Settlement Reached with Temple University Health System

Posted on December 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Diversion of Controlled Substances

By Anonymous

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NOV 01, 2010 — PHILADELPHIA – The Temple University Health System (“TUHS”), today, agreed to pay $130,000 to the U.S. government for failing to keep proper receiving, dispensing and inventory records of controlled substances, and failing to take effective precautions to prevent theft or loss of controlled substances, announced United States Attorney Zane David Memeger. In addition, TUHS agreed to implement a detailed Compliance Assessment Plan to review and monitor its policies and procedures relating to controlled substances.

“Hospitals must have effective controls to prevent and detect drug diversion, in order to
prevent people from suffering significant physical harm, addiction or death when they use controlled substances without appropriate supervision from their doctor”, Memeger said.

Back to 2004

In 2004, Temple University Hospital’s lack of control over controlled substances allowed its then chief resident of anesthesiology to steal 107 vials of Ketamine and smaller amounts of Fentanyl, Midazolam and Morphine. The resident doctor, who attempted to sell the drugs to an undercover Drug Enforcement Administration (DEA) operative was charged and convicted. In addition, from January 2007 to February 2007, an anesthesiologist at Jeanes Hospital, a Temple University Health Systems facility, manipulated the computerized controlled substance distribution system to extract 35 vials of Fentanyl and five vials of Morphine for his own personal use. DEA Special Agent in Charge John J. Bryfonski stated:

“The public expects our health professionals to honor their oath and follow both regulations and the law to assure the health and safety of the people they treat. When these professionals depart from their oath and the law by diverting controlled substance-pharmaceuticals from legitimate medical uses to illegal uses, DEA will investigate and hold them accountable.”

The DEA Audits

Following these thefts, DEA audited five Temple University Health Systems facilities and found that the hospital failed to keep dispensing records for certain controlled substances; failed to note on the required DEA form the number of packages of controlled substances the pharmacy received and the date it received them; failed to verify the amount of controlled substances coming into the pharmacy on each invoice; and kept inaccurate inventory of certain controlled substances.

Stricter Future Controls

TUHS voluntarily initiated changes to their drug dispensing system, to provide stricter measures for accessing the medication and frequent counts of the facilities’ inventory. In addition to the monetary settlement, TUHS agreed to implement an innovative Compliance Assessment Plan whereby an independent consultant will survey the Temple facilities and recommend remedial changes as necessary. The agreement requires TUHS to report to DEA discrepancies revealed during these audits.

Assessment

This resolution is part of the Eastern District of Pennsylvania’s Special Focus team Health Care Fraud initiative. The case was investigated by DEA Philadelphia Division Diversion Group. The case was handled by Assistant United States Attorney Susan R. Becker, Auditor Allison Barnes and Healthcare Fraud Consultant Ray Uhlhorn.

Conclusion

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Is Medicine Still a Sovereign Profession? [A Voting Opinion Poll]

Posted on December 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Social Transformation of American Medicine

By Dr. David Edward Marcinko MBA CMP™

Historical Review, Book Excerpts and ME-P Survey for Modernity

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The Social Transformation of American Medicine [The rise of a sovereign profession and the making of a vast industry].

This classic book was written by Paul Starr in 1984. I first read it while in business school back in 1994-96. Here is an excerpt from pages 227 and 232. It is even more relevant for the healthcare industrial complex today.

Quoting Kenneth Arrow PhD

The structural features Arrow[*] discusses have a history. He writes that when the market fails, “society” will make adjustments. […] But, modern day economists like Austin Frakt PhD and others, have to ask: For whom did the market fail, and how did “society” make these adjustments?

Of Failed Markets

The competitive market was failing no one more than the medical profession, and it was the profession that organized to change it. […]. By the 1920s, the medical profession had successfully resolved the most difficult problems confronting it as late as 1900. It had […] won stronger licensing laws; turned hospitals, drug manufacturers and public health from threats to its position into bulwarks of support; and checked the entry into health services of corporations and mutual societies. It has succeeded in controlling the development of technology, organizational forms, and the division of labor. In short, it had helped shape the medical system so that its structure supported professional sovereignty instead of undermining it.

Master over Diseases

Over the next few decades, the advent of antibiotics and other advances gave physicians increased mastery of disease and confirmed confidence in their judgment and skill. The chief threat to the sovereignty of the profession was the result of this success. So valuable did medical care appear that to withhold it seemed deeply unjust. Yet as the felt need for medical care rose, so did its cost, beyond what many families could afford. Some agency to spread the cost was unavoidable. It would have to be a third party, and yet this was exactly what physicians feared. The struggle of the profession to maintain its autonomy then became a campaign of resistance not only to programs of reform but also to the very expectations and hopes that the progress of medicine was constantly arousing. To continue to escape the corporation and the state meant preserving a system that was at war with itself.

Notes: Arrow, Kenneth J. “Uncertainty and the Welfare Economics of Medical Care.” American Economic Review 53 (December 1963), pp. 941–73. Dr. Arrow is my favorite health economist and indeed father of the profession*.

Link: 1963Arrow_AER

The Opinion Poll [Please Vote]

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Is Medicine Still a Sovereign Profession? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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