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appropriate because his overriding concern was the welfare of his
patients.3
Dr. Ishmael, petitioners’ staff, and petitioners’ patients
viewed the chemotherapy treatments, and the drugs used in those
treatments, as medical services, not as the purchase and sale of
drugs.
The Pharmacy
PC maintained an onsite pharmacy, where chemotherapy drugs
purchased by both PC and Mid-Del were stored and where a
pharmacist employed by PC mixed and prepared chemotherapy
treatments; i.e., mixtures of chemotherapy drugs in prescribed
amounts, for both clinics. Chemotherapy drugs purchased by Mid-
Del were accounted for separately and held in a separate area
from chemotherapy drugs purchased by PC. Mid-Del paid PC a
monthly fee for PC's provision of pharmacy services to Mid-Del.
Petitioners used approximately 85 different chemotherapy
drugs to treat patients. Generally, petitioners attempted to
keep a 2-week supply of each drug on hand, although some
chemotherapy drugs were ordered on an as-needed basis.
Petitioners sometimes stocked up on a newly approved chemotherapy
3For example, Dr. Ishmael prescribed an experimental drug,
Taxotere, for a patient dying of lung cancer. The patient had
been doing very poorly and was getting ready to enter a hospice
program, but Dr. Ishmael persuaded her family to allow him to
provide the treatment. Treatment continued despite a cost to the
clinic of $10,000 per week. The treatment was successful.
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Last modified: May 25, 2011