Iowa Board of Pharmacy charges "the pharmacist" in compounding case

Graziano, Mark, Urbandale, Iowa, pharmacist license #16752

The Board issued a Statement of Charges and Emergency Order in May 2012 for 20 counts including:

Failing to maintain adequate control over and accountability for controlled substances

Failure to establish effective controls against diversion of controlled substances

Failure to maintain records as required by the Controlled Substances Act

Failure to properly sign and date invoices for controlled substances

Dispensing Schedule II controlled substances in quantities exceeding prescriber authorization

Failure to comply with requirements for the partial filling of Schedule II controlled substances

Failure to maintain complete and accurate perpetual inventories of Schedule II controlled substances

Failure to maintain a complete and accurate inventory of controlled substances

Failure to document verification of controlled substances refills

Failure to properly supervise dispensing functions that are delegated to non-pharmacists

Failure to maintain complete patient records

Failure to ensure that all pharmacy technicians have a current and active technician registration

Failure to maintain required policies and procedures for the operation of the pharmacy

Failure to provide proper security for prescription medications and pharmacy records stored in the basement

Failure to wear an identification badge

Failure to have required policies, procedures and documentation for pharmacy technician training

Failure to have a continuous quality improvement program

Failure to meet minimum standards for sterile compounding

Failure to provide labeling and record keeping for patient med paks

Failure to provide adequate patient counseling to patients

Charges were initiated following two secret shopper surveys of the pharmacy, a routine inspection of Bauder Pharmacy where he served as PIC, as well as an audit of controlled substances (looking at the DEA ARCOS report and PMP dispensing records) which found significant areas of non-compliance and the likelihood of diversion of hydrocodone-containing products.  The Emergency Order immediately and indefinitely suspended his pharmacist license.  An administrative hearing was held in February 2013.  The Board approved its Decision and Order in April 2013 in which it permanently revoked Mr. Graziano's pharmacist license.         [2013]

Following a partial remand order from Polk County District Court, the Board held an administrative hearing in October 2013 to hear additional evidence related to the pharmacy's policy and procedure manual to determine if its April 2013 Order would require any change.                 [PEND]