Published Aug 18, 2001
K.C. pharmacist surrenders, accused of diluting two drugs
Robert R. Courtney, 48, is charged with weakening cancer medicines. The FBI is looking for victims.
By Josh Freed
KANSAS CITY, Mo. - A wealthy pharmacist accused of diluting chemotherapy drugs surrendered to the FBI yesterday as investigators studied his records to find patients who may have been given weakened treatments for cancer.
Authorities said some intravenous drug bags contained less than 1 percent of the dosages ordered by doctors.
Robert R. Courtney, 48, is accused of diluting prescriptions for Taxol and Gemzar filled at his Research Medical Tower Pharmacy in Kansas City.
He was charged Tuesday with a single felony count of misbranding and adulteration of a drug and was ordered held without bond by a judge who called him a flight risk. The court order also said Courtney was worth more than $10 million in stock and property.
If convicted, he faces up to three years in prison and a $250,000 fine. He did not speak during the hearing, but defense lawyer Jean Paul Bradshaw - a former U.S. attorney in Missouri - said he expected his client would plead not guilty.
There was no immediate indication whether any patients had been harmed. An FBI hotline set up to find potential victims had recorded more than 100 calls by early yesterday.
"What we're looking at is possibly hundreds of patients. It's going to be a very long investigation," FBI spokeswoman Bridget Patton said.
Authorities declined to discuss a motive, but they have repeatedly pointed to the hundreds of dollars in savings per dose produced by the alleged dilution of expensive cancer drugs. In one alleged case, dilution would have saved the pharmacy about $780 for an order of drugs.
Taxol is a second-line therapy for advanced ovarian or breast cancer and is used against AIDS-related Kaposi's sarcoma and lung cancer. Gemzar is used to treat pancreatic cancer and some types of lung cancer.
According to the U.S. Attorney's Office, the dilution was discovered by a sales representative for Eli Lilly & Co., which makes Gemzar.
The representative noticed a discrepancy between the amount of Gemzar the pharmacy ordered and the amount it had billed an unidentified Kansas City-area doctor.
The doctor consulted with Eli Lilly and then sent a sample of some of the drugs to an independent laboratory, which reported back in June that the sample contained less than one-third as much Taxol as prescribed.
Last month, the doctor gave the FBI and Food and Drug Administration additional samples, which turned out to contain only 17 percent to 39 percent of the amount of Gemzar that had been prescribed.
Tests on later samples showed Taxol at 28 percent of the prescribed strength, the U.S. Attorney's Office said.
Federal agents seized records from Courtney's Kansas City pharmacy Monday. He also owns a pharmacy at the Shawnee Mission Medical Center in Merriam, Kan., but the FBI did not say if it was under scrutiny.
Susan Winckler, a pharmacist and an attorney at the American Pharmaceutical Association, said such cases were rare.
Everyone here is absolutely disgusted by this individual. We are all wondering now what affect he had on cancer sufferers and are asking 'how long has this been happening???'.
It's absolutely HORRIBLE. This person is a monster. A possible 3 year jail sentence is rediculous and a slap in the face to his victims. I hope he doesn't have a red cent left when the patients and their families are through with him!!!!
GREED, is a nasty individual........
I hope all the suffers/families sue his pants off.
I would suggest that it be assumed, just as it is when drug dealers assets' are considered, that all of his income and property were derived from illegal activity, and therfore should be siezed by court order.
I think it should be donated then, to local hospices for cancer patients.
Althugh it may be appropiate for him to end up in prison as the wife of the guy with the most cigaretts:p , I think he should instead be required to assist the nurses in the care of the patients that had given him thier trust, and see what true suffering is all about.
Hi. I saw this on the news last night. I've only got two words to describe the behavior of this pharmacist. Greedy and callous. My prayers are with the patients and families who received the diluted drugs.
I once saw a prosecuter on TV talking about bringing criminal charges against two nurses who had made an honest to goodness medication error that resulted in a death. Maybe these cops and judges should save the criminal prosecutions for individuals that commit crimes like this and let the accidental deaths be handled by the tort laws and state boards.
Profits before Patients......once again.
The first thing I thought of when I heard about this was how hospitals give NM bonuses for coming in under the budget. And the HMOs give MDs bonuses for NOT making referrals or sending their pts for expensive tests & treatments which they may need.
I wondered what incentive this guy's employer was giving him to cut expenses too.
He should be tried for murder.
The plot thickens....
Report: Lilly Worker Suspected Drugs
Story Filed: Sunday, August 26, 2001 10:11 PM EDT
KANSAS CITY, Mo. (AP) -- An Eli Lilly and Co. drug salesman had become suspicious and notified his company about cancer drugs handled by a Kansas City pharmacist but they did not contact authorities, The Kansas City Star reported Sunday.
Pharmacist Robert R. Courtney was indicted Thursday on federal charges alleging he diluted expensive cancer drugs so he could pocket the difference in prices.
Lilly salesman Darryl Ashley became suspicious in early 2000, but the newspaper said it wasn't clear when Ashley notified his superiors. Eli Lilly would not provide a date when contacted by The Associated Press.
A spokeswoman for the Indianapolis-based drug maker confirmed that the company did not tell authorities. Judy Moore said the company's own investigation determined that problems with the cancer drug Gemzar did not originate at Lilly's plant.
Moore said Lilly ``acted honorably'' and is cooperating with the FBI's investigation. ``Lilly takes patient safety very, very seriously.''
In May 2001, Ashley talked with Kansas City oncologist Dr. Verda Hunter and that led Hunter to alert federal officials, court records and company officials say.
Federal authorities say at least one patient who received drugs from Courtney has died.
But Michael Ketchmark, an attorney for relatives of Courtney's patients, said he will file nine lawsuits in state court Monday claiming the Indianapolis-based drug maker should have notified authorities and stopped selling Gemzar to Courtney.
In four lawsuits the family members allege that Lilly's silence contributed to a relative's death. In the other five cases the patients are still alive.
All nine lawsuits, which seek unspecified emotional and punitive damages, will also list Courtney and his Kansas City pharmacy as defendants, Ketchmark said.
Courtney, 48, is charged with eight counts of tampering with consumer products, six counts of adulteration of a drug and six counts of misbranding a drug.
Authorities say he saved hundreds of dollars per dose, and was motivated by profit and $600,000 in looming tax bills.
This past May, Ashley told Hunter that he had noticed a discrepancy between the amount of Gemzar that Courtney ordered and the amount he was billing Hunter.
Hunter then ordered tests on medications supplied by Courtney, found the drugs had been diluted and notified federal officials. The FBI's investigation started July 27.
``Eli Lilly knew by its own salesman's admission to the FBI that in early 2000 Robert Courtney was diluting cancer drugs,'' Ketchmark said Sunday.
Court records say Hunter tried to get Lilly to test her samples, but the company didn't respond. Lilly spokesman Jeff Newton said the company had no record of a letter Hunter sent.
Ketchmark said his clients want Lilly to disclose what the company knew and when they knew it.
``What they haven't talked about is the 18-month time period between their salesman's concerns and the investigation,'' he said. ``In that time period, people are receiving diluted drugs.''
Courtney's attorney Jean Paul Bradshaw said Ketchmark was just looking for publicity.
``There's no allegation in the criminal case that anything he did caused a death of any sort,'' Bradshaw said Sunday. ``We haven't pulled out and looked at all the individual medical records, but I do not believe from what I know about the case that there will be any credible cause for a wrongful death.''
The FBI says samples of drugs prepared by Courtney's Research Medical Tower Pharmacy contained generally less than half of the medication prescribed.
Prosecutors have said they have evidence of at least 150 instances of dilution, which could have affected hundreds of patients.
But Bradshaw has said Courtney's dilutions affected only about 30 to 35 patients and that he will plead innocent to the federal charges. Courtney is being held without bond.
Copyright © 2001 Associated Press Information Services, all rights reserved.
This is incredibly sad and I feel for the whistle blower in this case who wasn't afraid to keep on following up on his concerns.
It isn't often that you see medical "care" issues become criminal matters (instead of a civil matter) but this certainly is one time it seems justified.
One more posting for those that are interested in following this story:
Diluted-Drug Case Hinged on Luck
Story Filed: Friday, August 24, 2001 2:52 PM EDT
KANSAS CITY, Mo. (AP) -- Robert R. Courtney, the pharmacist accused of diluting chemotherapy drugs, was caught not by a government inspector, but by a drug salesman who noticed Courtney was billing doctors for more medication than he was buying, investigators say.
Industry experts say regulatory agencies are so understaffed that catching crooked pharmacists can be a matter of luck.
And drug companies cannot be expected to watch every druggist, said Jeffrey Newton, a spokesman for Eli Lilly, maker of the chemotherapy medicine Gemzar.
Prosecutors say Courtney, 48, made thousands of dollars by diluting Gemzar and Taxol with saline, denying potentially lifesaving medicine to perhaps hundreds of cancer patients. Unlike most other pharmacists, Courtney mixed the intravenous bags of medicine that he sold to doctors.
So far, Courtney is charged with 20 counts of altering medication. Investigators are still looking into whether the scheme contributed to the deaths of any patients. Courney has been hit with at least one lawsuit so far over a woman's death from ovarian cancer.
His lawyer said he will plead innocent.
``If you don't have people occasionally looking over your shoulder, you don't have the incentive to do what you should do,'' said Dr. Michael R. Cohen, a pharmacist and president of the Institute for Safe Medication Practices.
He said more and more pharmacies are mixing IV medications like the ones Courtney is alleged to have tampered with. And he said state pharmacy regulators generally are not trained to monitor those mixtures.
Missouri's pharmacy board has six inspectors who make unannounced visits at pharmacies. But they are responsible for nearly 6,800 pharmacists at 1,550 pharmacies.
The Food and Drug Administration has an enforcement arm, too. But it has just 150 agents nationwide, and they are responsible for regulating drugs, not pharmacies. The 11 agents in Kansas City cover 11 states.
Members of the FDA's Kansas City Office of Criminal Investigations helped run the sting that led to the charges against Courtney. But they got involved only after a drug salesman became suspicious.
Investigators said Eli Lilly salesman Darryl Ashley noticed Courtney wasn't buying as much Gemzar as he was billing to Dr. Verda Hunter, one of several cancer doctors Courtney supplied with IV bags of medication. Hunter alone bought $100,000 per month worth of drugs from Courtney.
The drug salesman contacted Hunter with his suspicions.
Hunter then found an IV bag from Courtney's pharmacy that contained Taxol and had it tested. The bag contained less than one-third as much Taxol as she had prescribed. She notified the FDA, which eventually brought in the FBI.
Hunter worked with investigators to order more chemotherapy treatments from Courtney, which were tested and are now being used in the case against the pharmacist.
While the FDA officers have seen cases where addicted medical workers stole drugs to feed a habit, they could hardly believe what they found in this case, said Larry Sperl, head of the FDA Kansas City criminal-investigation office.
``I think we knew, as soon as this thing really started coming together, that this was a whole different animal than what we've been seeing in these other cases,'' he said.
Cases of pharmacists adulterating drugs are considered rare.
In California, two lawsuits filed earlier this month accuse AIDS doctor George S. Kooshian of Newport Beach of administering saline instead of expensive AIDS medications.
Kooshian has not been charged with any crimes, and he denied the accusation to the Orange County Register. But he also told the paper that he gave his patients solutions of multivitamins when he couldn't procure the AIDS drugs. The state medical board is looking into the matter.
In Grand Rapids, Mich., in 1995, a pediatrician resigned his practice after admitting he gave 649 children bogus vaccinations for polio and measles, mumps and rubella. In that case, a nurse noticed that Dr. James Ledrick's drug supply wasn't depleted enough for the number of vaccinations he was supposedly giving. Ledrick's medical license was suspended for six months.
In 1997, a morphine-addicted doctor in Minnesota was convicted of tampering in 1997 for stealing the drug from patients' IV bags -- while relatives were in the room -- to feed his habit.
Cohen, from the Institute for Safe Medication Practices, said a buddy system for doctors or pharmacists who mix drugs might help prevent mistakes and thievery. If two people supervised each mixture, it would be difficult for either to hold back on the drugs, he said.
Courtney employed two other pharmacists at his pharmacy but told investigators no one else was involved with the drugs he diluted, authorities said.
David Witmer, director of professional practice and scientific affairs at the American Society of Health-System Pharmacists, said he hopes the case does not provoke a rush for more regulation.
``If this were much more prevalent, we would have heard more about it than we have,'' he said.
But Larry D. Sasich, a pharmacist with Public Citizen Health Research Group, said the high cost of drugs might be increasing the temptations for doctors and pharmacists.
``It has only been recently where we've started to think about the fact that some drugs are more expensive than gold, and that there is probably a perverse financial incentive'' to cheat, he said.
This is such a horrible story; a medical professional clearly motivated by greed; this looks to me like a case of premeditated murder if people died while being "treated" by this guy's watered down chemotherapy. As a chemotherapy nurse I am horrifed and offended, he has undermined the trust we need between medical professionals; There must be some method to oversee these procedures; our chemo is mixed in our hospital pharmacy and always has two signatures on the bag and we have two nurses double check and cosign both the Doctor's order and the chemo record. This is just too awful for words. The guy should be put away permanently. What is this country coming to when runaway greed has taken over the most trusted professionals. I am so upset about this. Now, I wonder when giving chemo exactly what is it in that bag?? Are we helping or harming? I am so disgusted and dismayed.
Create well-written care plans that meets your patient's health goals.
This study guide will help you focus your time on what's most important.
Choosing a specialty can be a daunting task and we made it easier.
By using the site, you agree with our Policies. X