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Drug diluting in Kansas City: A pharmacist's crime shakes a community

Physicians are left scanning medical records, notifying some patients and reassuring others. Rebuilding trust will likely be as complex as sorting everything out legally.

By Victoria Stagg Elliott, amednews staff. May 20, 2002.

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Last month, Audrey Kunin, MD, a dermatologist in Kansas City, Mo., received two letters. One was from the local health department informing her that a drug she ordered to treat a patient's skin disorder may have been diluted by the local pharmacist who filled the prescription. The other told her that her own medication -- a blood thinner she took to prevent a second stroke -- was not necessarily what the doctor ordered.

"I could have died. The good news is I'm fine, but I'm very angry," said Dr. Kunin, president of DermaDoctor.com Inc., who also used to be in private practice. "It's a huge betrayal. Everybody who was doing their best to give quality medical care was screwed."

The Kansas City area medical community is reeling from the revelation that Robert Courtney, owner and operator of two local pharmacies, may have diluted tens of thousands of injectable and infused medications during the past decade. His goal: to make more money.

Courtney's wrongdoing began to unravel last year after suspicions raised by a drug company marketing representative led to oncologist Verda Hunter, MD, ordering lab testing of a drug sample. Ultimately, the pharmacist was convicted of 20 counts of drug tampering. Dr. Hunter received the FBI's 2001 Director's Community Leadership award but is not commenting on the case.

After the evidence came to light, Courtney admitted to diluting anti-cancer drugs for 34 patients treated by one physician from November 2000 to May 2001. But even then, there were suspicions the betrayal had gone further. [...]