Weekly Mass Torts Bulletin 2023-June-26

Cheshire Medical Centre (CMC) in Keene will pay $2 million to address claims that it violated the prohibited drugs Act (CSA) by failing to maintain correct records of prohibited drugs, including opioids.

Due to Cheshire Medical Center's violation of the Controlled Substance Act, prescription narcotics, including potent opioids like fentanyl, were stolen. As a result, an alarmingly high percentage of the medications in CMS's inventory was missing. The attorney said that the discovered shortcomings called for a multi-million dollar fine and a strict remedial action plan. This is one of the biggest drug diversion lawsuit settlements against a hospital in the nation.

A DEA special agent stated that the agency is dedicated to ensuring that all registrants are in compliance with the necessary laws, which are enforced under the Controlled Substances Act. Inaction puts public health and safety in danger and raises the possibility of diversion. To guarantee that these laws and regulations are followed, DEA promises to collaborate with our law enforcement and regulatory partners.

The CSA prohibits the inappropriate use of restricted drugs and the illicit distribution, possession, dispensing, and distribution of these substances, all of which have fueled the opioid crisis. To avoid misuse, the CSA mandates precise inventorying, monitoring, and documentation of each prohibited drug.

After a nurse stole 23 intravenous bags of fentanyl solution from an automated drug dispenser, the Drug Enforcement Administration (DEA) launched an investigation against CMC. In February 2022, CMC first informed the DEA about this theft. Six hundred thirty-four further bags of fentanyl were eventually listed as missing by CMC. On March 3, 2022, the nurse who allegedly took these medications passed away. In April 2022, DEA investigators conducted audits of eight controlled substances at CMC's inpatient pharmacy, which included audits of fentanyl 2ml vial; fentanyl 50 ml vial; fentanyl 50 ml IV bag; midazolam 2ml vial; lorazepam 1ml vial; hydromorphone 4mg tablet; hydromorphone 1 ml vial; and morphine sulphate 1ml vial.

Additional 17,961 missing controlled drug units were found as a result of this audit, and CMC was also found to have a number of associated recordkeeping flaws, including failing to retain appropriate purchase and dispensation records. The audit also showed that CMC did not, among other things, regularly review reports to look for potential diversion, have adequate systems in place to notify it when purchases of controlled substances significantly increased from one month to the next, or enforce various controlled substance security policies.

The agreement put an end to claims that CMC had broken the CSA's and its rules' record-keeping guidelines. In addition to the voluntary enhancements made by CMC before and during the DEA investigation, CMC has committed to additional security and recordkeeping procedures as part of the settlement. The investigation that resulted in the settlement agreement was overseen by the Drug Enforcement Administration.

As part of a multi-state settlement with pharmaceutical companies Teva and Allergan, as well as retailers CVS and Walgreens, the State of Idaho will receive $76 million to aid in the battle against the opioid crisis.

The firms will pay $17.3 billion in total as part of the deal. Walgreens will pay $5.7 billion, while CVS will pay $5 billion, according to reports. Allergan and Teva, two producers of opioids, will each pay $2.37 billion and $4.25 billion, respectively. Idaho will receive $76 million over 15 years, and funding for state and local governments is anticipated to begin flowing by the end of 2023.

According to Idaho's AG, the pharmaceutical industry has made money for years by selling and distributing harmful opioids. Unrestricted access to these substances has wreaked havoc on our neighborhoods. This agreement holds the whole industry accountable and shows our dedication to altering the ways in which opioid medicine manufacturers and their distributors conduct business.

In accordance with the agreements, Teva's opioid division must also offer strict injunctive relief to stop all opioid marketing and guarantee that safeguards are in place against drug abuse. Additionally, Allergan must stop marketing opioids for the following ten years.

Pharmacies CVS and Walgreens have committed to monitoring, reporting, and exchanging information about any questionable behavior involving opioid prescriptions.

Attorneys General from North Carolina, Iowa, California, Illinois, Maryland, Massachusetts, New York, Pennsylvania, Tennessee, Texas, Vermont, Virginia, and Wisconsin led discussions with Teva and Allergan.

Attorneys General from North Carolina, California, Colorado, Connecticut, Delaware, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Nebraska, New York, Ohio, Pennsylvania, Rhode Island, Tennessee, and Texas were in charge of the discussions with CVS and Walgreens.

Summit County stands to earn a piece of the $209 million that Utah will get as part of a recent nationwide opioid settlement with drugstore chains and pharmaceutical companies.

The most recent accord, which is a part of a $17.3 billion multistate settlement with pharmaceutical companies Teva and Allergan as well as retailers CVS and Walgreens, was made public by the Utah Attorney General. Walmart is a party to a federal deal that is still being finalized but is likely to happen soon. Summit County will receive an undisclosed amount of money, although it is anticipated that payments will begin before the year's end.

Walmart must pay up to $2.74 billion in 2023, with the remainder payments to be made over the following six years, according to the total deal, while Allergan must pay $2 billion over a seven-year period.

Additionally, Walgreens must pay $5.5 billion over 15 years, while CVS must pay $4.9 billion over 10 years. Teva must pay $3 billion over 13 years and, depending on the state, either offer $240 million in cash instead of the product or $1.2 billion of its generic version of Narcan, a drug that quickly reverses an opioid overdose, for 10 years.

Additionally, it stops Allergen and Teva from promoting and selling opioids for ten years. The settlement stipulates that the pharmacies must alter the way they manage narcotics.

Although the lawyer was unable to give particular statistics since the payoff schedule hasn't yet been made public, the shorter time frame will result in more money for Summit County up front. As part of the initial settlement, the County Courthouse is anticipated to receive payments totaling roughly $70,000 each.

The state will keep half of the new $209 million settlement, while the remaining sum will be distributed to the counties that agreed to the agreement. Nearly all of Utah's 29 counties are said to have taken part in the arrangement, and the shares are based on opioid usage risk, which frequently correlates with population. Certain restrictions, which reserve the majority of the funds for treatment and prevention, apply to the money.

The majority of the first round of settlement monies were given to treatment in November by Summit County, with the remaining 40% going to preventative initiatives. Last fiscal year, the county received two payments totaling $61,856 and $86,309 that might have been used for drug misuse prevention, education, and treatment.

Officials in the field of behavioral health pushed for the money to be used for supportive housing, medication-assisted therapy, training for law enforcement, job placement or training, and childcare for patients.

In the Summit County Jail, medically assisted treatment—medication used in conjunction with counselling and behavioral therapy to lessen withdrawal symptoms—was also suggested. Pre-arrest diversion and post-overdose response programmes, together with strengthening linkages between at-risk people and behavioural health providers, were potential preventative methods.

Additionally, Summit County can yet receive additional funds. The lawyer is defending the county in a number of ongoing litigation over the opioid epidemic. There are fewer lawsuits currently than there were last autumn since many of the larger defendants have already reached settlements, with little or no benefit to the neighborhood.