Pharmacist, drugstore chain fined in death

Thursday, Oct. 26, 2000 | 10:22 a.m.

A major drugstore chain and the managing pharmacist of one of its Henderson outlets have received maximum fines for their roles in the death of a Texas woman who was given double the prescribed dosage of a prescription.

The Nevada State Pharmacy Board on Wednesday levied a $1,000 fine against Rite Aid and a $4,000 fine against Leona Sopko, managing pharmacist of the store at 525 Windmill Lane.

Rite Aid also agreed to donate $14,000 to the Nevada College of Pharmacy that is scheduled to open in January. The money will be used to train licensed pharmacists who have competency issues.

Also, Rite Aid will pay 75 percent of the state's legal expenses and investigative costs resulting from the probe of the Oct. 22, 1999, death of Veneda Cook, 64, of Pittsburg, Texas. She died from a brain hemorrhage that authorities said was caused by her taking the wrong dosage of the blood-thinning medicine, Coumadin.

Sopko, who also was suspended for 60 days and will be on probation for two years during which time she cannot serve as managing pharmacist, will pay 25 percent of the yet-to-be-determined legal and investigative fees, the board said.

The stipulation submitted to the pharmacy board avoided a hearing that would have been set for December.

Louis Ling, the board's general counsel, said a full-blown hearing would have produced no different an outcome as Nevada law limits the maximum fine to $1,000 per count for professional misconduct, which was levied in the four counts against Sopko and the single count against the drugstore chain.

He said such a hearing only would have added more hurt to an already hurtful situation for both Sopko and Cook's family.

As part of the stipulation, Sopko, a veteran pharmacist who had no prior history of job-related problems, offered a tear-filled statement in which she took responsibility for her actions in the death of Cook, who was visiting her daughter, Mary Hosea, in Las Vegas a year ago.

"I am really devastated by (Cook's) death and her family's loss. ... I wish I could go back in time," said Sopko, who obtained her license in the Philippines in the 1980s and worked in Florida before coming to Las Vegas in 1996.

"I know I made a mistake. I accept full responsibility. ... What happened to Ms. Cook will stay with me the rest of my life."

Ling said because Sopko "is a good pharmacist who became involved in a bad situation" her license should not be revoked.

Bill Cook, Veneda's husband, urged the board to "do everything in its power to see that other families not have this problem."

To that end, the board, voting unanimously, ordered all Rite Aid stores statewide to develop a policy for the future distribution of "narrow therapeutic index" drugs, which include Coumadin and 15 to 18 similar drugs.

The board also ordered the company to add to its computers a flagging system for such drugs, to better alert its pharmacists of the dosage, labeling and substitutions.

At issue in the case was the size of the pills and whether Bill Cook, who picked up the medicine on Oct. 5, 1999, was properly instructed as to how much to give his wife.

Cook was prescribed 5-milligram pills of Coumadin while her prescription called for 2.5-milligram tablets. The substitution was made because the pharmacy did not have the smaller dosage, the board was told.

Cook's prescribed dosage was 3.75 milligrams a day or 1 1/2 pills. When she took 1 1/2 pills of the larger dosage she was taking 7.5 milligrams for two weeks.

Mark Miller, corporate vice president of pharmacy operations for Rite Aid's West Coast operations, offered his condolences to the Cook family and said his company is taking steps "to prevent misfills."

"We fill hundreds of millions of prescriptions a year and errors are rarely made," he told the board. "We want to prevent that from ever happening."

He said quality assurance is a top priority for Rite Aid.

The matter also is the subject of a civil litigation.