A Hagerstown pharmacist has been prohibited from dispensing drugs classified as controlled dangerous substances following allegations that he filled thousands of prescriptions for Oxycodone, OxyContin, methadone and other powerful painkillers written by two physicians whose licenses were subsequently suspended.
The Maryland Board of Pharmacy voted on Dec. 22, 2010, to summarily suspend the license of David Russo, owner of Russo's Rx at 25 N. Cannon Ave.
"There has since been a consent agreement by which my license has been restored, but I cannot dispense controlled dangerous substances," Russo said Tuesday. However, Russo said he can dispense other prescribed medications.
No formal charges have been filed against him, and an evidentiary hearing will be scheduled during which he will present a defense to the allegations made by investigators with the pharmacy board, Russo said.
"We hope to have it resolved at that point," Russo said. He deferred specific questions to his attorney, but issued the following statement:
"Russo's Rx has always endorsed the American Academy of Pain Management's Patient Bill of Rights to insure access to medications prescribed for the treatment of chronic pain. We also do our best due diligence in the performance of our corresponding responsibility to mitigate abuse and diversion of controlled dangerous substances. We look forward to a hearing and the chance to defend ourselves."
"Certainly, Mr. Russo did fill prescriptions written by those two doctors and others," said his attorney, Richard Karceski of Towson, Md. "Every prescription written was legitimate .... There were no forgeries."
The investigative findings accompanying the suspension order cited Russo for "dispensing inappropriately large amounts of CDS prescribed by doctors known to engage in suspicious subscribing patterns."
The prescriptions were written in 2009 and 2010 by Dr. Nicola M. Tauraso, of Frederick, Md., and Silviu Ziscovici, of Rockville, Md., according to the investigative findings.
The Maryland Board of Physicians summarily suspended Tauraso's license on Aug. 12, 2010, and Ziscovici's on Dec. 1, 2010, the report said.
Their licenses were suspended for prescribing high doses and large quantities of painkillers to mostly young people "who appeared healthy and did not appear to be in chronic pain or terminally ill," the Board of Pharmacy report alleged.
"It's not Dr. Russo's decision what to prescribe or how much," Karceski said. Those decisions were up to Tauraso and Ziscovici, both pain-management physicians, he said.
Investigators from the U.S. Drug Enforcement Administration met with Russo in January 2010 and questioned him about prescriptions written by the two doctors, Karceski said.
Russo provided them with copies of the requested prescriptions, he said.
Russo did not know what the investigation was about at that time and asked the DEA investigators if he should stop filling prescriptions from Ziscovici and Tauraso, Karceski said. The investigators told him he could continue to fill those prescriptions, he said.
Russo told inspectors he filled prescriptions for Tauraso's patients from Washington County, the report said. However, investigators alleged that Russo filled prescriptions for Tauraso's and Ziscovici's patients from other counties and states.
The telephone number for Tauraso's clinic was not in service, and there was no answer at the number for Ziscovici's practice.
A Board of Physicians spokeswoman said Friday that the licenses of Tauraso and Ziscovici were still suspended.
Maryland Division of Drug Control inspectors visited Russo's Rx on July 7, 2010, seven months after the DEA visit, and questioned him about Tauraso's prescriptions, the report said. Russo told the inspectors he was aware of the concerns, and that the DEA had alerted him about Tauraso, it said.
"The DDC inspectors obtained a profile of Dr. Tauraso's prescription's filled at the Respondent's pharmacy. From July 15, 2009, to July 21, 2010, approximately 5,518 prescriptions were filled; approximately 4,751 of those were filled in the first seven months of 2010," the report said, referring to prescriptions written by Tauraso and filled by Russo's pharmacy.
"Almost all of those prescriptions were for Oxycodone, Methadone, OxyContin and Alprazolam, totaling approximately 669,857 tablets," the board's report said.
"Between July 1, 2009, and July 21, 2010, the Respondent dispensed approximately 193,000 tablets prescribed by Dr. Ziscovici," the report said.
On Jan. 5, Russo appeared before the Board of Pharmacy for a hearing held to give him the opportunity to show cause why the summary suspension should not be continued, according to a copy of the interim consent agreement provided by Russo.
The agreement to stay the suspension was signed in February and included the following conditions that Russo:
- Not accept or dispense prescriptions for controlled dangerous substances.
- Not engage in "the practice of internet pharmacy."
- Provide the board with a weekly computer-generated report of all prescriptions dispensed.
- Not work in the prescription area of any pharmacy where CDS is dispensed.
- Cooperate with the board in its ongoing investigation of him and Russo's Rx.
- Withdraw his request for an evidentiary hearing on the Dec. 22 order for summary suspension.
The consent order "shall remain in effect until the Board issues a Final Order following an evidentiary hearing on any forthcoming formal charges related to conduct alleged in the Order for Summary Suspension," the agreement said.