer, etc., can look you up and see that you are under some kind of practice restriction. While the exact conditions of your obligation may not be publicly available, you can bet that questions will come.

The Alternative to a Preemptive PRN Evaluation.

Because no Board has the right to force you to have a PRN evaluation prior to considering your application, there are several things that you can do to avoid the program. The Board of Medicine is required to review every application on its own merits. This means that you can supplement your application with recommendations and evaluations from your own physicians.

The Board of Medicine often considers the recommendations of treating physicians and counselors as evidence that an applicant is safe to practice. What this means is that you can obtain your own evaluation outside of the PRN program. Such an evaluation would not have the potential of locking you into a monitoring contract before you have even applied.

A health care professional’s career rides entirely on his or her license to practice. It is not advisable that you face the Board of Medicine without at least consulting with a health law attorney.

Contact a Health Law Attorney Experienced in the Representation of Physicians and Other Health Care Providers Before the Board of Medicine.

The Health Law Firm and its attorneys are experienced in dealing with the Board of Medicine, PRN, and license applications. Our attorneys can help you get your application and supporting documentation together and present it to the Board in the most effective way possible.

Our firm has extensive experience in representing physicians, nurses, pharmacists and other professionals accused of drug abuse, alcohol impairment, mental impairment and sexual boundary issue, as well as in dealing with the Professionals Resource Network (PRN), its advantages and disadvantages, its contracts, its personnel, and its policies and procedures.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Comments?

What do you think about the recommendation made by the Board of Pharmacy to get a preemptive PRN evaluation? Do you think any other board will make the same recommendation? Please leave any thoughtful comments below.

About the Author: Lance O. Leider is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

By The Health Law Firm|2024-03-14T10:00:55-04:00June 1, 2018|Categories: Board of Medicine, IPN and PRN, The Health Law Firm Blog|Tags: board of medicine, Board of Medicine hearing, Board of Medicine license application, Board of Medicine representation, Board of Pharmacy, defense attorney, defense lawyer, health law firm, license, license application, license approval, mental health issues, nurse, nurse attorney, Nurse lawyer, preemptive PRN evaluation, prn, PRN contract, PRN evaluation, PRN evaluator, Professionals Resource Network, substance abuse issues, the health law firm|Comments Off

Orlando Pharmacist in Hot Water After Filling Fraudulent Prescriptions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Another pharmacist was led away in
handcuffs during a September 25, 2012, raid on an Orlando-area pharmacy, according to a number of sources. The pharmacist is accused of filling prescriptions for oxycodone, even though he allegedly knew the prescriptions were not legitimate.

Click here to see video of the arrest from WFTV in Orlando.

Ongoing Investigation Led to Pharmacy Raid.

In December 2011, narcotics agents searched the same pharmacy and found 22 prescriptions that were suspected to be fraudulent, according to the Orlando Sentinel.

Agents believed the prescriptions were fakes because they apparently matched phony prescriptions found at other local pharmacies. The prescriptions had the same patient names, and the telephone number listed on the prescription belonged to a suspected drug abuser, not a physician.

One customer who received pills from the pharmacist told the Orlando Sentinel that because she was using fake prescriptions, the pharmacist would mark up the price of the pills.

Pharmacists Beware of Phony Prescription Rings Around the State.

We have previously published several blogs about groups of criminals who have operated phony prescription rings in Central Florida. In a number of cases they have obtained professional counterfeit-proof paper and had prescription forms printed that are indistinguishable from the real thing.

Click here to see blog one. Click here to see smurf blog.

Given that there are mandatory minimum prison sentences for such activities, young people (those who are usually involved) should avoid these people like the plague. It is just not worth the risk for a few hundred dollars or a few pills. You screw up your life forever, and you spend years in prison.

How to Handle Legal Issues.

The pharmacist in this casewas arrested on 22 counts of trafficking in oxycodone, 22 counts of conspiracy to traffic in oxycodone, and one count of trafficking in hydrocodone. On top of those charges, the Department of Health (DOH) ordered an emergency suspension order on the pharmacist’s license.

To read the article from the Orlando Sentinel, click here.

To see our blog on possible remedies for an emergency suspension order, click here.

Spike in Pharmacy Raids and Shutdowns in the Sunshine State.

If you’ve been watching the news at all lately, you can tell there have been an increased number of raids on pharmacies, arrests of pharmacists and emergency suspension orders issued from the Department of Health (DOH).

Just in the past month the Drug Enforcement Agency (DEA) served a Walgreens distribution center in Florida with an immediate suspension order (click here to read more on this story), and pulled the controlled substance licenses from two Central Florida CVS Pharmacies (to learn more, click here).

In my personal opinion, if the large retail giants can’t survive, the small independent pharmacies stand little chance.

Do you agree? What do you think of the war on prescription drugs in Florida? Leave your comments on this story below.

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEA investigations, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Pavuk, Amy. “Agents Raid Orlando-Area Pharmacy, Arrest Pharmacist.” Orlando Sentinel. (September 25, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-pharmacist-arrested-orlando-20120925,0,6879000.story

WFTV. “Pharmacist Arrested on Charges of Trafficking Oxycodone.” WFTV.com. (September 25, 2012). From: ttp://www.wftv.com/news/news/local/pharmacist-arrested-charges-trafficking-oxycodone/nSLgg/

By The Health Law Firm|2024-03-14T10:00:37-04:00June 1, 2018|Categories: In the Know, Licensing issues, Pharmaceutical Drugs, Pharmacy, The Health Law Firm Blog|Tags: controlled substances, DEA investigation, Department of Health (DOH), doctor, DOH investigation, Drug Enforcement Agency (DEA), emergency suspension order, Florida prescription drug abuse, Florida prescription drug crackdown, nurse, overprescribing, pain clinics, pain management, pharmacies, pharmacist, pharmacist license, physician, pill mill, pill mill laws, prescription drug trafficking|Comments Off

Nurses Need to Monitor Their Personal Nursys Profiles

By Carole C. Schriefer, R.N., J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Nurses, did you know that the status of your license and disciplinary actions taken against you are constantly being tracked by employers? It is actually relatively easy with the National Council of State Boards of Nursing (NCSBN) database, called Nursys. What’s even scarier is employers can sign up for an e-Notify option. This is an e-mail notification system that delivers real-time updates to employers about nurses. The Nursys’ e-Notify option is frequently used by hospitals and medical groups to regulate and screen employees. Click here to read a previous blog on Nursys.

It is imperative, as a nurse, you regulate your own profile regularly for discrepancies. You can do so by clicking here for the Nursys website.

Be Familiar with Nursys and the e-Notify Option.

Nursys is the only national database for license verification, discipline and practice privileges for registered nurses (RNs), licensed practical nurses (LPNs), practical nurses (PNs), certified nurse midwives (CNMs), certified nurse practitioners (CNPs), clinical nurse specialists (CNSs) and certified registered nurse anesthetists (CRNAs). The data on Nursys comes directly from the Florida Board of Nursing and forty-six (46) other state nursing boards. The e-Notify option provides automatic email notifications of licensure status changes and discipline action changes to employers directly. Any institution that employs a nurse can track or check licensure and discipline information at any time.

Employers using Nursys have the ability to view and manage their institution’s nurse employees, including uploading nurse profiles, searching nurses by name, editing nurse information and viewing individual nurse reports.

Nursys Makes it Easy for Employers to Keep Tabs on Nurses.

According to the website, a nurse’s profile on Nursys contains:

– the nurse’s name,
– licensed jurisdiction,
– license type
– license number,
– compact status (single state or multistate),
– license original issue date,
– license expiration date,
– discipline against license, and
– discipline against privilege to practice.

e-Notify will alert subscribers when then following changes are made to a nurse’s record:

– license status,
– license expirations, and
– publicly available disciplinary and alert action and resolution.

Flaws in the Nursys Program.

If you have recently received discipline from the Florida Board of Nursing, or any other state board of nursing, it would be prudent to immediately check this website to verify that any information listed under your profile is accurate. The website clearly states that it is the nurse’s responsibility to contact the board of nursing to update his or her information.

Our law firm has encountered errors on this database that our client contended caused him to lose employment opportunities. Be responsible for verifying the information on your personal profile.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Did you know about Nursys? What do you think of the database? Do you monitor your profile? Please leave any thoughtful comments below.

About the Authors: Carole C. Schriefer is a nurse-attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

By The Health Law Firm|2024-03-14T10:01:17-04:00May 15, 2018|Categories: Nursing Law Blog|Tags: board of nursing, certified nurse midwives (CNMs), certified nurse practitioners (CNPs), certified registered nurse anesthetists (CRNAs), clinical nurse specialists (CNSs), Florida Board of Nursing (BON), Florida nurse attorney, Florida nurse lawyer, licensed practical nurses (LPNs), National Council of State Boards of Nursing (NCSBN), nurse, nurse defense attorney, nurse defense lawyer, nurse discipline, nurse discipline data, nurse license, nurse license discipline, nurse license expiration, nurse license notification system, nurse license status, nurse license verification, Nursys, Nursys database, Nursys defense attorney, Nursys defense lawyer, practical nurses (PNs), practice privileges for nurses, registered nurses (RNs), the health law firm, what nurses need to know about Nursys|Comments Off

Nurses: Protect Yourself Against Medication Errors

Nurses face a busy schedule often including a long list of patients and extensive work hours. As a result, they can become overworked and overtired, which may lead to a higher risk of making a mistake when administering medication.

An Institute of Medicine (IOM) report titled To Err is Human: Building a Safer Health System (IOM, Dec. 1999) states the deaths from medication errors that take place both in and out of hospitals, more than 7,000 annually, exceed those from workplace injuries. In a separate report, investigation by the Chicago-Tribune states that since 1995, at least 1,720 hospital patients have died and 9,548 others have been injured because of mistakes made by RN’s across the country (Associated Press, Sept. 10, 2000).

Because nurses usually are the front-line health care providers who are required to administer medications prescribed by physicians, they must be especially careful in their procedures and practices to avoid one of the many types of common medication errors.

Common types of medication errors involve:

1. similar sounding medication name;

2. administration without a prescription;

3. the wrong medication;

4. the wrong dosage;

5. negligent injection;

6. failure to note an order change;

7. failure to administer medication;

8. failure to discontinue medication;

9. use of an unsterile needle;

10. the wrong patient;

11. allergic reactions; and

12. failure to assure patient taking medications.

Nurses are required to handle and administer a vast variety of drugs that are prescribed by physicians and dispensed by an organization’s pharmacy. Medications may range from aspirin to esoteric drugs that are administered through intravenous solutions. These medications must be administered in the prescribed manner and dose to prevent serious harm to patients. There are a variety of ways to ensure that, as a nurse, you are helping to prevent medication errors within your facility.

Use this checklist from George Indest’s Nursing Law Manual in order to maintain safe administration procedures. Nurses are exempted from the various pharmacy statutes when administering a medication on the oral or written order of a physician. However, the improper administration of medications can lead to malpractice suits.

ADMINISTRATION OF CONTROLLED MEDICATIONS WITHOUT A PRESCRIPTION

A nurse should never administer prescription medications without a valid prescription or order from a physician. In effect, doing that constitutes practicing medicine without a medical license and is beyond the scope of a nurse’s license. Administering medications without approval may give rise to legal liability and disciplinary action against the nurse.

ADMINISTERING THE WRONG MEDICATION

The injection of the wrong medication into a patient can lead to civil liability or to a charge of substandard nursing care made to the Department of Health. A nurse who prepares medication for a physician is liable for the preparation of that medication. A physician can blame a nurse who fails to prepare the medication properly in order to escape liability.

In the case of Ambercrombie v. Roof, a solution was prepared by a nurse employee and injected into the patient by a physician, 28 N.E. 2d 772 (Ohio 1940). The physician made no examination of the fluid, and the patient suffered permanent injuries as a result of the infection. An action was brought against the physician for malpractice. The patient claimed that the fluid injected into her was alcohol and that the physician should have recognized its distinctive odor. The court, in finding for the physician, stated that the physician was not responsible for the misuse of drugs prepared by the hospital, unless the ordinarily prudent use of his faculties would have prevented injury to the patient.

GIVING THE WRONG DOSAGE

A nurse is responsible for making an inquiry if there is uncertainty about the accuracy of a physician’s medication order in a patient’s record. A nurse who is in doubt about a physician’s orders should contact that physician and seek clarification of their order.

WRONG ROUTE

In Fleming v Baptist General Convention, 742 P.2d 1087 (Okla. 1987), a nurse negligently injected the patient with a solution of Talwin and Atarax subcutaneously, rather than intramuscularly. The patient suffered tissue necrosis as a result of the improper injection. The suit against the hospital was successful. On appeal, the court held that the jury’s verdict for the plaintiff found adequate support in the testimony of the plaintiff’s expert witness on the issues of nursing negligence and causation.

FAILURE TO NOTE AN ORDER CHANGE

A nurse’s failure to review a patient’s record before administering a medication, to ascertain whether an order has been modified, may render a nurse liable for negligence.

FAILURE TO ADMINISTER MEDICATION

In Kallenberg v. Beth Israel Hospital, 357 N.Y. S.2d 508 (N.Y. App. Div. 1974), a patient died after her third cerebral hemorrhage because of the failure of the physicians and staff to administer necessary medications. When the patient was admitted to the hospital, her physician determined that she should be given a ceratin drug to reduce her blood pressure and make her condition operable. For some unexplained reason, the drug was not administered. The patient’s blood pressure rose, and after a hemorrhage, she died.

The jury found the hospital and physicians negligent in failing to administer the drug and ruled that the negligence had caused the patient’s death. The appellate court found that the jury had sufficient evidence to decide that the negligent treatment had been the cause of the patient’s death.

FAILURE TO DISCONTINUE A MEDICATION

A health care organization will be held liable if a nurse continues to inject a solution into a patient after noticing its ill effects. Once something is observed to be wrong with the administration of the medication, the nurse has a duty to discontinue its use.

NONSTERILE NEEDLE

The blood donor in Brown v. Shannon West Texas Memorial Hospital, 222 S.W. 2d 248 (Tex. 1949), sought to recover from a serious injury allegedly caused by the use of a nonsterile needle. The court held that the burden of proof was on the plaintiff to show, by competent evidence, that the needle was contaminated when used and that it was the proximate cause of the alleged injury. The mere proof, said the court, that infection followed the use of the needle or that the infection possible could be attributed to the use of an unsterile needle was insufficient. If the plaintiff had been able to prove the needle was not sterile, then the plaintiff would have recovered damages.

WRONG PATIENT

It is of utmost importance to check each patient’s name bracelet before administering any medication. To ensure that the patient’s identity corresponds to the name on the patient’s bracelet, the nurse should address the patient by name when approaching the patient’s bedside to administer any medication. Especially in nursing homes and hospitals where there may be more than one patient in a room, this is exceptionally important. Should the nurse unwittingly administer one patient’s medication to a different patient, the attending physician should be notified and appropriate documentation placed on the patient’s chart.

ALLERGIC REACTIONS

Any adverse reactions to a medication should be charted on the patient’s medical record. The attending physician and the facility’s pharmacy should be advised as to the patient’s allergic reaction.

FAILURE TO MONITOR AND ENSURE PATIENT TAKING MEDICATIONS

A nurse normally has a duty to monitor and ensure that a patient is taking their medications. A failure to perform this act can lead to nursing negligence on the part of the nurse.

The nurse may be the last wall of defense to protect a patient from a medication error. Guard at every turn against medication errors. For more information about nursing law, or to read more from the Nursing Law Manual, visit www.TheHealthLawFirm.com.

By The Health Law Firm|2024-03-14T10:01:54-04:00May 15, 2018|Categories: Medication, Patient Care, Prescription|Tags: giving wrong dose, medication, medication errors, nurse, nurses, patient care|Comments Off

Nurses: Beware of Nationwide Telephone Prescription Drug Scam

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Drug Enforcement Administration (DEA) is warning nurses to be aware of a prescription drug scam. This telephone scheme is extorting money from people all over the country. On November 28, 2012, the DEA released a press release explaining the details of the scam.

Criminals Ask Victims for Cash Over the Phone.

The scam starts with criminals posing as DEA agents calling victims by telephone. Frequently the victims will have recently purchased prescription drugs over the internet or by phone. The imposters tell the victims that purchasing the drugs in that manner is illegal, and that they must pay a fine. If the victims refuse to send money, the phony DEA agents threaten to arrest the victims or search their property. Some of the victims have also reported unauthorized use of their credit cards after purchasing the prescription drugs.

Click here to read more on this scam from a DEA press release.

The DEA wants to remind nurses that no DEA agent will ever contact you by telephone. They might show up at your house early in the morning or while you are eating dinner, however. Also, agents never request money or any other form of payment.

Nurses You Need to Know the Rules for Purchasing Drugs Electronically or By Phone.

Many times it may be illegal to purchase controlled drugs by phone or over the internet. That’s why you should go to Canada to do it. There are direct flights from Orlando. However, some pharmacies that meet stringent requirements and are registered by the DEA are allowed to sell drugs over the internet or by phone. So don’t be fooled by this telephone scam.

How Do Scammers Get Your Information?

The scammers are counting on the fact that if you have done this, you, as a nurse, will get scared and believe their accusations. Many people have no idea whether such conduct is legal or illegal. These imposters are banking on your ignorance and fear of losing your license to practice. They are also banking on the fact you won’t report this to the real police.

Where do they get this information? Chances are, they are just “cold-calling” people. There are bound to be a certain number of people they reach who have done this. However, if they seem to have your personal information (or credit card number) report this to the police right away. Be sure to obtain a written police report. Also, you should file a HIPAA Privacy Complaint with the Office of Civil Rights (OCR) to begin an investigation if you believe your personal information has been stolen by or given to someone else to use.

Why Pain Patients Turn to Alternative Means to Obtain Drugs.

It is no surprise that the DEA, along with other law enforcement agencies, has stepped up its efforts to cut down on overprescribing. To see examples of what I am talking about read my past blogs: Walgreens fights the Drug Enforcement Administration’s (DEA) immediate suspension order and Drug Enforcement Administration (DEA) pulls controlled substance licenses from two Sanford, Florida, CVS pharmacies.

If the largest, legitimate pharmacy chains in the state and nation are not allowed to fill these prescriptions, where will chronic-pain patients turn? Are these actions driving our citizens into the hands of shady pharmacies that have fewer safeguards and less accountability, such as online pharmacies? Are these actions driving our citizens to seek out illegal drug dealers and turn to illegal drugs to cope with their legitimate medical problems? That is just one opinion. Tell us yours below.

Contact Health Law Attorneys Experienced with Investigations of Nurses.

The attorneys of The Health Law Firm provide legal representation to nurses and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

As a nurse, have you been contacted by these phony DEA agents? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “DEA Warns of Prescription-Drug Scam.” Orlando Sentinel. (November 29,2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-dea-warns-scam-internet-20121128,0,5800536.story

Drug Enforcement Administration. “DEA Scam Alert – Extortion Scheme.” DEA. (November 28, 2012). From: http://www.justice.gov/dea/divisions/mia/2012/mia112812a.shtml

Think You Have Professional Liability Insurance Through Your Employer? Think Again, Nurse!

By Joanne Kenna, R.N., J.D., The Health Law Firm

Not a week goes by without a call coming into the firm from a nurse whose license is under investigation for some reason or another. The nurse is generally dumbfounded that this has happened. “But I’m a good nurse. I never thought this could happen to me,” is the sad refrain.

Very often the nurse is correct. He/she is a clinically good nurse. Often there has never been any prior problem or any question of this. But all it takes is one instance, just one violation that gets reported to the Department of Health (DOH), and the nurse is suddenly in the position of having his/her license investigated. The nurse then has to defend his/her actions to protect the integrity of his/her license, and possibly even his/her ability to continue practicing, against the allegations of the violation.

Employer’s Insurance Coverage Protects the Employer, Not You.

Normally when a licensure investigation is initiated, the nurse is upset and angry, and is determined to do whatever is necessary to protect his/her license. At this point the intelligent nurse will usually start making telephone call(s) to seek legal advice and counsel. Then comes the harsh reality. Obtaining good legal services is expensive. It can be very expensive. Inevitably the question is put to the nurse as to whether he/she has insurance. All too often the nurse responds that his/her insurance is (or more often at this point, was) through his/her employer.

Then more reality hits. Often the nurse has already been terminated from employment by this point. So, no insurance. Even if the nurse is still employed, the nurse quickly finds out that the coverage he/she believed existed, and often was led by the employer to believe existed, is not really a policy for the nurse at all. The nurse is “covered” under the hospital’s (you can substitute nursing home, clinic, etc., as applicable here) policy really only to protect the hospital’s interests. Therefore, this “coverage” extends only to those situations and occurrences where the hospital might have liability. (And even in that case the nurse should be wary because it is really the hospital’s interests that are being protected by the policy. Where the nurse’s interests happen to be aligned with the hospital’s, all is good. But where they are not, well, the hospital has coverage and its interests will be protected; as for the nurse, he/she is on his/her own).

What you should know is that the hospital’s insurance coverage is there to protect the hospital – – period.

Protect Your Nursing License with a Personal Professional Liability Insurance Policy.

You should also recognize that no nurse is immune from a professional liability claim. No matter how conscientious and clinically competent the nurse may be, the potential for a professional licensure action always exists. Day after day nurses forego legal representation when they are under licensure investigation because legal representation is unaffordable for them. While some nurses get lucky and will have a good outcome in spite of this, many others will not. The very idea of gambling with your nursing license that took so much effort to earn and is the key to your future earning capacity, is not only risky, it is downright foolish.

The truth of the matter is that all nurses should protect themselves by obtaining a personal professional liability insurance policy. A good policy will provide medical malpractice and, very importantly, licensure protection coverage. The cost on these policies varies, but it is generally quite affordable, often costing little more that $10 – $15 a month.

Licensure protection coverage provides the nurse with the ability to obtain competent legal representation from an attorney or a law firm that is familiar with handling licensure investigations and the disciplinary actions that can ensue from them. Good policies will provide $10,000 – $25,000, and even more for legal expense. Having this money available at the time it is needed allows the nurse to focus on his/her defense and provides the nurse the opportunity to pursue this defense all the way through the administrative process. All too often the alternative is having the limited available funds dictate the nurse’s acceptance of an undesired resolution to the matter.

Be Smart, Get Professional Insurance Before it is Too Late.

So, if your independently wealthy, you can continue practicing without much concern about how you will be able to afford legal services for licensure defense if and when that becomes necessary. If though you are not, and your answer to the question of whether you have insurance would be that you do through your employer, now is the time to start thinking about changing that. Tomorrow just might be too late.

Contact Health Law Attorneys Experienced in Representing Nurses.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do you have personal professional liability coverage? Are you thinking about getting it now? Please leave any thoughtful comments below.

About the Author: Joanne Kenna is a nurse-attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

By The Health Law Firm|2024-03-14T10:01:17-04:00May 15, 2018|Categories: Nursing Law Blog|Tags: am I covered by my employer’s insurance, counsel for nurses, CPH and Associates, Department of Health (DOH), employer insurance coverage, good nurse, Healthcare Providers Service Organization (HPSO), hospital’s insurance, legal advice for nurses, license investigation, licensure defense, licensure investigation, licensure protection coverage, Lloyd’s of London, medical malpractice insurance, nurse, nurse attorney, nurse insurance, nurse insurance coverage, nurse investigation, Nurse lawyer, nurse license investigation, nurse professional liability insurance, Nurse Service Organization (NSO), nurses, nursing license, practicing nurse, professional liability claim, professional liability insurance, terminated nurse, the health law firm|1 Comment

The “Seven Rights” of Patient Medication

There is a checklist every nurse should learn called the “Seven Rights of Medication.” If this checklist is memorized and followed in every case, medication errors would be significantly reduced or eliminated altogether. Every nurse and nursing student should memorize this list and go through it in her mind every time a patient is administered a medication by the nurse. Always check for and confirm:

1. The right medication;

2. The right patient;

3. The right dose;

4. The right time;

5. The right route;

6. The right reason; and

7. The right documentation.

Adminstering medication is one of the major areas that an overworked nurse is at risk for making a mistake. Be sure to remember the items on this checklist, especially if you are feeling rushed. Taking an extra second to think everything through can save you from discplinary or legal action down the road.

For more information about nursing law, please visit our website at www.TheHealthLawFirm.com.

By The Health Law Firm|2024-03-14T10:01:54-04:00May 15, 2018|Categories: Medication, Patient Care, Prescription|Tags: medication, medication dosage, nurse, nurses, nursing, patient care, wrong patient|Comments Off

Nurses: Locate a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida Company Cases

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the Florida Department of Health (DOH) they had difficulty finding an experienced attorney in Florida who would accept their professional liability insurance. In this case, I am speaking specifically about Healthcare Providers Service Organization (HPSO) Insurance.

Benefits of HPSO Insurance.

The professionals who are covered by HPSO Insurance have excellent insurance coverage. HPSO Insurance provides professional liability coverage that protects in the event of a lawsuit or negligence claim. But much more often the professional receives a notice of an investigation, a subpoena for a deposition in someone else’s case, a demand because of an allegation of sexual harassment or sexual impropriety, a complaint because of a breach of medical records confidentiality or Health Insurance Portability and Accountability Act (HIPAA) Privacy complaint, or some other administrative type of action.

HPSO provides great coverage for these. For example, HPSO currently reimburses up to $10,000 in legal fees and expenses just for representation of you at depositions. HPSO currently reimburses up to $25,000 in legal fees and expenses for your defense in a DOH or Agency for Health Care Administration (AHCA) notice of investigation or complaint. HPSO currently reimburses up to $25,000 in legal fees and expenses for your legal representation in defense of a complaint or investigation regarding breach of medical confidentiality.

If you are a pharmacist, own a pharmacy, are a massage therapist, own an assisted living facility (ALF), are a mental health counselor or a social worker, or you are one of the many other types of health care professionals who HPSO insures, it should be fairly easy to find experienced health lawyers to represent you, especially in Florida.

Our firm and our attorneys, including George F. Indest III, Michael L. Smith, Joanne Kenna, Carole C. Schriefer, Lance O. Leider, Christopher E. Brown and Danielle M. Murray, routinely represent licensed health care professionals, interns and students in all types of administrative investigations and hearings and in defending lawsuits and other actions that have been filed. We also represent health facilities in license defense, survey complaints and administrative hearings. We represent them throughout Florida, from Pensacola, to Jacksonville, to Key West. We also occasionally represent them in other states, as well. We accept HPSO Insurance assignments.

Free Legal Advice: Get Insurance Immediately.

It is very important for every health professional to carry insurance that covers any investigation, complaint or administrative hearing that might be filed or opened against your license. You may think that you are covered for this by your employer, but you are not. If your employer contradicts this, ask for a statement in writing that your employer will pay for your legal defense for any such matter arising during your employment.

What typically happens, especially in the case of a hospital employee, nursing home employee, pharmacy employee or corporate employee, is that the employer is the one who terminates the employee and then files a complaint with the DOH. The DOH then opens an investigation against the health professional. The employer is not going to pay your legal defense costs if the employer has reported you.

You may very well be out of work, out of money and face an investigation and complaint that could terminate your professional license and career. You should not take this chance. Insurance such as HPSO Insurance is inexpensive and reliable. Buy it while you can afford it. After the actions have occurred, it is too late.

Find an Experience Health Law Attorney in the Event of an Investigation.

Also, you should immediately contact an experienced health law attorney if you are telephoned or visited by any investigator, or if you receive a letter advising you that an investigation has been opened regarding your care. Call immediately for advice before you speak with an investigator or provide any documents or statements of any kind.

You cannot and should not seek “legal advice” on what to do from the investigator, from a DOH employee, from your professional board or from any attorney representing any of them. They are not your friends. They are on the side against you. You should definitely not take any advice from them.

Do Not Skimp on Insurance Coverage.

If you have good insurance, it will pay for your legal expenses from the very beginning, so use it. However, beware of cheap insurance policies from professional associations that do not provide any coverage for disciplinary complaints and licensure investigations. Always check to be sure this is covered. Get it in writing. With some companies you have to pay an extra premium to obtain this coverage. With some insurers, they do not offer it, and you have to purchase a completely separate policy covering just this. It is worth it! Do it!

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

Our firm regularly represents pharmacists, massage therapists, mental health counselors, registered nurses, assisted living facilities, home health agencies, nurse practitioners, lab technicians, occupational therapists, physical therapists, social workers, physician assistants, psychologists and other health professionals in many different legal matters.

Services we provide include representation before your professional board, in DOH investigations, in administrative hearings, in civil litigation, in defense of malpractice claims, in professional licensing matters, in defense of allegations concerning HIPAA privacy violations and medical record breaches, in Drug Enforcement Administration (DEA) actions, and in many other matters.

We routinely represent physicians, dentists, nurse practitioners, and others in defending against malpractice claims, civil lawsuits, administrative complaints, peer review actions, DOH investigations, Medicare audits, Medicaid audits, and other matters. In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do you have professional liability insurance? Why or why not. Please leave any thoughtful comments below.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

By The Health Law Firm|2024-03-14T10:01:57-04:00May 15, 2018|Categories: Administrative Complaints, Administrative Hearing, ALFs, ARNP, CRNA, Defense, Insurance, Nurse Aide|Tags: administrative attorney, administrative complaint, administrative hearings, administrative lawyer, advanced registered nurse practitioners (ARNPs), Agency for Health Care Administration (AHCA) investigation, AHCA complaint, assisted living facility (ALF), defense attorney, defense lawyer, doctors, DOH investigation, experienced health attorney Florida, experienced health lawyer Florida, Florida defense attorney, Florida defense lawyer, Florida Department of Health (DOH), Florida license defense, health facilities, health professionals, Healthcare Providers Service Organization (HPSO) Insurance, licensed mental health counselors (LMHCs), massage therapists, nurse, nurses, physical therapists, professional liability insurance, psychologists, registered nurse, social worker|Comments Off