Pharmacists, politicians grapple with fallout from Courtney cas

KANSAS CITY, Mo. -- As Robert Courtney begins serving his 30-year term prison term for diluting drugs, the pharmacy industry and politicians are weighing the fallout from a crime that shook the public's confidence in those who mix and dispense drugs.

Pharmacy organizations say the national attention the case received has already prompted some changes, with more possible as they try to prevent a similar case from ever happening again.

Courtney was sentenced Thursday after pleading guilty in February to diluting 158 chemotherapy doses for 34 patients from March 2001 through June 2001. But he admitted that greed drove him to dilute drugs since 1992, affecting as many as 4,200 patients, 400 doctors and 98,000 prescriptions.

When sentencing Courtney, U.S. District Judge Ortrie Smith said his crimes had shocked the conscience of the nation.

"You alone have changed the way a nation thinks," Smith told Courtney. "The way a nation thinks about pharmacists. The way a nation thinks about prescription medication."

Sen. Kit Bond, R-Mo., has called for Senate hearings to study ways to more strictly regulate compounded medications, which are usually mixed by independent pharmacists not subject to the regulations imposed on drug companies.

'New territory here'

Bond's spokesman, Ernie Blazar, acknowledged that finding the right regulations will be difficult.

"This is a relatively new practice, and as such there has not been much study of proper regulations," he said. "Nobody has even raised these questions before. We are into new territory here."

Pharmacists across the country have reported that patients are questioning them about the Courtney case and about their prescriptions, said Susan Winkler, vice president for policy and communications for the American Pharmaceutical Association.

Pharmacists consider Courtney an appalling aberration in their profession, and Winkler said everyone wants to find ways to stop anyone who might commit a similar crime. But she urged caution in creating regulations that may damage trustworthy pharmacists.

"Really what we are trying to find is a balance," she said. "What steps can we take to make sure there are not more people like him out there? But at the same time, making sure that we don't put in new checks and balances that are going to hurt good people."

For example, Winkler said, if a board of pharmacy can suddenly revoke the license of a pharmacist who made an honest mistake, pharmacists are less likely to report those mistakes.

"One of the most difficult aspects of error prevention is being able to talk openly about those errors," she said. "If there is the possibility of a serious sanction, people may hide honest errors. We have to be able to talk about how to prevent them."