MISSOURI pharmacist charged with diluting cancer drugs; officials trying to find patients


Wednesday, August 15th 2001, 12:00 am
By: News On 6



KANSAS CITY, Mo. (AP) _ A wealthy pharmacist accused of diluting chemotherapy drugs surrendered to the FBI on Wednesday as investigators studied his records page by page to find patients who may have been given weakened treatments for cancer.

Authorities said some intravenous drug bags contained less than 1 percent of the dosages ordered by doctors.

Robert R. Courtney, 48, is accused of diluting prescriptions for Taxol and Gemzar filled at his Research Medical Tower Pharmacy in Kansas City.

He was charged Tuesday with a single felony count of misbranding and adulteration of a drug and was ordered held without bond by a judge who called him a flight risk. The court order also said Courtney was worth more than $10 million in stock and property.

If convicted, Courtney faces up to three years in prison and a $250,000 fine. He did not speak during the hearing, but defense attorney Jean Paul Bradshaw _ a former U.S. Attorney in Missouri _ said he expected his client would plead innocent.

Bradshaw said Wednesday he and Courtney were cooperating with the government to address some of its concerns, specifically the issue of the number of patients that may be involved.

``Any patients the government would be concerned about is a much smaller number than has been suggested in recent media reports,'' Bradshaw said. He declined to elaborate.

Federal investigators said Tuesday there could be hundreds of patients who received improper dosages.

There was no immediate indication whether any patients have been harmed. An FBI hot line set up to find potential victims had recorded more than 150 calls by Wednesday afternoon.

``What we're looking at is possibly hundreds of patients. It's going to be a very long investigation,'' FBI spokeswoman Bridget Patton said.

Another FBI spokesman, Jeff Lanza, added: ``Our records indicate there were many instances over a period of time.''

Authorities refused to discuss a possible motive, but have repeatedly pointed to the hundreds of dollars in savings per dose produced by the alleged dilution of expensive cancer drugs. In one alleged case, dilution would have saved the pharmacy about $780 for an order of drugs.

Taxol is a second-line therapy for advanced ovarian or breast cancer and is used against AIDS-related Kaposi's sarcoma and lung cancer. Gemzar is used to treat pancreatic cancer and some types of lung cancer.

According to the U.S. attorney's office, the dilution was discovered by a sales representative for Eli Lilly and Co., which makes Gemzar.

The representative noticed a discrepancy between the amount of Gemzar the pharmacy ordered and the amount it had billed an unidentified Kansas City-area doctor.

The doctor consulted with Eli Lilly but at that time did not have any Gemzar in stock that had been supplied by the pharmacy. The doctor sent a sample of Taxol, which is made by Bristol-Myers Squibb, to an independent laboratory, which reported in June that the sample contained less than one-third as much Taxol as prescribed.

Last month, the doctor gave the FBI and Food and Drug Administration other samples, which turned out to contain only 17 percent to 39 percent of the amount of Gemzar that had been prescribed.

Tests on later samples showed Taxol at 28 percent of the prescribed strength, the U.S. attorney's office said.

Federal agents seized records from Courtney's Kansas City pharmacy Monday. He also owns a pharmacy at the Shawnee Mission Medical Center in Merriam, Kan., but the FBI did not say if it was under scrutiny.

Susan Winckler, a pharmacist and an attorney at the American Pharmaceutical Association, said such cases are extremely rare.

While pharmacists have been known to steal drugs such as morphine for their own use, Winckler didn't know of another case where a pharmacist had diluted a potentially lifesaving treatment for cancer.

``If the allegations are true, it's tragic,'' she said.

Courtney's pharmacy license was placed on probation for one year beginning in July 1992 for practicing after his license had expired, said Kevin Kinkade, executive director of the Missouri State Pharmacy Board.

Referring to the latest accusations, Kinkade said: ``I don't know of any other case that we've had like that.''