One location in Virginia Beach was fined $470,000 for serious dispensing errors. Pharmacists say its a systemic problem.
Over the last two years, employees at a CVS Pharmacy in Virginia Beach have raised repeated concerns over patient safety.
At one point, multiple pharmacy technicians told a state inspector that a pharmacist at the store had mistakenly given a patient a hundred extra doses of Percocet — a powerful prescription opioid. Another customer received an antibiotic despite a known history of not tolerating the drug and was taken to the emergency room after an allergic reaction.
In another instance, a patient received the right medication with the wrong instructions, according to another pharmacy tech, who said the oral cholesterol drug came with directions to insert the pills vaginally.
The root of the errors, employees said, was chronic understaffing and an unsustainable workload that made it impossible for pharmacists and technicians to focus on their jobs.
“The pharmacists cannot properly concentrate because they have so much to do,” said Kristopher Ratliff, a member of Virginia’s Board of Pharmacy, reading from a more than 600-page investigative report produced by state regulators.
“A staff pharmacist stated hours had been cut to the point where she didn’t know how the pharmacy was supposed to function,” added Mykl Egan, the board’s discipline case manager, reading from the report. “A fourth pharmacist described the pharmacy as a ‘sweatshop.’”
The findings, which covered a single CVS store, resulted in a $427,000 fine for the chain and one unannounced inspection within the next 12 months. CVS “respectfully disagree[s]” with the board’s order, according to spokesman Mike DeAngelis, and is “considering our options” for potential next steps.
But news of the investigation came as no surprise to former CVS employees in Virginia, who said working conditions were so bad that they had affected their mental and physical health. Nor were the problems contained to a single store, according to two former pharmacists, who worked in multiple locations across the state and heard similar concerns from other staff members.
“The sheer number of people who go home and cry because of the pressures they’re under — it’s unbelievable,” said Michelle Harmon, a former CVS pharmacist in the Hampton Roads region who’s still part of a Facebook group for mothers in the industry. “You’re so mentally drained you don’t have time for your family. I was just existing — going to work, coming home, doing whatever I could to hit the numbers so my patients were taken care of.”
Safety and staffing issues at national pharmacy chains have become a growing issue for state regulators both in Virginia and across the country. A 2020 investigation by The New York Times found that at least two dozen states have received multiple complaints from pharmacists and physicians worried that chain pharmacy policies are undercutting patient care.
In many cases, the errors have had significant consequences. An 85-year-old in Florida died after a Publix pharmacy dispensed a chemotherapy drug instead of the antidepressant she was prescribed. At the CVS in Virginia Beach, a state inspector reviewed 200 hardcopy prescriptions and found 74 mistakes — an error rate of roughly 37 percent. In at least two cases, pharmacists dispensed medications at multiple times over the prescribed dosage, including cyclobenzaprine, a muscle relaxant, and dexamethasone, an anti-inflammatory drug that’s been used to treat COVID-19 patients.
“Now, in my 32 years of practice in retail pharmacy, this is a classic symptom of going too fast, too distracted, to pay attention to what you’re doing,” Ratliff said during the hearing. At one point, he described the working conditions as “unacceptable,” but the board’s secretive disciplinary process makes it difficult to determine how widespread the problems are across Virginia.
Diane Powers, director of communications for the Virginia Department of Health Professions, said that board investigations are complaint-driven. However, complaints against pharmacies are considered confidential under Virginia state code, she said, making it impossible to know whether other CVS stores have experienced the same problems.
The board did release its final order in the case, but refused to provide the Mercury with a copy of the full investigative report, which was referred to repeatedly during the public hearing. Powers also said the report was exempt from disclosure under the state’s Freedom of Information Act laws.
“Investigations are confidential under law and therefore, the board can neither confirm or deny the existence of any ongoing investigations,” she added in a follow-up statement.
Nearly half of the board’s disciplinary case decisions involving pharmacies over the last 90 days have been issued in response to violations by large chain locations, including CVS, Walgreens and Rite Aid. But it’s unclear if any involved complaints similar to those filed against the CVS store in Virginia Beach.
Both Harmon and another former CVS pharmacist, who requested anonymity because she feared professional repercussions, say understaffing has been a growing problem at CVS for years. It only became worse with the arrival of COVID-19, they said. Continue Reading