Published August 18, 2016 LAW Sexual Misconduct by Pharmacists Part 2: An Examination of Cases Virgil Van Dusen, DPh, JDBernhardt Professor of PharmacyCollege of PharmacySouthwestern Oklahoma State UniversityWeatherford, Oklahoma John R. Barnett, PhDChair/Associate ProfessorDepartment of PsychologyCollege of Professional and Graduate StudiesSouthwestern Oklahoma State UniversityWeatherford, Oklahoma W. Steven Pray, PhD, DPhBernhardt Professor of PharmacyCollege of PharmacySouthwestern Oklahoma State UniversityWeatherford, Oklahoma US Pharm. 2016;41(8):21-25. As discussed in this column in the June issue, sexual misconduct by pharmacists is an area of concern. The authors conducted an original study and surveyed 51 Boards of Pharmacy (all 50 states and the District of Columbia), requesting up to two cases related to discipline based on sexual indiscretion. Twenty states responded (a response rate of 39.2%), providing 21 cases. Ten boards reported no such cases. Although the primary focus of the investigation was pharmacists, one board furnished details about a technician. That case is discussed here as an illustration that other pharmacy personnel may also engage in sexual misconduct. Most furnished the identities of the offenders, but one state redacted them. Some boards reported the criminal penalties assessed the offenders. Additional details regarding criminal and/or civil actions were obtained by use of Google searches using the offenders’ names. In one case, no records of criminal litigation were provided, nor could any be located. Boards were also asked to describe the disposition of the cases. Of the 21 cases received, dispositions were provided for 20. The 21 cases fell into several distinct and separate categories. Each category of offense is described below. Child Pornography Five of the reported cases (23.8% of total cases) involved child pornography. A male pharmacist from New York admitted to transporting child pornography across state lines.1 Specific criminal penalties were unavailable. He was granted a consent order that suspended his pharmacy license for 6 months, with another 18 months of suspension stayed; he was fined $1,000 and forced to undergo a 2-year probationary period. Another male New York pharmacist was convicted of attempting to possess a sexual performance by a child (i.e., a type of child pornography), a class A misdemeanor.2 Specific criminal penalties were not provided and could not be located. He was granted a consent order that suspended his pharmacy license for 3 months, with another 21 months of suspension stayed. He was fined $1,000 and forced to undergo a 2-year probationary period. A male pharmacist from New Mexico was convicted on one felony count of possession of child pornography.3 Specific criminal penalties were unavailable. His license was revoked, but this action was held in abeyance pending his successful compliance with seven stipulations (e.g., completion of sex offender and mental health counseling as recommended by a probation officer). The board later reinstated a limited license, and imposed 14 additional stipulations. He was required to enter into a 5-year contract with the New Mexico Monitored Treatment Program for counseling. He was also required to obtain 60 hours of continuing education (CE), beginning with the date his license was revoked, and had to pass the Multistate Pharmacy Jurisprudence Examination (MPJE). An Oklahoma pharmacist pled guilty to one count of possessing an image of child pornography on a computer, the image having been obtained online.4 He was sentenced to 3 years’ imprisonment. His license was suspended for 10 years, and he was fined $1,000. A male pharmacist was discovered by agents of the Georgia Bureau of Investigation to be e-mailing child pornography.5,6 The agents used an automated program that monitored sharing of computer files, focusing on those containing child pornography. They traced the IP (i.e., Internet Protocol) address of one such individual to him, and he was arrested at his home, accused of sharing child pornography files. The pharmacist expressed relief at being caught and received extensive sex offender treatment. He pled guilty to eight counts of sexual exploitation of children for the images found on his home computer. The judge noted that, although he had never touched a child, he had still created a market for child pornography and had also contributed to the exploitation of children. The pharmacist was sentenced to 18 months in prison, and another 20 years of supervised probation. His license to practice pharmacy was summarily suspended and his nuclear pharmacist license was inactivated. Inappropriate Contact With Minors In another five cases (23.8%), four pharmacists and a technician engaged in inappropriate contact with minors. A male pharmacist from Oregon was convicted on one count of Felony Encouraging Child Sexual Abuse.7 Criminal penalties were not provided. He was placed on probation for 10 years and given numerous conditions of probation to follow. They included a prohibition on Internet and physical contact with persons under the age of 18 years. A male New York pharmacist sexually assaulted his 8-year-old female neighbor and her 9-year-old female friend.8-10 He pled guilty to three counts of first-degree felony sexual abuse and was sentenced to two consecutive 1-year jail terms, with 10 years of probation. He was also labeled a Level 3 sex offender (those most likely to reoffend). He applied to surrender his license and the board granted this request. A male pharmacist from Georgia made a written solicitation for performance of oral sex to a 16-year-old boy that he coached in basketball.11 The boy’s family attempted extortion of the pharmacist, who then reported the entire affair to a sheriff. At that time, the pharmacist also admitted that he had previously done the same thing to a 15-year-old boy. He pled guilty to, and was convicted of, a felony for solicitation of sodomy from a minor. He was given a 4-year sentence, to be served in a detention center for 90 to 120 days, after which he would be on probation. He was also forced to pay a $1,500 fine. His license was summarily suspended by the board. However, he sought a lesser sanction that would still allow him to practice pharmacy. Accordingly, after the close of evidence but before issuance of a final decision, he filed a Motion for an Order Allowing the Introduction of Additional Evidence, that being a report from his treating psychiatrist. The motion was denied because it had not been presented in a timely manner. A male pharmacist from Nevada inappropriately touched two girls, aged 9 and 12 years.12,13 He coerced one of the girls to massage his leg and invited her to touch him in a sexual way. He was convicted of one count of Attempted Lewdness With a Minor Under the Age of Fourteen, a category B felony. He was sentenced to 240 months in the Nevada Department of Prisons, with minimum parole eligibility of 96 months. The sentence was suspended pending his completion of a probationary period (not to exceed 5 years), during which he would comply with two pages of specific conditions, some intended to prevent him from having any sexual contact with persons under the age of 18 years. He was required to serve 6 months in a detention center. His license was suspended for 1 year, but the suspension would be stayed if he complied with terms of a 5-year probation (e.g., reports from his treating mental health practitioner). He was also banned from direct public contact in any pharmacy where he would be employed, his patient communication being limited to telephone or electronic means (e.g., e-mail). He was required to pay investigative costs and an administrative fee, a total of $1,210. A female technician from Oklahoma had a sexual relationship with a 15-year-old boy.14 She was charged with 12 felony counts; seven were for lewd molestation and five for rape in the second degree. She pled guilty to one rape count, and the others were dismissed. The technician was sentenced to 10 years’ imprisonment on each count (which was suspended), with the sentences to run concurrently with each other. She was also forced to pay a fine and court costs, a total of $3,319. Her technician license was also revoked. Trading Drugs for Sex In three cases (14.3%), a pharmacist traded drugs for sexual favors. An Oklahoma pharmacist confessed to diverting hydrocodone and carisoprodol, and also to refilling a personal prescription for alprazolam for the purposes of sharing at least 50 to 60 doses with four different people he had dated.15 His hydrocodone diversion stretched back for 12 to 18 months. He gave the hydrocodone to a woman he had photographed. The pharmacist confessed that he had diverted 200 doses of hydrocodone and 120 doses of carisoprodol. No information was available on criminal penalties, if any. His license was suspended, and he was required to enter into a contract with Oklahoma Pharmacists Helping Pharmacists (OPHP). The board further ordered that if he obtained the release of a hold on his license (placed by the Oklahoma Tax Commission), and if his license were to be reinstated, the suspension would be stayed and he would be placed on probation for 10 years. This agreement would be valid only if he complied with the OPHP contract and if his future practice would not put the public at risk. He was fined $10,000 and required to attend a 1-day law seminar during each of 2 years in addition to the normal requirement of 15 hours of CE per year. A male Maryland pharmacist met with an undercover female police informant, to whom he gave a bag that contained prescription drugs for which she had no prescription.16 Among the medications given to her were five tablets of chlordiazepoxide, a schedule IV benzodiazepine. He pled guilty in Baltimore County Circuit Court to Unlawful Distribution of a Controlled Dangerous Substance and received probation. He was required to perform com-munity service and was thereafter placed on 2 years of unsupervised probation. Available documents do not clearly state that he expected sexual favors for the drugs, but the state boards were asked to provide cases with a sexual transgression, making this a logical assumption. His license was suspended for 2 years, but the board stayed the suspension and placed him on probation, subject to specific conditions. He was required to complete a college-level course in ethics, complete 15 hours of CE on the dispensing of controlled dangerous substances (in addition to the usual yearly CE requirements for maintaining his pharmacist’s license), and obey other directives. Repeat Offender: In another case of trading drugs for sex, a male pharmacist from Maryland asked a female customer at the retail pharmacy where he was employed to “exchange sex for pills.”17 He also told her that he knew she had passed fraudulent prescriptions in the past. The patient, known as the confidential informant, related this story to a narcotics squad. She was asked to wear a recording device to a meeting with the pharmacist in a diner, where he suggested they collaborate in a scheme to trade Lortab for sex. He demonstrated how she could forge a prescription for 50 or 100 Lortab 7.5 mg. He promised to pay for the prescription himself. He also urged his victim to go to a hotel with him to prolong their encounter. He later met her in the parking lot of the pharmacy, but gave her only five Lortab tablets in exchange for her forged prescription. He later met her to deliver the balance of the tablets, where detectives observed empty stock bottles and blister packs in his vehicle’s back seat. The pharmacist was arrested and the incident was televised, causing him to phone the state board to report that he had a sexual perversion. He asked the board to refer him for counseling. Meanwhile, a second informant (Patient A) came forward to report her experiences with the same pharmacist. He had called her house at 11 pm to deliver Percocet and OxyContin, for which he would not accept payment. He later called her cell phone, stating he had obtained the number from her patient profile. He went to her home and offered a “therapeutic massage” to help her neck and back problems, but insisted that he would only perform the massage at a time when her son was in school. He reportedly smirked as he offered to “rub her down all over her body.” He visited her late at night on another occasion and asked for a kiss. When she refused, he asked for a hug. On two or three other occasions, he made deliveries to her home but refused to take copays. Patient A reported that the pharmacist illegally switched strengths of OxyContin without contacting the prescriber at least twice, and undercounted the tablets, accusing her of taking them out of the bottle herself when he was challenged. She attempted to fill a legitimate prescription in his store, but called the police after he made her wait for 2 hours while helping other customers. He reportedly filled a Topamax prescription for her son, in a potentially lethal dose. However, no prescriber had ordered Topamax. Another patient’s experiences with the same pharmacist (Patient B) were even more bizarre. The pharmacist filled prescriptions for her, giving her free pens and eye drops. She had back surgery for which she required OxyContin. He met her for lunch during this time and bragged about the size of his genitalia. He offered to obtain free tablets for her. She later took him an OxyContin prescription, but he refused to fill it unless she “did something for him.” He gave her a “couple” of tablets, but insisted she meet him at a supermarket, locating him by looking for his new white Lexus. He forced her to lie down flat on the back seat so she would not be seen, and drove her to his home. He said she would not get her prescriptions unless she had sex with him, and she complied. He continued this pattern, often offering her wine or Xanax to relax her. He typically threw the prescription bottle at her after sex. He also attempted to withhold her son’s legal Adderall prescription. This pattern of behavior went on until a week before his arrest. Another patient (Patient C) also testified against the same pharmacist. She reported being incapacitated during a visit to the pharmacy where he worked. Taking advantage of this, he followed her home, where he engaged in a nonconsensual sexual act, forcing her to perform oral sex. She awakened the next morning in pain and bleeding, and he called later to say he was “very sorry.” He was charged with two counts of possessing a narcotic with intent to distribute, possession and distribution of a controlled dangerous substance, forgery of prescriptions, and prostitution. His criminal penalties, if any, were not available. His license was suspended for 18 months, and he was ordered to pass the Maryland MPJE. After that time, he would be placed on immediate probation for at least 3 years, during which time he was ordered to enroll in and complete six college-level credits in a board-approved ethics course, engage in therapy regarding sexual addiction and professional boundaries, and obey other conditions delineated by the board. Mingling Drugs in a Manner Not Customary In two cases (9.5%), pharmacists administered drugs to persons with-out their knowledge. In one such case, a male New York pharmacist was engaged to be married, but had carried on a 2-year affair with a pharmacist coworker.18-20 His pharmacist girlfriend became pregnant, and he offered to obtain misoprostol to induce contractions and force an abortion. She declined this offer, but made an appointment for an abortion, which she later decided against. He went to her house when she reached the 13th week of gestation, and without her knowledge placed misoprostol in two of her drinks (juice and water). He also inserted a misoprostol tablet intravaginally during each of two separate sexual acts. She miscarried, and the child did not survive. She noticed a partially dissolved tablet in her discharge, and realized what he had done to her. The male pharmacist was fired by his employer when his crime was discovered. He was charged with criminal homicide of an unborn child, first-degree murder of an unborn child, aggravated assault of an unborn child, and tampering with or fabricating physical evidence. Upon conviction, he was sentenced to prison for up to 23 months for violating Pennsylvania’s abortion laws (where the girlfriend lived at the time). Evidence tampering got the pharmacist another year in prison, and he was forced to pay a $1,500 fine. He applied to surrender his license, and the application was granted. In a second case of administering drugs to a person without her knowledge, a male Louisiana pharmacist pled “no contest” to administering drugs to a female, who became incapacitated as a result of the drugs; she later awoke in a different location without any memory of having gone there.21,22 The pharmacist was arrested on two counts of mingling harmful substances. Criminal penalties were unavailable. His license was suspended for 5 years, but the board suspended the period of suspension and his license was placed on probation for 5 years, with several conditions. For instance, he was required to attend a Professional Boundary Course (PB-24) and was forced to pay $250 in administrative costs, in addition to other actions. Indecent Exposure There were two cases (9.5%) in which a pharmacist exposed himself to others. A male pharmacist from Iowa was convicted of the serious misdemeanor of indecent exposure.23 He admitted to police officers that he had, on at least 20 occasions, engaged in a specific pattern of behavior. He would park his car in a retail pharmacy’s parking lot. When an adult female returned to her car, he would expose himself to her. He would next follow his victim to another location, but he did not elaborate on what he did thereafter. No information on the criminal penalties was available. His license was suspended indefinitely. However, the board stayed the suspension for a period not exceeding 60 days, during which time he was required to obtain complete physical and mental health examinations from a physician/provider approved in advance by the board. A report was required from the evaluator. The fully documented, written summary report had to affirmatively conclude that his mental and physical fitness allowed him to practice pharmacy, or his license would be suspended indefinitely. In a second exposure case, another male pharmacist from Iowa exposed himself to a female while at work.24 He admitted that he had also been drinking alcohol excessively for a period of time. His criminal penalties were not available. He agreed to an indefinite suspension of his pharmacist license. Other Inappropriate Behaviors In two cases (9.5%), pharmacists committed sexual battery or were otherwise inappropriate. A male pharmacist from Washington State was convicted on two counts of harassment with sexual or inappropriate touching, a gross misdemeanor.25 Criminal penalties assessed are unknown. His pharmacy license was placed on probation for 2 years, as long as he complied with terms and conditions. For instance, he was required to submit progress reports and notify the board if he retuned to practice in Washington. It is not known whether the victim was an employee or a patient. A pharmacist from Oregon made inappropriate comments to a female employee and gave her a gift.26 The gender of this pharmacist is unknown, due to the redaction of the offender’s name and the lack of revealing pronouns such as “his” or “her” in the board-supplied documents. His or her criminal penalties are not known. The license was reprimanded, and the offender was required to complete a course on inappropriate behavior and personal boundaries. Two cases (9.5%) were received in which the pharmacist had inappropriate contact with patients. A male pharmacist was working at a New York retail pharmacy when he was approached by a 42-year-old female visiting from Lebanon who asked for help with a nonprescription product.27 The pharmacist recommended a blood pressure reading and then offered to perform a breast examination, to which she agreed. Video cameras documented this “unreasonably long” procedure (4 minutes). After speaking to family members, the patient realized that the pharmacist’s actions were not routine and filed assault charges with authorities. She also filed a $40 million lawsuit. A company spokesman asserted that the pharmacist had been terminated as a result of an internal investigation. It is not known whether he was charged with or convicted of any crime. This research did not discover any action taken against him by his state pharmacy board. In a second case of inappropriate contact with a patient, a male pharmacist from New Mexico spoke to a female patient who complained of excessive abdominal cramping and pain.28 She apparently exposed her cesarean section incision site to the pharmacist. The pharmacist was accused of examining it both visually and manually. It is not known whether he was charged with or convicted of any crime. His license was suspended for 2 years, which was held in abeyance except for 30 days. He was required to inform the board when he would serve the 30 days of actual suspension. He was assessed a $1,000 fine, required to complete the New Mexico MPJE, and required to complete (at his own expense) a minimum of five counseling sessions with a licensed counselor or psychologist approved in advance by the board. These sessions would address appropriate boundaries in the pharmacist-patient relationship and any other issues underlying his conduct. Conclusion Pharmacists, like most people, have desires that may result in sexual indiscretions. Legal ramifications of these indiscretions include criminal penalties and possible actions by Boards of Pharmacy. Past board actions based on such indiscretions have resulted in penalties ranging from financial claims to license revocation. Pharmacists should be aware that sexual misconduct can significantly impact their professional career. REFERENCES 1. Summary of Regents Actions on Professional Misconduct and Discipline. Pharmacy. New York State Office of the Professionals. January 2011. www.op.nysed.gov/opd/jan11.htm. Accessed February 1, 2016.2. Summary of Regents Actions on Professional Misconduct and Discipline. Pharmacy. New York State Office of the Professionals. July 2012. www.op.nysed.gov/opd/jul12.htm. Accessed February 1, 2016.3. New Mexico Board of Pharmacy, Case No. 2002-094 (2003).4. Oklahoma State Board of Pharmacy, Case No. 882 (2008).5. Georgia State Board of Pharmacy, Docket No. 2013-0294 (2013).6. Prison awaits man who copped to child porn. Gwinnett Daily Post. July 31, 2011. www.gwinnettdailypost.com/archive/prison-awaits-man-who-copped-to-child-porn/article_2e972278-e6a4-5053-9b4b-f7f058e85815.html. Accessed February 1, 2016.7. Oregon State Board of Pharmacy, Complaint ID #19617 (2012).8. Summary of Regents Actions on Professional Misconduct and Discipline. Pharmacy. New York State Office of the Professionals. September 2011. www.op.nysed.gov/opd/sep11.htm#pharm. Accessed February 1, 2016.9. Higgins L. N.Y. teen sues molester who moved back next door. USA Today. February 9, 2014. www.usatoday.com/story/news/nation/2014/02/09/teen-sues-molester-next-door/5326449. Accessed February 1, 2016.10. Higgins L. Child molester says victim to blame for injuries. USA Today. February 13, 2014. www.usatoday.com/story/news/2014/02/13/child-molester-blames-victim-for-injuries/5471353. Accessed February 1, 2016.11. Georgia State Board of Pharmacy, Office of State Administrative Hearings, Docket No. OSAH-PLBD-PHAR-02-31226-134-JRA (2002).12. Nevada State Board of Pharmacy, Case No. 01-008-RPH-S (2001).13. Goudge v. State of Nevada, 287 P3d 301 (Nev 2012).14. Oklahoma State Board of Pharmacy, Case No. 974 (2010).15. Oklahoma State Board of Pharmacy, Case No. 988 (2010).16. Maryland State Board of Pharmacy, Consent Order for License No. 10300 (1996).17. Maryland State Board of Pharmacy, Case No. 08-076 (2009).18. Summary of Regents Actions on Professional Misconduct and Discipline. Pharmacy. New York State Office of the Professionals. June 2011. www.op.nysed.gov/opd/jun11.htm#pharm. Accessed February 1, 2016.19. Ertelt S. Pharmacist convicted for forcing girlfriend to have abortion. LifeNews. March 10, 2011. www.lifenews.com/2011/03/10/pharmacist-convicted-for-forcing-girlfriend-to-have-abortion. Accessed February 1, 2016.20. Smith PJ. New York cops nab pharmacist charged with murdering his unborn child. LifeSiteNews. April 8, 2010. www.lifesitenews.com/news/new-york-cops-nab-pharmacist-charged-with-murdering-his-unborn-child. Accessed February 1, 2016.21. Louisiana Board of Pharmacy, Case No. 14-0268 (2015).22. Lake Charles man arrested on drug-related charges. KPLC Louisiana News. April 9, 2011. www.kplctv.com/story/14483165/lake-charles-man-arrested-on-drug-related-charges. Accessed February 2, 2016.23. Iowa Board of Pharmacy, Case No. 2004-57 (2006).24. Iowa Board of Pharmacy, DIA No. 10PHB015 (2010).25. Washington State Pharmacy Quality Assurance Commission, Docket No. 07-04-1086PH (2007).26. Oregon State Board of Pharmacy, Complaint ID #21710 (2015).27. Ortiz P, Perlman MJ, Yaniv O. Tourist claims she was fondled at Duane Reade, sues for $40 million. NY Daily News. June 19, 2013. www.nydailynews.com/new-york/tourist-sues-duane-reade-fondled-exam-article-1.1377529. Accessed February 2, 2016.28. New Mexico Board of Pharmacy, Case No. 99-001 (2000). To comment on this article, contact rdavidson@uspharmacist.com.