Vermont’s Office of Professional Regulation is pursuing charges against Walgreens pharmacies across the state, alleging the company’s policies and procedures are to blame, in part, for unsafe conditions at those stores during the last three years.
The allegations include untenable working conditions for pharmacists due to insufficient staff; medication and vaccination errors; stores losing track of controlled substances; and unexpected store closures without notice, leaving patients with no clear way to fill prescriptions for days at a time.
On June 21, the office’s prosecuting attorney filed a 40-page charging document against the national chain, requesting that the Vermont Board of Pharmacy “revoke, suspend, reprimand, condition or otherwise discipline” the licenses of the state’s 32 Walgreens, all of which are implicated in the document.
Fraser Engerman, Walgreens’ senior director of external relations, said in an email Thursday that the company would not make any statements at this time.
According to S. Lauren Hibbert, director of the Office of Professional Regulation, the charges emerged from 70 complaints filed by Walgreens employees and customers, as well as employees of other Vermont pharmacies.
According to the office’s investigation, in the spring of 2021, a patient at the Manchester Walgreens was allegedly prescribed capsules five times stronger than her usual dose, which resulted in hallucinations, nausea and blurred vision for several days and caused her to miss school.
In October 2021, according to the charging document, a patient at the Pearl Street Walgreens in Essex Junction was given a Pfizer Covid booster instead of the flu shot they requested.
The document describes another incident at the St. Johnsbury Walgreens in November 2021, during which three children received Pfizer vaccines that were erroneously diluted with a substance that had not been approved for that use, which meant the children needed to receive another dose.
At the Walgreens in Morrisville on April 9, 2021, the document states, pharmacy staff found the safe containing Schedule II Controlled Substances ajar and discovered the drugs in question on the main shelves as well as discrepancies between the inventory and what was in the store. The pharmacist-manager for the store indicated that he had been unable to keep up with the controlled drug inventories for some time due to the workload, adding that he sometimes left the safe door open because it was tricky and on a three-minute delay between inserting the key and opening the safe.
A large number of the allegations detail unexpected store closures without notice to patients that prevented them from being able to pick up necessary prescriptions, causing missed doses and out-of-pocket charges from other pharmacies.
In one instance, a patient identified as “L.N.” missed multiple doses of his strict medication protocol for a tick-borne illness in May 2021 due to the unexpected closure of the Walgreens on Putney Road in Brattleboro. The document states that L.N. and his family spent hours attempting to get the medication, including calling the store multiple times and traveling to the store during normal business hours to find it closed. Eventually, L.N. was able to get his prescription filled at a Walgreens in New Hampshire.
At the Walgreens location on Susie Wilson Road in Essex Junction, the document states that the pharmacist-manager worked 12-hour shifts daily, and came in early and stayed after her finishing shifts. She was also allegedly required to work during a time when her partner, with whom she shared a home, tested positive for Covid.
The Essex Junction pharmacist-manager reached out to Walgreens on a number of occasions with concerns about the untenable workload and stressful conditions, but the company “failed to provide any assistance and told the employee to ‘be patient’ and ‘be a leader,’” the document states.
In October 2021, the pharmacist-manager resigned, citing “horrible pharmacy practices” resulting from the lack of resources and support from Walgreens.
Complaints from the same store also reported that the pharmacy staff members were unable to answer the phone most days. In November 2021, a floater pharmacist allegedly informed a caller that the pharmacy was “barely open” and whatever prescription the caller was looking for “probably wasn’t ready” due to the lack of staff.
When the same floater pharmacist reported the unsafe workload and lack of staffing issues to his district manager, he reported being told to “figure it out” and “we need to be Netflix, not Blockbuster.” According to the charging document, Walgreens Corp. provided no assistance in response to the floater pharmacist’s plea for help.
Documentation shows that the lack of pharmacy staff resulted in over 325 days of unexpected Walgreens closures throughout the state between July 2020 and April 2022.
According to Hibbert, the majority of violations fall under the unprofessional conduct statute for pharmacies, which was added by the Legislature in 2021 after urging from her office. The Office of Professional Regulation asked the Legislature to modify the statute after a survey of workplace conditions for pharmacists in the fall of 2020 found that conditions for pharmacists were stressful and difficult, creating an unsafe situation for patients.
Hibbert told VTDigger on Thursday that state law constrained the extent of her comments, but the document itself speaks to why the enforcement division felt it needed to act.
“Pharmacies play a critical role in the health care of Vermonters, who deserve safe and reliable access to the important medications they depend on,” Secretary of State Jim Condos said in a statement on Thursday afternoon. The Office of Professional Regulation is part of the Secretary of State’s office.
According to Hibbert, Walgreens has 20 days from the June 21 filing date to respond to the charges. After that response, a hearing will be held by the Board of Pharmacy, during which the state will be asked to prove the allegations.
Condos said that process can take time to complete.
Lauren Bode, interim executive director of the Vermont Pharmacists Association, said Thursday that the association was “utterly appalled” by the complaints detailed in the document but, “unfortunately, not terribly surprised.”
“The pandemic has certainly exacerbated the working conditions in certain pharmacies, but these trends predate the pandemic as well,” she said. “These have been known issues, and we’re really grateful to the Office of Professional Regulation for doing this diligent investigation and weighing these charges at the responsible party – which is the pharmacy chain.”