What Happened
The United States filed and settled a civil action against New York Methodist Hospital in Brooklyn after alleging that medical residents wrote fraudulent Adderall prescriptions on hospital forms.
The government alleged that between May 2008 and July 2010, medical residents employed by New York Methodist Hospital issued 194 prescriptions for Adderall without a legitimate medical purpose, using hospital prescription forms, filled the prescriptions at local pharmacies, and consumed or sold the pills. A related criminal prosecution of one former resident led to a 2012 conviction.
Under a consent judgment announced September 20, 2013, the hospital agreed to implement measures to prevent further prescriptions issued in violation of the Controlled Substances Act, including a prescription-tracking database and compliance program, and paid a $70,000 civil penalty without admitting wrongdoing.
What Went Wrong
Hospital prescription forms were used by multiple residents to generate fraudulent Adderall prescriptions over more than two years before the pattern was addressed. Key failures included:
- Prescriptions written on hospital forms were not verified against a legitimate treatment relationship or medical record before being honored at outside pharmacies.
- No prescription-monitoring process flagged a pattern of Adderall prescriptions originating from hospital residents for non-patients.
- The scale — 194 prescriptions over roughly two years — suggests the hospital lacked ongoing oversight of resident prescribing activity.
How It Could Have Been Prevented
- Implement a prescription-tracking system that flags controlled-substance prescriptions written by residents outside their assigned patient panels.
- Periodically audit resident controlled-substance prescribing volume and patterns against expected clinical caseload.
- Require attending physician co-signature or review for stimulant and other Schedule II prescriptions written by residents.
- Check state prescription drug monitoring program data against internal resident prescribing records on a routine basis.
Related Guidance
- Hospital Diversion Prevention Checklist — Hospital self-assessment covering prescribing and recordkeeping controls.
- 15 Red Flags of Drug Diversion — Behavioral and transactional indicators of prescriber-level diversion.
- Controlled Substance Inventory Requirements — Recordkeeping practices relevant to prescription-pad controls.