The Post and Courier reported the lawsuit filed by South Carolina against Purdue Pharma which is one of the largest pain pill manufacturers in the nation. The complaint filed is aimed at Connecticut-based Purdue Pharma, the maker of OxyContin — one of many synthetic opioids that have been manufactured, shipped, prescribed and sold throughout the United States.
The lawsuit accuses Purdue of failing to comply with a 2007 agreement it signed with South Carolina over allegations of its promotion of OxyContin. The State accuses the drug manufacturer of encouraging doctors to prescribe pain pills for unapproved uses and downplaying how addictive the company’s prescriptions are.
“Opioid addiction is a public health menace to South Carolina,” AG Wilson said as family members of overdose victims and addiction survivors stood behind him. “We cannot let history record that we stood by while this epidemic rages.” Wilson said the scourge has cost South Carolina billions of dollars.
More than 565 South Carolinians died of an overdose tied to highly addictive opioids in 2015, the most recent year that data is available. Opiods are the leading cause of death for Americans under the age of 50.
State Medicaid data shows that 1,855 prescriptions — or more than $1 million worth — of OxyContin reimbursed under the state-run insurance program last year. That number is down from the 3,620 prescriptions worth more than $2 million that were reimbursed in 2012.
Health in Aging reported on new research published in the June 2017 issue of the Journal of the American Geriatrics Society.
Medical experts know that older adults who have dementia or other mental health concerns that impact thinking or decision making should avoid certain “potentially inappropriate medications” (PIMs). PIMs can worsen confusion and raise the risks for falls, fractures, and even death, particularly for people with complex health needs.
PIMs may include treatments like:
- Benzodiazepines (medications sometimes called “tranquilizers” and used to treat sleep problems, anxiety, or to relax muscles)
- Antipsychotics (medications sometimes used to address mental health conditions)
- H2-blockers (medications sometimes used to decrease the production of stomach acid)
- Anticholinergics (medications that block a substance called acetylcholine, a “neurotransmitter” that transfers signals between certain cells to impact how your body functions. Anticholinergics have been used to treat several different conditions, including incontinence and chronic obstructive pulmonary disorder, or COPD).
Researchers investigated how often healthcare providers prescribed PIMs to older adults living with dementia or other mental health concerns in nursing homes. The research team discovered that 44 percent of people with dementia or cognitive impairment were taking a PIM. The frailer the person, the more likely they were to be taking a PIM.
After admission to a nursing home, many residents who were initially prescribed PIMs stopped taking PIMs:
- 5 percent stopped taking antipsychotic medications.
- 3 percent stopped taking benzodiazepines.
- 9 percent stopped taking H2-blockers.
- 2 percent stopped taking medications with anticholinergic properties that worsen memory or thinking.
A smaller percentage of study participants–from 1.2 percent to 10.9 percent, depending on the specific medication–were newly started on PIMs in the nursing home. Antipsychotics and benzodiazepines were the most frequently prescribed PIMs.
The researchers concluded that many nursing home residents with dementia or other cognitive impairments enter nursing homes on PIMs. They also concluded that PIMs are more likely to be prescribed for frail older adults after admission. The researchers suggested that strategies for a person-centered approach to discontinuing PIMs should be encouraged, especially for frail older adults.
It’s also important to remember that “potentially inappropriate medications” are just that: potentially inappropriate. They should be considered carefully before use, but that doesn’t mean that they should never be used in all cases or for all older people. If you have been prescribed a PIM or if you’re concerned about the way a treatment may affect your health, be sure to speak with your healthcare provider first before changing your routine or stopping the use of specific medications.
A former nurse, who previously pled guilty to tampering with a consumer product, was sentenced to imprisonment for a term of 48 months. Christina Lovern Calloway, while working as a nurse in a nursing home, diverted liquid morphine intended for patients to her own use. The defendant, on more than one occasion, took some of the liquid morphine from a bottle and used it herself. She then used tap water to refill the bottle in an attempt to hide her crime. The diluted morphine was then administered to patients.
KTLO reported that additional charges have been filed against a nurse who fled from law enforcement officers earlier this month following a traffic stop after police responded to a complaint of an intoxicated driver on July 16. When they located the vehicle and attempted to conduct a traffic stop, the driver refused to stop, and a short pursuit ensued.
The driver, Geneva Liveley, was apprehended and taken into custody. An inventory of the vehicle revealed numerous prescription medications belonging to other individuals, a loaded firearm, drug paraphernalia and cash totaling $1,110.
Liveley was charged with simultaneous possession of drugs and firearms, possession of a controlled substance (Hydrocodone), both felony counts, as well as misdemeanor charges.
Chief Manuel says an investigation began into Liveley’s possession of prescription medications belonging to other individuals. It was learned she worked at a local nursing home and stole medications from residents. The medications in her possession were logged by her as being received by the residents.
Liveley was arrested again and charged with four felony counts of controlled substances-fraudulent practices and six misdemeanor offenses.
Goupstate reported the arrest of Natalia Mikhailovna Roberts, a caregiver at Lake Emory Post Acute Care in Inman, S.C. Roberts is accused of taking medications from patients and charged with two counts of violating drug distribution laws and theft of a controlled substance.
Warrants from the Department of Health and Environmental Control accuse her of intentionally taking doses of hydrocodone and oxycodone that were intended for patients.
In one incident on May 27, records reflect that there were 78 doses of oxycodone for a patient when there should have been 96 tablets remaining, according to a warrant.
Another warrant states that on June 17, a page was missing from a controlled medication utilization record for another patient regarding hydrocodone doses.
Until a few months ago, Lake Emory was designated as a Special Focus Facility and was even fined almost $200,000 on Jan. 11, 2017. Lake Emory is owned and operated by Fundamental Long Term Care now known as Hunt Valley Holdins, a national for-profit chain with hundreds of nursing homes in numerous states.
The Columbus Dispatch reported that Eric Banks was accused of causing a fatal overdose by selling fentanyl to a resident of Manor at Whitehall Nursing Home. Banks has been indicted for involuntary manslaughter and other charges. In addition to involuntary manslaughter, Banks was indicted on one count of corrupting another with drugs and two counts of aggravated trafficking in drugs.
Prosecutor Ron O’Brien said Banks went to the Manor at Whitehall Nursing Home on Feb. 10 and sold fentanyl, a powerful synthetic opioid, to Dale Rogers, 56. Nursing staff found Rogers unresponsive, started CPR and called 911. Whitehall medics administered Narcan, which can reverse the effects of an opioid overdose, and took him to a hospital, where he was pronounced dead.
Rogers had texted an order for ”‘Chinese food’, which is slang for heroin, fentanyl or a mixture,” O’Brien said. Investigators found that Banks was the recipient of the text.
Toxicology tests on Rogers and lab work on drugs that investigators found on Banks all came back as fentanyl, O’Brien said.
The American Pharmacist Association published on their website that the FDA has since 2005 warned about the risks of transdermal fentanyl patches, particularly among opioid-naive patients, but nursing homes have not completely phased out the long-acting analgesics.
FDA has since 2005 warned about the risks of transdermal fentanyl patches, particularly among opioid-naive patients, but nursing homes have not completely phased out the long-acting analgesics. A study led by Camilla Pimentel, MPH, PhD, of the University of Massachusetts Medical School analyzed a sample of Medicare patients living in long-stay facilities in 2011. Of more than 12,250 patients who received the patch within 30 days of admission that year, 9.4% had not taken opioid analgesics in the prior 60-day period.
The practice, according to Pimentel, is contrary to FDA recommendations, which indicate that the long-acting opioids “should only be given to patients who have developed tolerance to opioid medications through regular treatment with other opioids. Otherwise, they are at higher risk of unintentional fatal overdose because of respiratory depression.” Although use of the patch persists in opioid-naive patients in nursing homes, Pimentel and colleagues report in the Journal of the American Geriatric Society, use of long-acting opioids overall is down in this setting, accounting for just 5% of all long-stay Medicare nursing home residents.
Prosecutors say three nursing home caregivers carelessly made a mistake with dangerous morphine causing a resident’s death. The wrongful death happened in 2015 at Greenbriar Healthcare Center in Boardman. In November of 2015, just after the death, Greenbriar Health Care was placed on a Medicaid “worst of the worst” watch list.
Johonna Hull was arrested and charged with abuse of a patient and tampering with medical records. Brenda Lamancusa is also charged with patient abuse. Another person, who hasn’t yet been arrested, also faces charges.
The family has filed suit against the three facility employees who are accused of neglect and trying to coverup their negligence. The employees are accused of giving William Wolfe extended release morphine that had not been prescribed. He was found unresponsive the next morning and pronounced dead at the hospital.
“Evidence indicated, and the autopsy showed, that a gentleman … was mistakenly given the wrong medication … The charges are largely over not only the mistake in providing him that medication, but probably even more importantly, the lack of action that was taken by the staff at Greenbriar,” Michael McBride, an assistant Mahoning County prosecutor, said to station WKBN.
JAMA Network had another article on the overuse and abuse of anti-psychotics in nurisng homes. In May 2011, the Office of Inspector General (OIG) released a widely publicized report, “Medicare Atypical Antipsychotic Drug Claims for Elderly Nursing Home Residents,” revealing that 83% of atypical antipsychotic drug claims were prescribed for nursing home residents without a US Food and Drug Administration (FDA) indication, and that 88% of claims were related to use in residents with dementia, for whom antipsychotics are associated with an increased risk of mortality as specified in the FDA black box warning.
“Despite long-standing and widely recognized concerns about safety and efficacy, antipsychotic agents, including older “typical” agents (ie, haloperidol and chlorpromazine) and newer “atypical” agents (ie, quetiapine, risperidone, and olanzapine), have been commonly used to treat behavioral and psychological symptoms of dementia.”
This Viewpoint describes a national initiative of the Centers for Medicare & Medicaid Services (CMS) focused on the use of antipsychotics in nursing homes. These efforts have led to a 33% relative reduction (from 23.9% to 16.0%) in the prevalence of antipsychotic use among long-term nursing home residents over the past 5 years.