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The Virginia Board of Medicine reports that three physicians practicing in the Twin Counties were reprimanded for pre-signing multiple blank prescriptions for a nursing home, in violation of state code.
The prescriptions were to be used only for emergencies, but were “not dated or signed by [the doctors] on the day when issued, as required by the Code [of Virginia],” the board found.
The board issued the reprimands in June 2012. All three physicians are still permitted to practice medicine, and their licenses were not revoked or suspended.
All three physicians have signed consent orders with the Virginia Board of Medicine, which stipulate that they admit to the board’s findings of fact.
The physicians reprimanded were Dr. Bradley Jackson Goad, doctor of osteopathy; Dr. Vanessa Sturgill Fant, M.D.; and Lee Adam Thompson, a physician’s assistant.
According to consent orders signed by the physicians, in early 2011 they signed blank prescriptions “with the intent that the prescriptions be kept on-site at a long-term care facility for which [the] practice group provided care.”
The board’s report does not identify the nursing home or its location.
On April 18, 2011, “in order to obtain Lortab [hydrocodone] that had been ordered by a physician assistant for Patient A’s acute pain event, a member of the nursing staff at the long-term care facility used one of the pre-signed blank prescriptions and wrote in the medication prescribed, dosing instructions, quantity and refill amount,” according to the board’s report.
“The nurse who completed the prescription stated that she wrote in the medication and dosing instructions based on a telephone order from a physician assistant in [the physicians’ group to which Fant, Goad and Thompson belong]; however the nurse determined the quantity and refill amount ‘based upon what the physicians normally prescribe,’ in this case 30 dosage units with six refills,” the board reported.
“The prescription was then faxed to a pharmacy, and the pharmacy gave permission to nursing staff to obtain Lortab from the facility’s on-site stat-drug box so that it could be administered to Patient A.”
The board reports says the prescription included printed information identifying Thompson as the prescriber, although he was not the physician assistant who orally ordered the medication for the patient.
Fant, Goad and Thompson all stated that the pre-signed prescriptions were only intended to be used for nursing home residents in emergency cases “and were intended to be completed only by three members of the nursing staff at the facility who had been designated by the practice group as ‘prescribing agents,’” according to the consent order.
The medical board’s orders in each case state that the physicians “shall maintain a course of conduct in [his or her] practice commensurate with … all laws of the Commonwealth.”
The North Carolina Medical Board issued similar reprimands to Goad and Fant last month, relating to the same incident in Virginia. They both have licenses to practice in that state, as well.