James R.
Yelp
On 20 November, we used the Walmart (Supercenter #201, 2608 Green Mount Commons Dr., Belleville, IL 62221) fill scripts including one for NORCO. The NORCO was 5-325 strength and was prescribed by the doctor (hospital discharge instructions) to be taken every four hours (2 per) for a total of 12 tablets per 24 hour period. When I left the hospital around 1600 on 20 November after having the required NORCO and Tramadol as well as other drugs prescribed by the surgeon, my pain management was good. We arrived at home and started setting up a schedule for the dispensing of all associated drugs that were prescribed. However, when we checked the discharge instructions against the Walmart directions on the NORCO label, there was a statement not to exceed 8 doses (16 tablets) in 24 hours. My wife and the Home health nurse attempted to mitigate the disparity in instructions but couldn't. Therefore, we followed the instructions on the label. For a couple of days I suffered in level 4-5 pain and it continued to worsen.
The surgeon was contacted and a refill requested. My wife went to get the prescription only to find out the surgeon had written the prescription for "325" instead of "5-325" and the Walmart pharmacist refused to fill the prescription. My wife returned home and we again contacted the surgeon for assistance. A new prescription was ordered and my wife picked it up. During the briefing being provided by the pharmacist he stated the "FDA recommends no more than 8 doses per day" and he'd inserted that statement on the original prescription and this prescription. It was because of that change I suffered level 4-5 pain for a couple of days and eventually had to return to the ER in level 8-9 pain.
I sent an email complaining about the issue and received a call from the pharmacy in just a few days. The conversation brought about how that statement which reduced my pain medication by two doses every 24 hours. Walmart is actively trying to reduce the opioid issues and the doctors office was contacted about the original dosage. The pharmacist explained to the individual (office clerk/nurse) and got "permission" to reduce the dosage. The pharmacist I spoke with stated it is Walmart's policy to accept the response from the individual answering the phone. The problem is the individual answering the phone/question(s) is not a physician and in most cases, it's a large office where phones are answered by office workers, not qualified medical personnel. The physician normally is not available to answer the phone or the question, so the pharmacist is not getting a medically qualified answer.
The pharmacist I spoke to also stated they (Walmart) assume every office they contact will have a standard protocol in place to properly handle this type of situation...that's a far reaching assumption believing every medical office will have a blanket protocol in place to answer inquiries from a pharmacist for every patient and possible situation! The opioid was just one of several drugs being used as a "cocktail" to control my pain.
His actions caused me extreme (Level 4-5) pain for days because we diligently followed the instructions on the bottle even though they differed from the discharge instructions. After several days my pain worsened and at level 8-9 pain I was in the ER being admitted to the hospital.
We know the pharmacist has a critical job in the health system and I've been "warned" by a pharmacist whenever there was a dangerous overlap of drugs. However, none have ever overrode a doctors actual prescription by adding a critical statement "not to exceed" which in effect adjusted the original dosage.
He followed Walmart's policy and in doing so, I suffered extreme pain for several days and endured a hospital stay. Additionally, the opioid was just one of several drugs I was given to control the pain. The doctor was conflicted/confused as to why the "cocktail" of drugs failed. The new cocktail included a higher dose opioid. WE WILL NEVER USE WALMART PHARMACY IN THE FUTURE!!!