A spokeswoman for the Washington State Board of Pharmacy confirmed Tuesday that the complaints filed against Ralph’s Pharmacy for refusing to stock and dispense Plan B emergency contraception as prescribed are now in the process of legal review by Board of Pharmacy staff attorneys. Presumably, a Board Panel has found Ralph’s to be in violation of Washington State pharmacy code.
Until the legal review is completed, details of the findings against Ralph’s are not public information. However, the complaints would not be subject to legal review unless violations were found and disciplinary action had been recommended by the Board Panel.
In July of 2006, nine women in the Olympia area filed complaints with the Board of Pharmacy because they had been unable to fill prescriptions for emergency contraception at Ralph’s. Investigation into the actions of the managing pharmacist, Stan Berdinka, found him to have behaved professionally to the best of his ability; he was unable to fill these prescriptions because of the store owners’ refusal to stock Plan B as a matter of store policy. An investigation was then initiated into the pharmacy itself. Complainants felt that Ralph’s pharmacy was in violation of Washington Administrative Code 246.869.150, which states that a "pharmacy must maintain at all times a representative assortment of drugs in order to the meet the pharmaceutical needs of its patients."
In April of 2007, the Pharmacy Board adopted new rules that require pharmacies to dispense legally prescribed medications and medications whose distribution is restricted to pharmacies by the FDA regardless of a pharmacist’s “moral” or religious objections. It will be interesting to see if new complaints if Ralph’s continues to refuse to stock and dispense Plan B after these new rules take effect (some time later this month). However, the nine complaints filed in July of 2006 contended that Ralph’s was in violation of the existing WAC cited above, which was in force at the time of the refusals in June and July of 2006. If new complaints are filed after the new codes are in effect, Ralph’s may well be found to be in violation of not one, but three Pharmacy Board statutes, which will most likely be cause for extensive disciplinary measures.
What disciplinary actions are likely, and when will they be imposed? A spokeswoman for the Board of Pharmacy reported this morning that until the case is closed, the Board panel’s recommendations cannot be made public. The legal review could potentially take as long as 170 days, however this is not likely, since given its high profile, this case “is not going to be put to the back of the pile.”
A quick review of past Board disciplinary actions shows that a broad range of corrective measures have been imposed on other pharmacies for code violations. A pharmacy can be required to formulate a plan of correction. Fines can be imposed. Refusal to bring the pharmacy into compliance with pharmacy statutes can result in forfeiture of the pharmacy’s license. Until the legal review is complete, it is uncertain what measures will be enacted against Ralph’s.
Advocates of birth control access are gratified to see that the Board panel has presumably found violations, and is proceeding toward action. But what lies ahead is uncertain: there is a possibility that the complaints will be stalled or quashed in the legal review process. Ralph’s may choose to come into compliance with WAC 246.869.150, pay fines, or close its pharmacy rather than abide by Pharmacy Board statues. . In the past, pharmacies and pharmacists have appealed Pharmacy Board disciplinary actions in Country Superior Court and the Washington Court of Appeals. Perhaps Ralph’s will choose a similar course of action.
Regardless of these uncertainties, one thing is obvious: Complaining paid off! The women who stood up for their right to have prescriptions filled without judgment, who took the time to file complaints and spent hours completing paperwork have proven their case, and pharmacy consumers in Washington state will be better served because of it.
Update, 1:38 p.m., 6/7/7: I just got a call from the Olympian, asking me about this post. The reporter wanted to know how I knew Ralph's had been found to violate a statute. Let me reiterate that it is an inference. I drew this inference based on my understanding of the complaint process as explained to me by Lisa Salmi, the Executive Director of the Washington State Board of Pharmacy. She told me, back in April, that the investigation into the complaints was concluded, that a Board member was reviewing the complaint and would make a presentation about it to a Board Panel. It was my understanding that IF the Board Panel felt that there had been a violation and disciplinary action was warranted, it would go to a legal review. Since the complaint has gone to a legal review, I have inferred that the Board panel found a violation and recommended disciplinary action. The Board of Pharmacy has not made public any information about the findings of the panel. I'm not a lawyer, I'm just a complainant in the case, so it's possible I have misunderstood the process, and have drawn an incorrect inference. Hey, I'm just a blogger! But it's exciting to know that the "real media" is watching what's going on here on Olyblog.