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Straight TalkPharmacy Technicians:Truth and ConsequencesWith the flu season quicklyapproaching, imagine anabsolutely unbearable workdayin your pharmacy. Anticipating theworst, you call in extra pharmacists andpharmacy technicians to help fill whatare expected to be some of the busiestprescription days of the year. Sureenough, on a typical day during the fluoutbreak, a line starts early at the prescriptiondrop-off counter and continuesto build throughout the day. Carsare stacked up at the drive-through prescriptionwindow as though McDonald’swere giving out free Big Macs. As physicians’offices open, the pharmacy’sphones ring incessantly with new prescriptionorders and permissions to refillolder prescriptions. Everyone is workingto their fullest capacity, which necessitatesextra effort from all pharmacy personnel.Pharmacists’ and technicians’fingers are furiously tapping the computerkeyboards trying to input data asquickly as possible while making sure important informationis accurately recorded into patients’ medicalrecords. Medication stock bottles are being pulledfrom every shelf in the pharmacy, with their tabletsand capsules ready to be poured out into the smallerprescription containers and bottles lined up on theprescription counter, each awaiting a label withinstructions to be affixed to it. Once filled, the prescriptionswill be checked by a pharmacist beforebeing dispensed to the patient. The pharmacy counteris a mess and resembles the trading floor of the NewYork Stock Exchange after a busy day, with notes onscrap paper strewn everywhere. Pharmacy techniciansand pharmacists line up to fill the waiting prescriptionbottles and vials like a General Motors assembly line.And then it happens. . . a pharmacy technician preparesa prescription that contains a fatal dose of themedication. Because of the craziness in the pharmacy,the error gets passed over by a pharmacist who is supposedto check each and every prescriptionbefore it is dispensed.A doomsday scenario, you say, thatwould never happen in your pharmacy?Maybe, but the truth is, it does happen,and it is more than likely that thepharmacist, not the technician, will paythe consequences of any error. Dependingon its severity, the error could resultin a hefty fine and prison time for thepharmacist. While the above scenariomay be fictitious, a case reported byU.S. Pharmacist’s legal contributor, JesseC. Vivian, BS Pharm, JD, in thismonth’s Legal Considerations column(page 66), is unfortunately all too real.In that case of a fatal error, the technicianwas charged with negligenthomicide but was given a “get out ofjail free” card by the court, wasn’t evenfined, and actually went back to workin a retail pharmacy. The pharmacist,however, was found guilty of involuntarymanslaughter and faced up to 5years in prison and a $10,000 fine. His license wasrevoked, and he will probably never work again as apharmacist. All this because he did not check theaccuracy of a prescription filled by the technician.The column should be a wake-up call for everypharmacist who works closely with one or more pharmacytechnicians. While it is true that each case ofnegligence involving a technician will be judged onthe merits of the case, the message is clear. The truthis that if a pharmacist is not diligent about checking atechnician’s work, the consequences could be dire.Harold E. Cohen, RPhEditor-in-Chiefhcohen@jobson.com4U.S. Pharmacist • November 2009 • www.uspharmacist.com