August 18, 2022

"Instead of addressing the real causes of the opioid crisis, like pill mill doctors, illegal drugs and regulators asleep at the switch, plaintiffs’ lawyers wrongly claimed..."

"... that pharmacists must second-guess doctors in a way the law never intended and many federal and state health regulators say interferes with the doctor-patient relationship."

Mark Lanier, the Texas lawyer who led the plaintiffs’ trial team, said of the pharmacy chains: “These companies are rending the fabric of society apart. They should not only show remorse, they should show they need to rectify what they’ve done. And they won’t do it. So the judge is doing it.”... 
Michael DeAngelis, a CVS spokesman, also said the company would appeal, adding, “Pharmacists fill legal prescriptions written by D.E.A.-licensed doctors who prescribe legal, F.D.A.-approved substances to treat actual patients in need.”

The top-rated comments at the Times:

1. "Legit pharmacies such as CVS, Walgreens, et al should not be on the hook for filling legit prescriptions as prescribed by an M.D. A pharmacy's purview doesn't extend to making judgment calls about the prescription."

2. "Wait a minute here - they filled prescriptions that were issued by competent medical personnel. Had they refused to fill them they might well have been sued for negligence. How is a local druggist the arbiter of the physician’s prescription?"

3. "I was a medical student at the time this whole thing started. We were taught that 'pain is the fifth vital sign.' We learned that treating pain was so crucial, that opiates were safe, and that we should not cheat patients out of a pain free experience. Yes there were unscrupulous doctors and pharmacies, but many in the profession thought they were doing the right thing. It’s not the first time that the medical profession got it wrong. Doctors used to say smoking was ok for goodness sake. This is not a 'good versus evil' battle. These huge payouts don’t bring back lost lives, and ultimately the costs will be passed along to the consumers, while the lawyers will make millions, and then move on to their next deep-pocketed targets. This is a complex issue, and I don’t consider this judgement a victory."

4. "There's a problem here. This enormous verdict is being awarded to two counties in Ohio. There are a lot of counties in the United States...."

48 comments:

Joe Biden, America's Putin said...

book recommendation

rhhardin said...

Clay Travis and Buck Sexton, Limbaugh's replacements, are on a crusade to claw back profits and penalize covid vaccine companies, who are immune to lawsuits, apparently not realizing that vaccine makers are always immune so that they're willing to produce vaccines at all.

Somebody always dies from vaccines so punitive damages always make vaccine manufacture unprofitable in the extreme, otherwise.

The policy idea is more lives are saved than lost in a huge ratio that way.

Even the right can't handle more than one variable, it seems.

PB said...

Some pharmacists like to inject themselves. I appreciate them reminding on how to take the medication, but if they question the need, I'll ask them where they got their MD.

Fred Drinkwater said...

News reporting on this, including the oh-so-vital NPR yesterday, made NO mention of the legal theory under which the pharmacies were found liable. Any lawyer in the commentariat feel like explaining it?

FullMoon said...

Lawyers get $350,000,000.00. plaintiffs get 25 cents each.

FullMoon said...

Same people who applaud this screaming to shut down the Pharmacy refusing to fill day after script.

Owen said...

Thanks to the magic of jury awards in tort cases like this, CVS will write that check without costing all its other "stakeholders" a penny. Employees, shareholders, suppliers, customers, will be unscathed. We who go to CVS for all kinds of other medications will not see pressure to increase what we pay, nor will any services (or sites) be impaired, ever. If that were to happen, it would be proof positive of CVS management's retaliation, and further lawsuits would be in order.

Magic.

Mike (MJB Wolf) said...

So very stupid. They have made it difficult for legit pain patients to get treatment while allowing the cartels to flood the streets with fentanyl and fake opioids. Every step in the treatment of real patients has been “reimagined” by regulators to make it magnitudes more difficult to do correctly and maintain safe and timely medication. At the same time there’s an irrational war on benzodiazepines so that patients frustrated and anxious over the new hoops to jump through have no relief for the fear of running out of meds every month. Kyphoplasty and other options are only useful when cracks appear and the long term trend is to wean patients down to an opioid level that is ineffective and leaves at risk patients like my wife in constant horrible pain. Thanks Big Government! You assholes.

Leland said...

Interesting that the regulators that approved opiates for prescription use aren’t the bad people having to pay. They’ll retire with full pensions. Yet the doctors, hospitals, pharmacist, and pharmacies that followed FDA and NIH guidance are the bad guys in the opioid crisis.

I noticed that Democrats are talking about big Pharma again in trying to make it an issue against Republicans. Just a year ago, if you dared question big Pharma, you were labeled as a science denier and anti-vaxxer by the left. It wasn’t the Right that welcomed the head of Pfizer to the Davos World Economic Forum.

Anyway, I hope this decision is tossed out on appeal.

Joe Smith said...

Opioids don't work on me so I can't comment on their addictive nature, but doctors who prescribe it willy-nilly should be sued and jailed.

The pharmacist is the last guy in the chain. Their job should be making sure you get what a doctor prescribed, not acting as an arbiter of medicine...

Sydney said...

This really is a miscarriage of justice. Pharmacists can not and should not second guess physicians. It is even sky than this, though. Ohio also sued vendors who supply medications to physicians and pharmacies, like Henry Schein. Henry Schein paid a million dollar settlement to be dismissed from the suit. It’s a shakedown.
I clearly remember when the pain activists went to work to change our attitudes toward prescribing opioids. I learned in medical school and residency that they were only for severe acute pain or terminally ill patients because of the high potential for addiction and overdose. A common refrain was “Pain won’t kill you, but these drugs will.” The campaign used the same tactics the transgender activists are using now. They presented it as a harm to fail to eliminate pain completely, ignoring the fact that pain is a complex issue - a mixture of a physiology response and a psychological response. Even with opioids it can often not be eliminated or even reduced enough to a patient’s satisfaction. They claimed that pain would kill people because people in pain were more likely to kill themselves.
They minimized the harms of opioids. I actually sat in lectures where the medical “expert” in pain claimed they weren’t addictive if used for chronic pain. I remember thinking at the time that was pure bullshit.
Even more ludicrous was making pain a vital sign. In medicine a sign is something that can be objectively measured. Feeling a mass on physician exam is a sign. A vital sign is one that is a vital indicator of your state of health: pulse, blood pressure, respiratory rate, temperature. You can look at those values and right away know if someone is critically ill. Pain is not objective, it is subjective. I have to rely on your description of a feeling on a scale of one to ten. And that description does not tell me if you are critically ill. Addicts will always say their pain is a 10 so they can get more meds. People who fear meds will always report lower on the scale. And of course, the stoic will also report lower values, the anxious higher ones. It was a mess.
Hospitals required nurses to assess pain regularly. They would wake patients from a sound sleep to ask if they were in pain. I definitely saw an uptick in opioid dependence and drug seeking behavior in those days. Also overdoses, especially in patients who went to pain clinics where they supposedly were experts. Most of them were anesthesiologists with no training in addiction.
Then the state stepped in and the pendulum swung hard the other way. It became risky to prescribe opioids appropriately because of complex state rules and regulations. Doctors risk losing their license if they trip up even once. (In my state if you forget to check the state database, that’s it for you) As a result, the addicted and the abusers turned to heroin and fentanyl. It was easier to get, but also deadlier and more addictive. And here we are.
It took a long time for the pendulum to swing. I wonder how long it will take for the transgender pendulum to swing?

Dagwood said...

The members of that jury probably couldn't make it all the way through "Dick, Jane and Spot" without a collective effort.

Another old lawyer said...

I read many anecdotal tellings and re-tellings of pharmacists and pharmacies who refused to fill ivermectin prescriptions during after the start of the COVID pandemic, or who required to know the illness to be treated with the ivermectin. I thought those questions are beyond the scope of their role and obligations.

So long as the drug prescribed - opioid, ivermectin, whatever - doesn't interact with another drug that the pharmacist knows I'm also prescribed, the only thing I want to hear from my pharmacist is how long it will take for my prescription to be ready and what's the charge.

Ray - SoCal said...

My Father was taking an opioid for pain for 20 years.

His Dr. changed (died - hmm, could it be...), and new Dr. refuses to prescribe him the pain medicine that worked. The new stuff has nasty side effects, and is not addressing the pain issues (he has major spine damage).

I am not sure what to do. Supposedly none of the other Dr. in his health plan will prescribe what he was taking, he sees a bunch of specialists.

Sydney said...

Sorry for the typos and autocorrect errors in my lengthy post. How the heck does “worse “ become “sky”?

Sebastian said...

"... that pharmacists must second-guess doctors in a way the law never intended and many federal and state health regulators say interferes with the doctor-patient relationship."

American law is a shake-down racket. They do teach that at UW, don't they?

Freder Frederson said...

Well, this guy and all the above comments, are full of shit.

It is not the individual pharmacists that are the problem, it is the corporations. The corporation is the entity that ignored the fact that they were filling way too many prescriptions than what was reasonable and expected.

Interesting that the regulators that approved opiates for prescription use aren’t the bad people having to pay. They’ll retire with full pensions.

Regulators?! What the fuck about the Sacklers? Their fortune is vastly larger than any pension a regulator might retire on.

Mike (MJB Wolf) said...

Ray I feel for your Dad. We are in the same boat here in SoCal. To actually get pain meds, my wife has to see a pain specialist every month and no 'script can have refills. Being on two different opioids (long- and short-acting) means two different requests to Dr. F every month, and at least one has to be in-person with full "specialist" copay just like our oncologist gets. Then it takes at least one phone call or visit to the pharmacy to get the medication off the automatic hold and "started" in-process. One does not just show up and pick it up if it's pain meds! It takes two steps with the pharmacist.

Then she has to have a psych consult in order to get a new benzo 'script each month, which is being halved every other month until they get her to zero, even though she used to take twice or more as much of everything before, with no adverse interaction/reaction. History be damned. The Science has declared no mixing of pain relief and benzos for anxiety.

Guess what all this red tape and added steps and extra pain does for her anxiety now!

n.n said...

George "fentanyl" Floyd syndrome has pervasive legal and illegal roots that proliferate with advocacy, activism, and in darkness.

Leland said...

I’m going to disagree with those claiming Pharmacist should not question doctor’s prescriptions. Generally, I agree, but pharmacists do have a roll in checking for problems with prescriptions. They are not a rubber stamp nor should they be. However, pharmacist should fill lawful prescriptions for a drug deemed safe by the FDA for the prescribed usage.

Michael K said...

NO mention of the legal theory under which the pharmacies were found liable. Any lawyer in the commentariat feel like explaining it?

Question.

FullMoon said...

Lawyers get $350,000,000.00. plaintiffs get 25 cents each.


Answer.

My wife has rheumatoid arthritis and also has an immunodeficiency disease that prevents her from taking the usual biologicals for RA. She has a time getting anything for pain.

Tina Trent said...

PB, what the heck are you talking about when you say "pharmacists inject themselves"? Pharmacists are highly trained medical providers who administer inoculations and teach patients how to use drugs such as insulin and emergency epi pens. In our increasingly complex medical system, they're the last line of defense if two doctors have failed to check a medical chart before prescribing drugs that can interact poorly with each other.

And it's often a miserable, dangerous job, especially in cities run by anti police Democrats.

Aggie said...

Why go after the guilty, when you can go after the deep pockets, instead?

Tina Trent said...

Good luck Mike. Sorry you have to watch your wife suffer.

Joe Smith said...

Btw, unless you are an advocate for closing the Southern Border, I don't give a fuck what you think about the 'opioid epidemic.'

walter said...

rhhardin said...Somebody always dies from vaccines so punitive damages always make vaccine manufacture unprofitable in the extreme, otherwise.
The policy idea is more lives are saved than lost in a huge ratio that way.
--
The standards for yanking vaccines once problems are found have been obliterated with the covid jabs. It's not been just a more good than harm situation.
But even that metric has been extremely abused here.

wendybar said...

Good thing we have a WIDE OPEN border with Coyotes smuggling up illegal Fentanyl to kill thousands of Americans who can't get pain medication because of abuse by some. You can Thank Joe Biden for their deaths.

walter said...

Another old lawyer said...
I read many anecdotal tellings and re-tellings of pharmacists and pharmacies who refused to fill ivermectin prescriptions during after the start of the COVID pandemic, or who required to know the illness to be treated with the ivermectin. I thought those questions are beyond the scope of their role and obligations.
--
I gave up on area pharmacies filling Ivermectin. I had pharmacists lying about even having it in stock and ability to get it. I contacted the distributor and was told otherwise.

walter said...

I should add that I was able to get it filled initially, but that changed.

effinayright said...

rhhardin said...
Clay Travis and Buck Sexton, Limbaugh's replacements, are on a crusade to claw back profits and penalize covid vaccine companies, who are immune to lawsuits, apparently not realizing that vaccine makers are always immune so that they're willing to produce vaccines at all.

Somebody always dies from vaccines so punitive damages always make vaccine manufacture unprofitable in the extreme, otherwise.

The policy idea is more lives are saved than lost in a huge ratio that way.

Even the right can't handle more than one variable, it seems.
**************

Explain thalidomide lawsuits. Explain polio vaccine lawsuits. Explain these lawsuits:

https://www.thelyonfirm.com/defective-products/vaccines/

https://www.phillipslaw.com/defective-drugs

The gratuitous SNOT in your final sentence is downright snortable, so:

SNORT

Jay Vogt said...

Funny, the Sackler family name doesn't come at all here. They're only pretty rich now. Who'd want to make them less so. I mean after all the . . . . #%&**# they've done.

Lets go after pharmacists instead.

Ampersand said...

The defendants will appeal, and given the potential for other suits, certainly can't afford to settle while on appeal. So the appeals court will reverse.

lonejustice said...

My mother had horrific pain the last 6 months of her life. Her doctor eventually put her on a fentanyl patch. She was then able to read, watch TV, go outside, and talk with her children and grandchildren. It made a big difference in the qualify of her life.

I don't fear death so much. What I do fear is suffering horrific pain while dying. Opioids are a real blessing when properly used. I hope these huge jury awards don't make doctors hesitate to help people who are in real pain.

Rich said...

Not entirety clear on the theory underpinning the claims in this particular case, but having read "American Cartel: Inside the Battle to Bring Down the Opioid Industry," available at Amazon, I'm understanding that the gist is not that they failed to second-guess individual prescriptions, but that they failed to perform monitoring, required by statute and regulation as a condition of licensure, to ascertain and report spikes in aggregate prescriptions within a particular geographic or temporal boundary, which information was calculated to alert authorities to the ongoing presence of pill mills and the like. If there was a material uptick in prescriptions in a particular town (or, as relevant here, county) during a defined time period, that meant there was something afoot. The legal claim was that they failed to perform this required monitoring, leading to damage to county government coffers as they attempted to deal with the fallout. That's why counties and not patients were the plaintiffs.

tim in vermont said...

Are doctors prescribing the illegal fentanyl that pours across our undefended, unmonitored Mexican border from China? They deliberately mix in prescribed and illegal drugs to muddy the waters on this, because they don't want to address the real issue.

Greg The Class Traitor said...

Fred Drinkwater said...
News reporting on this, including the oh-so-vital NPR yesterday, made NO mention of the legal theory under which the pharmacies were found liable. Any lawyer in the commentariat feel like explaining it?


The "legal theory" is "we want someone to pay".

The lawsuit is evil bullshit. No pharmacist should be second guessing the patient's doctor. it's not their skill, and none of their f'ing business.

If I believed in God, I would pray that every single jury member ends up in desperate need of pain killers, and has their prescription refused by a pharmacist

MayBee said...

One of Obama's big lines in his push for Obamacare was (paraphrasing) sometimes granny doesn't need the surgery, sometimes she just needs the pill.

Let's sue Obama for pushing us into the Opiod Epidemic. It was his policy goal, achieved.

HoodlumDoodlum said...

We dropped the pretense of "the rule of law" a while ago--most of the big litigation now is just about who has money. How to get that money from the entities that have it is just a detail, in the end.
When were the big asbestos cases, late 60's early 70's? Workers would normally be limited by worker's comp payments and by the time people had health effects many of the companies that were actually at fault were long gone, but no one was happy with that so the search was on for who had money. That's part of the law, now.
I'm honestly surprised it's taken this long for firearm manufacturers to face the same treatment, but that's just getting started.

Some pharmacies are owned by large corporations and those corporations have money. It doesn't matter that the pharmacies weren't actually at fault, it matters that they have money. That's the law, baby!

Howard said...

This is now classified as a disease because the perps are doughy Trump republicans. It's China and Mexico fault that these well meaning innocent babies are being forced to eat OXY against their will. I'm sure the folks in Compton feel your pain.

hawkeyedjb said...

Law enforcement (and the law industry) always go after the easy target and the big bucks. Going after individual doctors is tedious and won't yield the $$$ as easily.

It's exactly the same principal with gun control, which is why criminals are never inconvenienced by it. They are not the intended target. So much easier to harass law-abiding gun owners and manufacturers.

Fred Drinkwater said...

Rereading the reports, the phrase the jumps out is "partial liability". I've seen this before; it always means "there's a defendant who can plausibly be shown to be partly responsible. But the division of $ judgement should be based on their ability to pay."

Michael K said...


Blogger Howard said...

This is now classified as a disease because the perps are doughy Trump republicans.


Get back on your meds, Howard. You have been goofy all day.

Joe Biden, America's Putin said...

The drug companies .... are to blame for much of it.
They need everyone hooked so they can roll in the money.
Much like the Biden family.

read the book I posted at the top. quick read. very good. It'll make you mad.

effinayright said...

I may have reported here that my hospital, Lahey Health, wanted me to sign a form requiring me to stipulate that I would not sell, give away or use my med (gabapentin) as a reagent to make any other substance. I also was to agree to bring my meds to the hospital on demand to be counted to show I was using them only as prescribed. AND to agree to its employees visiting my home unannounced to ensure compliance.

I told them to pound sand.

They wrote the prescription. It turned out to be utterly ineffective.

Ironically, CBD oil works, very well. (no THC in it, btw)

This bullshit began, IIRC, when they started asking, "Are you safe at home"?

But apparently they were trying to CYA, bigly.

~ Gordon Pasha said...

Pharmacists have been lobbying for, and getting, both the power to prescribe but also the power to censor Rx (vide, ivermectin and hydroxychloroquine). I had a number of patients with long standing Rx for the latter being denied refills. What does around, comes around.

effinayright said...

Howard said...
This is now classified as a disease because the perps are doughy Trump republicans.
***********

Yeah, doughy Trump republicans, just like George Floyd.

Here's a partial list of others:

https://newsone.com/playlist/famous-black-deadly-drug-overdoses/item/18

typingtalker said...

Mark Lanier, the Texas lawyer who led the plaintiffs’ trial team, said of the pharmacy chains: “These companies are rending the fabric of society apart ... "

typingtalker, an internet commenter with no inside information on the subject, said of the lawyer team, "These law firms are rending the fabric of society apart by going after deep-pocket drug store chains rather than regulators that ignore the problem ... "

hpudding said...

It would take the ignorance of a Dr. Mercola to pretend that pharmacies were behind missing refills for anti rheumatoid or anti parasitic drugs. The runs on those from people pushing them as snake oil cures for COVID caused their supply in the marketplace to dip, leaving patients who needed them in the lurch. This was widely covered; unfortunately some doctors don’t have a clue about basic economics.

And maybe this was why so many were once so naive to basic marketing tricks. The drug makers were the ones pushing opiates to physicians by branding pain as a “fifth vital sign,” which they bought hook, line and sinker. Prescriptions skyrocketed, billions were made, American small towns started looking like 19th century opioid dens. And the pretty sales reps got nice resume boosters. The reps that blinked at credulous, horny doctors asking, “How high?” To jump through their britches.

They might want to brush up on Dan Schneider and Jacqueline Cleggett.

Younger physicians are generally less naive when it comes to the tricks of the same drug making trade that the older ones bash when relegated to drug pushers behind the counter. Not completely, but they at least realize they’re supposed to READ the trials and studies.