BOSTON — Random inspections by the Massachusetts state board resulted in fines for 20 veterinary hospitals for having expired medications.
The Massachusetts Board of Registration in Veterinary Medicine reportedly swept through 104 veterinary practices in the state over the last year, according to officials.
But the recent activity spurred questions about board rules as it relates to expired medications, says Massachusetts Veterinary Medical Association (MVMA) Executive Director Susan G. Curtis. The inspections, Curtis adds, serve as a reminder for veterinarians to keep up on clinic housekeeping.
"In my opinion, I feel the board's guidelines are a little vague," says Curtis.
Dr. John Spodick of Swan Corner Animal Hospital in Tyngsborough was in the hospital during two board inspections of his practice in 2011. He says his staff tried to take care of as much in his one-doctor practice as they could, but left the task of sorting expired drugs to him when he returned.
"They were all put aside, but they hadn't written 'expired' on the side of the bottles, which apparently is the regulation," Spodick says.
After four months of dealing with personal illness, Spodick ended up with a $500 fine for two offenses.
Cases like Spodick's are the reason Curtis says MVMA asked the board to clarify its rules on expired medications. She heard of at least one of its inspectors telling a practitioner that expired medications needed to be labeled as such, not simply disposed of or separated from other drugs. Curtis says the guidelines don't mention anything about writing "expired" on the medication container, Curtis says.
"(Most veterinarians) have pretty stringent policies about maintaining their meds," says Curtis. "We just want to make sure the veterinarians in the state know what the board is looking for and we're all on the same page."
Curtis says she is hopeful to hear from the board soon, saying the clarification will ensure "there won't be any room for misinterpretation."
Although he didn't discuss specifics about his violations, Dr. Ronald Majdalany of Seekonk Veterinary Hospital in Great Barrington—who was fined $1,000 for his third expired medications violation following a Nov. 23, 2011 inspection—says he has no problem paying the board's fine and has already mailed it in. Medication containers can go unnoticed at the back of a shelf and be missed during inventory, and the violations came from "stuff that happened to be overlooked," he says.
Majdalany says his three violations were found at three separate unannounced visits by the board, all within the last year.
Dr. Laura Jones of Greylock Animal Hospital in North Adams also was visited by the board on Dec. 29, 2011, but no violations were found at the practice or its satellite location in Adams. But the Adams location had been warned for keeping medications in an "inadequate cabinet" that didn't attach to the wall, she says.
Dan Rosenfeld, director of communications for the Massachusetts Office of Consumer Affairs and Business Regulation, says inspections were chosen randomly from the more than 3,000 veterinarians licensed to practice in Massachusetts. Inspections are done "periodically," Rosenfeld says, adding the state's Division of Professional Licensure also carries out unannounced, random inspections at the offices of 30 other licensed professionals, including accountants, optometrists and funeral homes.
But it would make sense that the board may first revisit practices that were previously warned or fined, Jones says.
Curtis agreed. "I would think anyone who's been fined should expect to be seen again in a short period of time."
But overall, Jones says the inspection "wasn't that big a deal. We're pretty prepared and pretty careful with expired drugs, so I wouldn't say it was terribly inconvenient," she says, adding the inspection only lasted 15 minutes.
Although Rosenfeld says the inspections are not aimed at generating new revenue for the state through fines, Jones says she feels as though inspections increased as the economy worsened. She has worked at the same practice since 1990. In all that time, they had maybe one inspection until the last year, when the state visited twice.
"They've definitely stepped it up, especially since the economic downturn," she says.
In all, Rosenfeld says the inspections generated $3,800 in fines. Sixteen practices were fined $100 for a first-time violation of the expired medication regulation, and one was fined $200 for a first-time violation for both expired and unsecured medications. Two practices were fined $500 for a second-time expired medications violation and only one was fined $1,000 for a third-time violation. Another 83 practices were inspected by the board and found to be in full compliance, Rosenfeld reports.
Stay on top of expired drugs, but also make sure chemotherapy drugs are properly labeled and stored, Jones suggests. All controlled drugs should be stored properly, and she suggests keeping a lock box in treatment rooms for drugs used throughout the day.
"Certainly, being inspected is not a big deal if you keep on top of it," she says. "You really have to make it part of your schedule. Once a month, someone should go through your inventory."