The clinic’s maintenance’s staff contacted the tribe’s Department of Public Works to assist in unclogging a garbage disposal. Pills were found to have caused the clog.
“The medications were controlled medications and for security reasons the pharmacist documenting the medications for destruction, thought it would be best to destroy these medications right away, rather than waiting for the director to deliver to OPD,” said Jim Poels, Director of Pharmacy. “The pharmacist thought disposing the medications down the disposal would be safe and secure. Some of the medications are a new formulation that becomes gummy when exposed to heat or water. Because the medications became gummy, the disposal started to run slow.”
Poels assures that training of pharmacy staff dictates proper disposal of medication and that this incident is isolated.
“This is the first time a large quantity of medication has been disposed of improperly. Our normal standard is to send medications eligible for credit back to a contracted Return Goods company, or the Pharmacy Director takes them to the OPD drop box program,” Poels said.
Before the medication is sent back for credit or delivered to OPD Poels said a strict tracking procedure is to be followed by all pharmacy staff. While the medication waits to be disposed, it is locked in a secure cabinet.
“Summaries of medications are logged and witnessed by a second pharmacy employee. After proper documentation is completed, the Director of Pharmacy delivers the expired medication to the OPD lobby drop box for proper destruction,” explained Poels. “The only medication that is not delivered to OPD for destruction, is medication that the pharmacy can return for partial credit.”
The pharmacy works with a company called Capital Returns who will issue credits through the wholesaler.
“All medications that cannot be credited are inventoried and a report sent to Oneida Pharmacy on a destruction report,” added Poels.
A single pharmacist has been responsible for the improper disposal of medications. According to Poels, she has been following proper pharmacy protocol minus the disposal error.
“This person has been very diligent and precise in monitoring the dispensing, ordering and cross- checking records of controlled medications. She also completes a monthly inventory check to assure the accuracy of the pharmacy inventory,” said Poels.
Poels stressed though the disposal of medications through the sink is not best practice, it’s not illegal.
According to the Food and Drug Administration, little or no harm is done by flushing certain medications.
“The main way drug residues enter water systems is by people taking medicines and then naturally passing them through their bodies,” says Raanan Bloom, Ph.D., an environmental assessment expert at FDA. “Many drugs are not completely absorbed or metabolized by the body and can enter the environment after passing through wastewater treatment plants.”
In the aftermath of the improper disposals pharmacy leadership reiterated to staff during their monthly meeting the importance of proper medicine disposal. Also, reminder signs have been placed near sinks.
To dispose of your medications the Oneida Police Department has a drop box in their lobby. The medications are then destroyed by incineration.