Abstract
Robert Courtney, a pharmacist, diluted tens of thousands of injectable and infused medications during the course of a decade. He was found guilty under numerous counts and is now serving time in federal prison. The case has legal and ethical ramifications.
Keywords: drug tampering
The Robert Courtney Case
“Our law is by definition a codification of morality.” Barack Obama, 2006
Robert Courtney, a pharmacist, pleaded guilty to and was convicted for intentionally diluting cancer chemotherapy solutions for IV administration to patients. He was sentenced to thirty years in prison, which was an increase from the Guidelines for Imprisonment. The United States Court of Appeals affirmed the sentence (United States v. Courtney,362 F.3d 497).
Rights and Expectations of the Patient
Federal and state law and regulations determine what rights a patient has when undergoing healthcare. Moral and professional ethics determine what is the right way for a patient to be treated by healthcare providers.
Patients have the legal or ethical rights and expectations to (1) be treated with dignity and respect, (2) be attended by healthcare providers that are fully committed to their welfare, (3) be prescribed the right medications for their treatment, (4) be provided with the prescribed medications at the prescribed doses, (5) be cared by healthcare providers who act with honesty and integrity in their professional relationships; and, finally, (6) be treated with care (Pharmacist Code of Ethics).
Violation of Patient Rights and Expectations
Courtney provided diluted doses of chemotherapy agents to cancer patients in violation of his professional relationship with the patients. When the diluted medication was administered to the patients, they suffered serious bodily injury in violation of their legal rights and ethical expectations to be provided with the proper medications at the prescribed doses. Courtney may also be guilty of battery because the product he provided for the patient caused bodily harm. Withholding the proper treatment showed lack of care and violated the patients’ dignity.
Fiduciary Duty
Courtney was in a patient-provider relationship with the patients, a relationship that is protected by the ethical laws of the pharmacological profession (Pharmacist Code of Ethics), and as such he owed them the duty not to do harm. The patients were harmed as a direct consequence of Courtney’s actions.
Legal and Ethical Issues
Court Ruling
Courtney was found guilty of product tampering leading to serious bodily injury and of fraud. The court handed Courtney the most severe punishment it could under the guidelines for prisoners. In a special move, the court invoked a special law that allowed it to raise the level of punishment three levels (United States v. Courtney,362 F.3d 497).
Application of the Law
The court found that Courtney’s crimes were in severe violation of ethical principles of behavior. The court was able to raise the level of punishment by not allowing Courtney to enjoin all the patients into one wrong, but rather treating each patient’s case as a separate criminal and unethical event (United States v. Courtney,362 F.3d 497).
Criminal Liability
There is no question regarding Courtney’s criminal liability as to the tampering of products that resulted in bodily harm. He is also guilty of fraud for misrepresenting the product and for filing false insurance claims. What is not clear is whether he was also guilty of manslaughter or murder because it has not been determined whether any patient died as a direct result of the tampered medication (United States v. Courtney, 240 F.Supp.2d 1052).
Appeal
Courtney appealed for a reduction of his sentence citing his generous contributions to the community, his extreme remorse, and his responsible move in trying to make retribution to his victims. The court denied his appeal (United States v. Courtney,362 F.3d 497).
Imprisonment
Courtney was sentenced to 360 months in federal prison. He has to serve half his sentence before he can hope for parole (United States v. Courtney,362 F.3d 497).
Changes in Medication Protocol
There has been talk of new safeguards or laws to prevent crimes like this from ever happening again, but nothing specific has been accomplished. Eli Lilly, one of the pharmaceutical companies that provided drugs to Courtney, is considering designing tamper proof medications. Otherwise, most in the pharmacological industry feel this was an isolated case of malfeasance.
References
United States v. Courtney, 240 F.Supp.2d 1052, 1054 (2002). Retreieved from
http://www.leagle.com/xmlResult.aspx?xmldoc=20021292240FSupp2d1052_11174.xml&docbase=CSLWAR2-1986-2006
United States of America, Appellee, v. Robert Ray Courtney, Appellant.
United States Court of Appeals, Eighth Circuit. - 412 F.3d 855. Retrieved from http://law.justia.com/cases/federal/appellate-courts/F3/412/855/544702/
“Pharmacist Code of Ethics & Oath – Pharmacy Pledge & Sworn Statement.” Web.
Retrieved from
http://www.uspharmd.com/pharmacist/pharmacist_oath_and_code_of_ethics/
