On December 6, the Department of Justice announced that a federal court ordered Elk Pharmacy Inc., a pharmacy in Elkin, North Carolina, to pay a $500,000 penalty and comply with an injunction to prevent the unlawful dispensing of controlled substances. The injunction prohibits the pharmacy and its pharmacists from filling prescriptions, including for opioids, without implementing measures to “ensure the drugs will not be abused or diverted.”

The consent decree resolves a United States complaint filed on November 27. According to the government, Elk Pharmacy and its pharmacists, including owner Larry Irwin and pharmacists Susan Baker, S. Jason Couch, Beth Pence, and Lori Wyble, violated the Controlled Substances Act (CSA). The government alleged in its complaint that the individuals disregarded numerous “red flags” when filling prescriptions. The alleged red flags included filling prescriptions for dangerous drug combinations, long-term high-dose opioids exceeding medical guidelines, and prescriptions for individuals who appeared to be engaging in doctor or pharmacy shopping. Additionally, the pharmacists were accused of filling prescriptions written by providers suspected of illegal prescribing practices, including one barred by the North Carolina Medical Board from prescribing controlled substances.

The consent decree includes a permanent injunction prohibiting Elk Pharmacy and its pharmacists from filling certain prescriptions that raise “red flags.” It also requires the pharmacy to collect additional documentation to justify specific prescriptions before dispensing them.

Federal authorities emphasized the importance of accountability within the pharmaceutical industry. Principal Deputy Assistant Attorney General Brian Boynton, head of the Justice Department’s Civil Division, stated that pharmacists play a critical role in protecting consumers from the dangers of controlled substance abuse. He noted that the Justice Department will continue to hold medical professionals accountable when they fail to fulfill this duty. 

This case highlights the importance of pharmacists and healthcare providers establishing clear, defensible procedures to address potential “red flags” in controlled substance prescriptions. Ambiguities in what constitutes a red flag can leave professionals vulnerable to scrutiny. To mitigate this risk, pharmacists should develop and follow detailed internal guidelines for evaluating prescriptions, documenting their decision-making process, and ensuring compliance with regulatory standards. By maintaining thorough records and adhering to established protocols, providers can demonstrate due diligence if questioned about their practices.

If you or your business is facing allegations of noncompliance with controlled substance regulations or other healthcare-related investigations, the attorneys at Chilivis Grubman can provide experienced guidance and representation. Contact us today to discuss your options.