A 2-year-old. A death. A pharmacist facing jail. What will spur lasting change?

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Mortar and Pestle courtesy of Wikimedia Commons

CLEVELAND, Ohio — Trade groups are preparing a legislative push to shield pharmacists from criminal prosecutions — disturbed by the potential of jail time for a Cleveland-area pharmacist after his mistake contributed to the death of a young girl.

“The day we start putting physicians, pharmacists, dentists and others in the health profession in jail for mistakes that were made, honestly, with no malice, is the day people choose not to be in the profession,” said Ernest Boyd, executive director of the Ohio Pharmacists Association.

Former pharmacist Eric Cropp faces up to five years in prison after pleading no contest Wednesday to involuntary manslaughter.

Cropp in February 2006 approved a pharmacy technician’s mix of chemotherapy solution for 2-year-old Emily Jerry, who was being treated at University Hospitals Rainbow Babies & Children’s Hospital. The mix was 23 percent salt-based when it should have been only 1 percent.

In  state testimony later, the technician said she told Cropp there was something wrong with the mixture, though he still approved it. Emily died days later.

The case help spark scrutiny and reform of pharmacy technicians along with the prosecution of Cropp, who was stripped of his license in 2007 for his error in the Jerry case and 15 subsequent other errors. Ohio legislators passed Emily’s Law, which created licensing and minimum education requirements for pharmacy technicians — a change largely cheered by educators and others in the local industry. A federal version of the Ohio law, Emily’s Act, was introduced and referred to a Congressional subcommittee last year.

USA Today included the Jerrys in a series of stories on pharmacy errors that highlighted, among other things, how the volume of work and retail chains’ ties to oversight committees can contribute to errors.

But concern over Cropp’s fate — and its impact on the pharmacy industry — have grown. The non-profit Institute for Safe Medication Practices, which focuses on the prevention of medical errors, late last month (pdf) called the prosecution “inappropriate and unwarranted.” Cases like this could make pharmacists less likely to report errors and slow systemic change — things that are likely to prevent future tragedies, the institute stated.

“Criminal prosecution sends the false message that clinical perfection is an attainable goal, and that ‘good’ health-care practitioners never make errors and should be criminally punished if they are involved in an error,” the institute stated.

Ryan Miday, spokesman for Cuyahoga County Prosecutor Bill Mason whose office handed Cropp’s case, declined comment on the prosecution because the case is ongoing. Cropp is scheduled for sentencing in mid-July.

Boyd thinks that even Emily’s Law would not have prevented the 2-year-old’s death. “I have to tell you that no amount of testing would have solved this issue — which is that someone didn’t pay attention at the right time,” said Boyd, who said a civil trial would have been more appropriate in the Emily Jerry case.

The Ohio Pharmacists Association has joined “internal conversations” with other chapters and their national association about pushing for a kind of “no fault” system similar to what was approved in the 1970s by the Federal Aviation Administration, Boyd said. Under the FAA’s doctrine, pilots and controllers are immune from disciplinary actions if they file timely reports — the exception being for “reckless operations, criminal offenses, gross negligence, willful misconduct and accidents,” according to a history of the agency (pdf).

Boyd said pharmacy groups plan to be ready in about a year to begin a likely federal effort.

The Jerry family, in testimony two years ago in front of the Ohio Pharmacy Board, called Cropp’s actions reckless and an “inexcusable and intentional homicide” of their daughter. If that’s the case, not even an FAA-like policy would have protected the former pharmacist.

“Eric Cropp’s incompetence goes far beyond conducting one reckless act,” Kelly Jerry, Emily’s mother, stated to the board. “Eric Cropp consciously disregarded any and every set standard of protocol regarding patient safety.”

[Photo courtesy of Wikimedia Commons.]

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Chris Seper

By Chris Seper MedCity News

Chris Seper runs MedCityNews.com and contributes regularly to the site. He is the vice president of healthcare for Breaking Media, MedCity's corporate owners. Reach him at [email protected]
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