Before:
And After:
Starting and operating nuclear pharmacies.
Starting and managing specialty IV compounding pharmacies.
Cardioplegia solutions.
TPN Solutions
Intrathecal Pumps Medications
Pharmaceutical Repackaging
Showing posts with label compounding. Show all posts
Showing posts with label compounding. Show all posts
Wednesday, March 30, 2011
Meds IV: More Sites Being Scraped
As we try to look more into the people and the company behind the 9 deaths in Alabama, we're seeing an effort to erase important information on several websites. We saw this with Tim Rogers's LinkedIn profile, and now we're seeing it with Advanced Specialty Pharmacy (owned by Tim Rogers, William Rogers, and Edward Anthony Cingoranelli), where they've completely removed their Alabama location. Here's the before and after:
Before:
And After:
Before:
And After:
Who is Tim Rogers of Meds IV?
We're going to start looking further into Tim Rogers, the man behind Meds IV, the compounding pharmacy that produced the nutrition IVs that resulted in 9 deaths in Alabama. There isn't much to be found on Meds IV at this point. They were hardly referenced at all online before the incident, there was no address listed on the website (which has since been taken down), and a search for the phone number on their site turned up nothing. We're taking this to mean it's either a fairly new company or they purposefully stayed under the radar. Update: We now learn that Meds IV has only been operating for 1 year. So to look into this more we'll be looking into the President of Meds IV Tim Rogers. As we find out more, we will continue to update this page. If there's not much here at the moment it's because it's still a work in process, stay tuned.
Tim Rogers is listed on the Alabama Society of Health-System Pharmacists board of directors site as the immediate past president of the organization.
What I find it interesting that he's the only one listed on the entire page that isn't a pharmacist or doctor. Go down the line and you see Pharm.D and Ph.D. With Tim Rogers there is no such title and simply mentions "Advanced Specialty Pharmacy, Inc."
Tim Rogers has just taken his LinkedIn profile down. We viewed it earlier today but when we try to go back now it says "We’re sorry, but the profile you requested does not exist." Fortunately we were able to save a copy.
A copy of his profile is below. I want to point out that while this may look like a big resume and list of accomplishments, many are very recent and look like projects he had been trying to start as opposed to established companies. And he's listed companies he is partnered with, not necessarily ones he owns or works for. Meds IV has only been operating for 1 year, MedworksRx (owned by Anthony Cingoranelli, dispensing at Drs. offices) he's been a partner with only 1 year, and PalliRx (a repackager, owned by Micah J Russell) a partner only 2 years. These 3 companies may have been leveraged to work together, for example PalliRx could become a distribution channel for Meds IV. The bulk of his work history is Advanced Specialty Pharmacy where he is an officer (owned by William Rogers), and Cardinal Health, one of the big 3 medical wholesalers.
From ereleases.com:
Tim Rogers is listed on the Alabama Society of Health-System Pharmacists board of directors site as the immediate past president of the organization.
What I find it interesting that he's the only one listed on the entire page that isn't a pharmacist or doctor. Go down the line and you see Pharm.D and Ph.D. With Tim Rogers there is no such title and simply mentions "Advanced Specialty Pharmacy, Inc."
Tim Rogers has just taken his LinkedIn profile down. We viewed it earlier today but when we try to go back now it says "We’re sorry, but the profile you requested does not exist." Fortunately we were able to save a copy.
A copy of his profile is below. I want to point out that while this may look like a big resume and list of accomplishments, many are very recent and look like projects he had been trying to start as opposed to established companies. And he's listed companies he is partnered with, not necessarily ones he owns or works for. Meds IV has only been operating for 1 year, MedworksRx (owned by Anthony Cingoranelli, dispensing at Drs. offices) he's been a partner with only 1 year, and PalliRx (a repackager, owned by Micah J Russell) a partner only 2 years. These 3 companies may have been leveraged to work together, for example PalliRx could become a distribution channel for Meds IV. The bulk of his work history is Advanced Specialty Pharmacy where he is an officer (owned by William Rogers), and Cardinal Health, one of the big 3 medical wholesalers.
Tim Rogers's Summary
Tim Rogers's Experience
President
Meds IV, Inc
Pharmaceuticals industry
2010 – Present (1 year)
Meds IV, Inc is a pharmaceutical company focused in delivering complex compounded sterile products to hospitals and physician offices including intrathecal pump medication refills and schedule II epidural and PCA products.
TPN/Cardiopelgia/Anesthesia Syringes/Oxytocin
Partner
MedWorksRx
Pharmaceuticals industry
2010 – Present (1 year)
MedWorksRx develops and manages retail pharmacy operations.
Partner
PalliRx, Inc
Privately Held; Pharmaceuticals industry
January 2009 – Present (2 years 3 months)
Pharmaeutical Repackager
Officer
Advanced Specialty Pharmacy
Pharmaceuticals industry
2005 – Present (6 years)
Nuclear Pharmacy Services
Immed-Past-President
Alabama Society of Health Systems Pharmacists
Pharmaceuticals industry
October 2009 – October 2010 (1 year 1 month)
President of the Alabama affiliate of ASHP
RVP
Cardinal Health
Pharmaceuticals industry
1999 – 2004 (5 years)
Lead the South East Region of Nuclear Pharmacy Services division of Cardinal Health.
Tim Rogers's Education
Samford University
BS Pharmacy, Pharmacy
1987 – 1990
Tim Rogers's Additional Information
- Groups and Associations:
-
ASHP, AlSHP, Birmingham Emmaus Community
- Honors and Awards:
-
2007 Birmingham Top 40 under 40
From ereleases.com:
Advanced Specialty Pharmacy, LLC (ASP) today announced that litigation initiated by Cardinal Health 414, Inc. ("Cardinal") against ASP and related parties has been amicably resolved.The original lawsuit (Case No. 2006-CV-2305) was filed on April 28, 2006, in the United States District Court, Eastern District of Louisiana.
Advanced Specialty’s counter-claim filed in this litigation against Cardinal that asserted violations of various federal and state antitrust laws will also be dismissed as part of the settlement.
Although the terms of settlement are to remain confidential between the parties, Advanced Specialty Pharmacy will continue to serve its nuclear pharmacy customers in all of its existing markets. "ASP envisions rapid future growth in these markets based on our business model of very competitive pricing and a responsiveness to customer needs that large national companies cannot match," stated Tim Rogers, a co-founder of ASP.
We will be looking into the initial claim by Cardinal against Advanced Specialty Pharmacy but take a look at the timing of it: This dismissal is from October 2006, the initial claim probably some time in 2005. Tim Rogers worked at Cardinal until 2004 and co-founded Advanced Specialty Pharmacy in 2005. We're thinking the litigation may have been regarding Tim Rogers violating a non-compete clause he had with Cardinal, especially since his counter suit asserted that Cardinal violated antitrust laws.
Compounding Pharmacy "Meds IV" Connected to 9 Deaths
Nine people have died in Atlanta, GA following an IV treatment. And the 9 deaths (19 outbreaks total) spanned across 6 different hospitals, so it isn't an issue with a particular hospital having a contamination or problem not following procedure. The common denominator? They all received a Nutrition IV from "Meds IV", a compounding pharmacy. It was found that the deaths were caused by a bacteria called Serratia marcescens.
from gbp.org:
We tried visiting the website of "Meds IV" but it appears they've recently taken the site down in light of the allegations. We were able to view a cached version before it was removed (click on image to view full size):
Their most important asset is their reputation...well, I guess that's all gone to shit. If customer satisfaction is guaranteed, what does that mean if they kill you? Do they bring you back to life?
We're trying to find more information about Meds IV, they don't appear to be that well known with much of a presence. They don't even list an address on their website and a search for their phone number 205-837-0899 turns up nothing.
Update:
We have found the president of Meds IV, Tim Rogers.
click on image to view full size.
There is next to nothing to be found about Meds IV, besides the latest articles. We're guessing this was a very small operation that was fairly new with not a lot of customers. Perhaps he offered the hospitals a steep discount to get his foot in the door. It could be that there are some legal issues with compounding pharmacies selling to hospitals. It is standard practice for a compounding pharmacy to make medications for a particular patient. But when they start producing it in bulk to resell to hospitals and aren't seeing any patients at all, that could be a problem. Instead of being a pharmacy they're getting into manufacturer territory and need to be treated and regulated as such.
Update 2: Was the Parenteral Nutrition I.V. a hard to find item (HTF)?
If you look at the list of products that were displayed on Meds IV's website, you may or may not notice that many of them are items that are in short supply. Heparin and Promethazine for example have had supply issues for quite some time now. It appears that indeed there were supply issues with the parenteral nutrition I.V., from nutritioncare.org:
People Liking People actually have a little experience in the little known hard to find market of hospital pharmaceuticals/I.V.s. Different medications go in short supply all the time. There's only so much supply to go around, and sometimes there's not enough to meet the demand, whether it's a raw material shortage, a legal issue, or manufacturing problem. Well some medications are absolutely vital and when you have a patient dying on a hospital bed, the hospital will try to do whatever they can to find the medication that they need. And they're also willing to pay a lot more for that medication. This sets the stage for the hard to find market.
The hard to find market consists of many distributors that make their money off these shortage problems. They get wind that a product is going to go short, so they stock up as many as they can at the low price from a variety of suppliers and manufacturers. They may either flip them to another distributor for a quick profit, or wait for the market price to quadruple and sell them to hospitals for much higher. It doesn't always go as planned, so there's a lot of guessing and risk/reward calculating going on.
Well for some medications there simply isn't any product left, even the hard to find distributors don't have any. Hospital pharmacists are calling all the suppliers they can think of and no one is able to get their hands on it. This sets the stage for the compounding pharmacy to enter the hard to find market. When the hospitals have run out, their primary wholesaler has run out, the manufacturer isn't able to produce much more, and the hard to find distributors can't get their hands on any, the compounding pharmacist is the only other option in creating availability, and they then take advantage of this situation and sell their compounded product at ridiculously high profit margins. Something that might cost $4 to make could be sold for $1,000.
It appears to us now that this isn't just your average compounding pharmacy that's just helping out and serving hospitals from time to time. It may be that their whole business revolves around these shortages. Not that that's necessarily an evil business model, but like I said before when you start compounding on a massive scale you go from compounder to manufacturer. And I'm willing to bet that Tim Rogers and whoever else ran Meds IV just wasn't up to the task. Every week they're probably making something new that the week before hadn't even heard of. It's short? Ok let's make it. They don't specialize in a group of particular meds, they switch between what's selling and what's not at the blink of an eye. So if that's truly the model it's no wonder that their quality control wasn't exactly up to par.
from gbp.org:
The Alabama Department of Public Health said it first learned of the problem on March 16, when two hospitals in the state notified officials of patients with bloodstream infections.This event will no doubt raise questions about quality control at compounding pharmacies. Unlike most pharmacies, compounding pharmacies make most of the solutions they dispense themselves. This provides a value for patients that require custom made ointments, oral solutions, and IVs. But it does make it more difficult to ensure the dosage and quality. Instead of mass producing thousands of the same pill on a daily basis as a pharmaceutical manufacturer might do which could be more easily monitored and controlled, compounding pharmacies produce their medications only when a particular patient has a need for it. They're made to order. So one minute a pharmacist is making an oral solution, the next minute the same pharmacist could be producing a completely different inhalant powder.
The cases of bacteremia were caused by Serratia marcescens, a germ that produces bright bright red colonies. The bacterium was identified and named in Italy in the early 1800s, after it was found to be turning polenta blood-red.
We tried visiting the website of "Meds IV" but it appears they've recently taken the site down in light of the allegations. We were able to view a cached version before it was removed (click on image to view full size):
Their most important asset is their reputation...well, I guess that's all gone to shit. If customer satisfaction is guaranteed, what does that mean if they kill you? Do they bring you back to life?
We're trying to find more information about Meds IV, they don't appear to be that well known with much of a presence. They don't even list an address on their website and a search for their phone number 205-837-0899 turns up nothing.
Update:
We have found the president of Meds IV, Tim Rogers.
click on image to view full size.
There is next to nothing to be found about Meds IV, besides the latest articles. We're guessing this was a very small operation that was fairly new with not a lot of customers. Perhaps he offered the hospitals a steep discount to get his foot in the door. It could be that there are some legal issues with compounding pharmacies selling to hospitals. It is standard practice for a compounding pharmacy to make medications for a particular patient. But when they start producing it in bulk to resell to hospitals and aren't seeing any patients at all, that could be a problem. Instead of being a pharmacy they're getting into manufacturer territory and need to be treated and regulated as such.
Update 2: Was the Parenteral Nutrition I.V. a hard to find item (HTF)?
If you look at the list of products that were displayed on Meds IV's website, you may or may not notice that many of them are items that are in short supply. Heparin and Promethazine for example have had supply issues for quite some time now. It appears that indeed there were supply issues with the parenteral nutrition I.V., from nutritioncare.org:
Compounding & The Hard-To-Find Market
Parenteral Nutrition Product Shortages
There is a growing and critical shortage of electrolyte and mineral injections needed for parenteral nutrition. We have heard from many consumer groups, healthcare systems, and clinicians regarding their short supplies or inability to obtain these products. The seriousness of this shortage has the potential to be similar to that of intravenous (IV) multivitamins, which resulted in significant complications and some deaths.
People Liking People actually have a little experience in the little known hard to find market of hospital pharmaceuticals/I.V.s. Different medications go in short supply all the time. There's only so much supply to go around, and sometimes there's not enough to meet the demand, whether it's a raw material shortage, a legal issue, or manufacturing problem. Well some medications are absolutely vital and when you have a patient dying on a hospital bed, the hospital will try to do whatever they can to find the medication that they need. And they're also willing to pay a lot more for that medication. This sets the stage for the hard to find market.
The hard to find market consists of many distributors that make their money off these shortage problems. They get wind that a product is going to go short, so they stock up as many as they can at the low price from a variety of suppliers and manufacturers. They may either flip them to another distributor for a quick profit, or wait for the market price to quadruple and sell them to hospitals for much higher. It doesn't always go as planned, so there's a lot of guessing and risk/reward calculating going on.
Well for some medications there simply isn't any product left, even the hard to find distributors don't have any. Hospital pharmacists are calling all the suppliers they can think of and no one is able to get their hands on it. This sets the stage for the compounding pharmacy to enter the hard to find market. When the hospitals have run out, their primary wholesaler has run out, the manufacturer isn't able to produce much more, and the hard to find distributors can't get their hands on any, the compounding pharmacist is the only other option in creating availability, and they then take advantage of this situation and sell their compounded product at ridiculously high profit margins. Something that might cost $4 to make could be sold for $1,000.
It appears to us now that this isn't just your average compounding pharmacy that's just helping out and serving hospitals from time to time. It may be that their whole business revolves around these shortages. Not that that's necessarily an evil business model, but like I said before when you start compounding on a massive scale you go from compounder to manufacturer. And I'm willing to bet that Tim Rogers and whoever else ran Meds IV just wasn't up to the task. Every week they're probably making something new that the week before hadn't even heard of. It's short? Ok let's make it. They don't specialize in a group of particular meds, they switch between what's selling and what's not at the blink of an eye. So if that's truly the model it's no wonder that their quality control wasn't exactly up to par.
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