Iowa pharmacy that posed an ‘immediate danger' is again sanctioned by state
A Fort Dodge pharmacy previously sanctioned by the state with an emergency order restricting its practices has been issued a warning for additional regulatory violations of the same nature.
In 2022, the Iowa Board of Pharmacy alleged that in December 2021 Daniel Pharmacy, 1114 Central Ave., Fort Dodge failed to comply with standards related to the compounding of hazardous drugs. The pharmacy was given 30 days to come into compliance, but in January 2022, the pharmacy remained in a state of noncompliance, the board alleged.
As a result, in June 2022, the board charged Daniel Pharmacy with two regulatory violations and issued an emergency adjudicative order indefinitely restricting the business' ability to compound hazardous drugs, alleging the store posed an 'immediate danger' to the public.
The restriction remained in place in October 2022 when the board placed Daniel Pharmacy's license on probation for two years.
In July 2024, the board charged Daniel Pharmacy with three regulatory violations: failing to document within its continuous quality improvement program an unspecified 'event' of some kind; failing to include all of the required elements in records related to compounding records; and failing to follow a set of standards related to compounding medications.
According to the board, the charges stemmed from a determination that Daniel Pharmacy's procedures had resulted in an unspecified error that was not properly documented with a root cause analysis of the incident. The board and the owner of Daniel Pharmacy then agreed to settle the case with a warning that the board approved last month.
Although the settlement agreement and warning provide no details on the nature of the compounding error, when it occurred, or whether it had an impact on any patient or customer, that information has been posted online as part of the 'confidential investigative information' within the case file's Statement of Matters Asserted, a document the Iowa Department of Inspections, Appeals and Licensing typically keeps confidential in licensing board cases.
That document indicates that on March 4, 2024, a board compliance officer, Dr. Britney Origer, reviewed the pharmacy's quarterly reports that were required as part of the 2022 probation order.
Origer allegedly found that an error had occurred in in the compounding of dexamethasone – a drug often used to treat inflammation or manage autoimmune disorders — six months earlier, in September 2023. The error went undetected by the pharmacy and the medicine was dispensed to the patient, according to the document.
Origer's review of the pharmacy's records allegedly showed none of the calculations used when compounding medicines were documented for the prescription in question. The pharmacy then gave the patient a replacement compounded medication, but the documentation for the replacement compound was also inadequate, the board concluded.
Pharmacy owner John Ferris Daniel III allegedly told the investigator the incident marked his first compounding error in 25 years.
In a separate but related case, the board has also restricted John Ferris Daniel III's license until he can complete training, at Miami's Fagron Academy, on the compounding of medications. He has 90 days to complete the training, according to board records.
Other pharmacists recently sanctioned by the board include:
— Hartig Drug Co. of Independence, which allegedly dispensed the incorrect dosage of a medication for a child. According to the board, the pharmacy received a prescription order on Feb. 16, 2024, for two dozen 7.5 milligram tablets of methotrexate sodium, a drug often used to treat cancer, with the directions for the minor patient to 'take three tablets (21 milligrams total) by mouth every seven days' — although three 7.5 milligram tablets actually adds up to 22.5 milligrams per week, not 21 milligrams.
The pharmacy then dispensed two dozen 2.5 milligram tablets of the drug with the instruction to take three of the tablets every day for a total of seven days, for a total weekly dosage of 52.5 milligrams.
The child's mother discovered the discrepancy in the instructions and contacted the pharmacy. According to the board, the pharmacy corrected the directions for future refills, but the staff failed to recognize the dosing error, and the child continued to take the incorrect dosage until March 18, 2024, when the patient's mother discovered that error and again contacted the pharmacy.
The board agreed to settle the case against Hartig Drug Co. with a warning and a $1,000 civil penalty. In addition, all pharmacists and pharmacy technicians at Hartig Drug Co. will be required to complete a medication-error and patient-safety continuing education program approved by the board.
— Thomas Kelly of Cedar Rapids, whose pharmacy license has been indefinitely suspended until he is 'deemed safe to resume practicing pharmacy.' The board alleges that in November 2024, it received notice that Kelly was fired from Hartig Drug Co.'s Belle Plaine store for diverting oxycodone. The next day, Kelly allegedly informed the board that between March 2024 and September 2024, he had stolen roughly 350 opioid tablets for his personal use. He allegedly took the drugs from 100-tablet bottles kept within the pharmacy's inventory. To conceal the theft, he then replaced the stolen oxycodone tablets with aspirin, according to the board.
Criminal court records indicate Kelly was charged with two counts of felony prohibited acts involving controlled substances and two counts of misdemeanor unlawful possession of a prescription drug. According to police reports, Kelly admitted taking 380 tablets of oxycodone and hydrocodone and replacing the tablets with Aleve.
Kelly recently pleaded guilty to the two felony charges with the understanding that the misdemeanor charges will be dismissed. He is scheduled to be sentenced on July 24, 2025.
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