I work as a clerk at a national pharmacy chain. I run the front register & requested a job with the least amount of responsibility. I DO NOT WORK IN THE PHARMACY DEPARTMENT! I don’t need a lot of stress right now, as I am perusing an education in the medical field. I want to eventually be a doctor, but I’d like to explore as many facets of the medical field as I can. (I don’t want to get too specific, as this happened about an hour ago & it might be seen as an attempt to go behind my boss’ back)

At the beginning of my employment I was made to watch training videos on store regulations, store procedure, customer service, & HIPAA regulations. The HIPAA video was very short & basically communicated that we (store employees) were not to disclose any patient information, of any kind to anyone. That video taught that the pharmacist was the only deciding factor in who should be privy to a patients prescription information. At the end of each video, we were tested on the content of the video & signed off on a paper that said we understood all of the material taught & would do all that we could to follow procedure properly.

I felt confident in my knowledge of HIPAA rules & regulations.

Yesterday, there was a situation where a customer accidentally left a bag in her buggy & the buggy was pushed up into the buggy rack. I had to dislodge the buggy from the others in the row. The bag had a customers prescription medicine in it & I immediately looked through the bag to take inventory of the items.

The bag & it’s contents were all in good shape, but had been a little crumpled from being stuck in the buggy. I looked at the patients name, in case they called (I am the first person to answer the phone, so I wanted to be able to tell the person we had their prescriptions if they called). I put all of the paperwork back together & stuck it all neatly in the bag & placed it in a basket behind the counter. Then I paged my shift manager to let her know what I’d found.

When she called my desk phone, I asked her what I should do. She snapped at me for the 3rd time & told me that she didn’t know exactly what to do, but she’d be there in a little bit to get the medicine & take it back to the pharmacy. She was very short with me & asked that I leave her alone, so that she could complete the project she was working on.

Over an hour later, a man who was with the woman who left her prescriptions came into the store & I recognized him immediately. He said that his grandmother had left her prescriptions & sent him in to get them. I looked out the front window & saw the woman in her car. (I can’t say that I am 100% sure it was her, but thought the glass, it looked like her & it was the car she had left in. I remembered, because they were in the handicap parking space & I never saw a handicap tag in their window.) iu asked him what specific name would be on the prescriptions & he said the name that was on the bag.

Today I went to work as usual, but halfway through my shift, I was asked to go speak to the store manager. I was escorted to a training room, where the head pharmacist (who is also the pharmacy department’s manager) was waiting with the store manager. The head pharmacist was working on the computer & didn’t seem to be paying attention to what the store manager & I were discussing. At this point, I had no idea what was going on & assumed that my store manager only wanted to discuss my new schedule, as my new semester is staring next week.

He then said that he’d watched the tape from the day before because of a totally separate incident & noticed that I had looked at the prescription bags & that it looked like I was reading the detailed information on the papers stapled to the prescription bags. I could see how it would appear like that on the tape, but I was not reading any information, I was only trying to put the papers back together, the only information I got from the papers was the patient name. I did check to see if all of the prescriptions were for the same patient.

He said that I’d violated HIPAA laws, & put us all at risk. He said that he had to assume that I had read all of the information on the papers, & that the corporate office had been contacted, even though the patient herself had not called to complain. He said that I violated HIPAA privacy laws by reading the prescription information, even though he believed that I didn’t read the papers.

He then stated that if for any reason, there was a problem with the medicine in the bags, I would be held liable. He described in great detail all of the different scenarios that could happen to come back on me. Then the pharmacist chimed in & said that she could lose her license & that the corporation would be held responsible if there were any problems with the medicines. She said that if for any reason the patient had a bad reaction to any of the medicine, that it would come back on all of us, because I could have tampered with the pills while they were in my possession.

They both agreed that I had no right to know the names of any patients that had prescriptions with us, & even my knowledge of the patients names was a HIPAA violation. The store manager explained that the correct way to handle the situation was to immediately take the medicines back to the pharmacy. I didn’t know that, but in retrospect it makes sense.

I assumed that the shift manager would have told me that I should take the bag back to the pharmacy when I talked to her, but she did not, she said that she would come & retrieve them when she was done with her project. Not to mention, the people who work the front trained to never leave their area, for any reason, unless they have someone to cover them.

There was no one to cover me & I didn’t see any problem with the way I handled the situation. I did what I feel like anyone would have done. I looked in the bag to see what it contained, organized the bag & corrected the damage the buggy had done to it’s contents, placed it in a safe location & contacted my manager.

I didn’t realize that merely looking at the patients name & being in possession of the prescriptions was a HIPAA violation. Nor did I realize that I was putting the entire company at risk. The pharmacist made it clear that if I had a HIPAA violation on my record that my scholarship would probably be revoked & my future career in medicine would never happen. This scares me, I have worked very hard to get to where I am in school & I want to do all that I can to reach my goals. I really never meant to put anyone else in a position to lose so much either.

Did I really put us all in a position where we could lose our careers? Is it really a violation of HIPAA law for me to know the patients name, even if I have no knowledge of the medicines they take? I don’t know how to handle this situation. My husband did point out that my store manager is a bit paranoid & that he is prone to make mountains out of mole hills, but in this situation it’s hard to tell.

What about the shift manager that I contacted? Shouldn’t she be liable as well? In my opinion, she should have told me to take to bag straight to the pharmacy, if that is in fact the companies policy. What about the patient? She never contacted the store about anything, so why is it even an issue?

The manager sent me home & told me that he would contact me after he got word from the corporate office, but he made it clear that my job was on the line. Now, I am a complete wreck, I know I didn’t tamper with the medicines or even see what they were, but what if something happens? Will I be held liable?

Any advise or information would be greatly appreciated & I apologize for the sketched-out nature of this post, I am very nervous now, because if what they are saying is correct, the last 5 years of my life & the future I had planned for myself is all flushed away because of a lapse in judgment. Thank you in advance,
~m

You were all wrong. You should have not looked in the bag at all. You should have immediately taken it to a store manager.

They are wrong because there was NO HIPAA violation. Patient information was not revealed to a third party. It's a little iffy because you could have seen patient info, but as long as you made no use of that knowledge it would be a long stretch that the store or anyone in it would have been cited for a HIPAA violation.

That's just it, I didn't even know the bag had prescriptions in it, I didn't know what it was, for all I knew it could have been candy. When I saw it was medicine, (you're right) I should have taken it to the store manager, but he gets weird when you bother him, we are trained to go to the shift manager first with any problems or questions that we have. So that's what I did. Thank you for your response, BTW>

When I saw it was prescriptions, I will admit I had a lapse in judgment, I shouldn't have touched it at all, but at the time, I wasn't thinking “These are prescriptions, I should take them to the manager”. I was thinking “Where's the shift manager? This bag is a mess, I should make sure everything is in order”.

I was thinking on the level of a clerk who gets berated with phone calls almost every night from customers about missing merchandise. not on a level of “this could get volatile”.

I know I was in the wrong, but if the patient has a bad reaction to the meds, will I really be investigated? They were saying that I could get in serious trouble for tampering with the meds, even if I didn't.

Its possible, but not probable.

And the person lost all rights to expect privacy when they left their bag unattended. At that point the bag was lost, and not part of any store medical record. Anyone was free to look at it, because of actoins of the patient. Now what would have happened if they had claimed there was 500 dollars missing in the bag, the company would have assumed you took it.

After speaking with a several coworkers & a man who is a professor of pharmacology, my nerves are much better now. Thank you all for the replies, it really helped to calm my nerves as well. The other employees said they would have done the same in my situation, because of the way the store is set up & my pharmacist friend said that on a state or federal level we could not be held liable for anything, unless I shared the information with a 3rd party, as stated before.

I am clear because I didn't even read the information on the prescriptions. The only reason I was so worked up about the whole thing, is because they made such a big deal about it all, they acted like I was in serious trouble! As I had hoped, they made a big deal out of nothing, so I think I'll just look for another job & be done with it. I wanted a no-stress position & I got more stress than I could handle!

I suspect they were trying to head off a repeat of this incident by scaring you with exaggerated possibilities.

That’s just it, I didn’t even know the bag had prescriptions in it, I didn’t know what it was, for all I knew it could have been candy. When I saw it was medicine, (you’re right) I should have taken it to the store manager, but he gets weird when you bother him, we are trained to go to the shift manager first with any problems or questions that we have. So that’s what I did. Thank you for your responce, BTW>

When I saw it was prescriptions, I will admit I had a lapse in judgment, I shouldn’t have touched it at all, but at the time, I wasn’t thinking “These are prescriptions, I should take them to the manager”. I was thinking “Where’s the shift manager? This bag is a mess, I should make sure everything is in order”.

I was thinking on the level of a clerk who gets berated with phone calls almost every night from customers about missing merchandise., not on a level of “this could get volatile”.

I know I was in the wrong, but if the patient has a bad reaction to the meds, will I really be investigated? They were saying that I could get in serious trouble for tampering with the meds, even if I didn’t.



Wow - my husband was a Doctor of Pharmacy, owned and managed pharmacies, worked for big box stores in the past. I took all the HIPAA classes with him and sat in when he taught them to his employees and co-workers.

In my experience the bag (in general, not knowing there were prescriptions inside) should have been turned over to your Supervisor. Employees are taught that once their hands are on something, they are fully liable until that "something" is turned over.

The very minute you realized it was a prescription (couldn't you feel the bottle through the bag?) the entire bag should have gone back to the Pharmacy.

In my experience if a prescription is "found" it is not given to the customer. The mediation is "dumped" and the prescription is refilled. No one should take a chance that there has been tampering. And, yes, if there is tampering you had your hands on the merchandise - which brings us back to having your hands on the medication and the allegation of tampering.

I think you showed very poor judgment but I also can't understand the store's actions in not dumping the medication. If you plan a professional career you have to think more like a professional and less like a store clerk. I don't know why you straightened up the bag but, anyway -

The store has enormous liability, the Pharmacist could lose his/her license due to your actions and I think you may be fortunate that they just warned you and didn't terminate you. In many stores the rule is that if it's not your prescription, do not touch it, and if you do touch it, take it back to the Pharmacy IMMEDIATELY.

I just wanted to say that no, you can't always feel the bottle through the bag - especially if there's more than one. It makes it hard to determine what's in there. On top of that prescriptions aren't always in bottles. And even if you could, imagine how many things you could buy at that kind of place that would come in a bottle.

After speaking with a several coworkers & a man who is a professor of pharmacology, my nerves are much better now. Thank you all for the replies, it really helped to calm my nerves as well. The other employees said they would have done the same in my situation, because of the way the store is set up & my pharmacist friend said that on a state or federal level we could not be held liable for anything, unless I shared the information with a 3rd party, as stated before.

I am clear because I didn't even read the information on the prescriptions. The only reason I was so worked up about the whole thing, is because they made such a big deal about it all, they acted like I was in serious trouble! As I had hoped, they made a big deal out of nothing, so I think I'll just look for another job & be done with it. I wanted a no-stress position & I got more stress than I could handle!



Again, I don't understand this - YOU are the third party who had no right to the information. There doesn't need to be someone else involved.

You actually acknowledged - if I am reading this correctly - to a party, not the patient, wihout verifying that that person was entitled to the info, that there was a prescription with the woman's name on it, acknowleging that you had the info.

If you need a (another) third party, there he is.

I just wanted to say that no, you can't always feel the bottle through the bag - especially if there's more than one. It makes it hard to determine what's in there. On top of that prescriptions aren't always in bottles. and even if you could, imagine how many things you could buy at that kind of place that would come in a bottle.


She already said she knew there were prescriptions in the bag and she went through it to take an "inventory" anyway -

And, no, I can't think of any that comes in a prescription bottle other than drugs.

At a pharmacy like walgreens or cvs or wherever you can buy all kinds of things in small bottles, they have makeup and lotions, travel size shampoos, conditioners. All I was saying is that someone could feel that there was a bottle in the bag and didn't know it was a prescription. I'm not saying anyone was right or wrong, I was just saying because you said "couldn't you feel the bottle through the bag?" you could feel a bottle but how would you know what kind it was.

To clear this up, no I didn't feel anything in the bag, except for a bunched up ball of paper. The medicine was in 3 or 4 separate, white paper bags, stapled together, with paperwork stapled to the bags, as well as a sales paper. All of this was bunched up inside a plastic store bag. The plastic bag & all of it's contents were bunched up, because they were in a buggy that was 3 buggies deep in the rack, it had literally been stuck in a part of the buggy! There was no significant damage to the contents of the bag, only the papers stapled to the bag itself. In fact, I never even heard a rattle you'd expect from a bottle of pills or the like.

I straightened it, because I felt like I needed to see if there was any other merchandise in the bag, along with the prescriptions. I also wanted to see exactly what damage had been done, so if anything had damaged the contents of the bag (medicine or not), I could take the proper actions to repair it. I ignorantly assumed that my every action was being caught on tape, because we were told, “you're always on camera”.

If this were true, I really would be in the clear & the management would have undisputable proof that the medicine NEVER left the stapled paper bags they left the pharmacy in. Now I know that the management lied about the cameras & only part of my actions were caught on tape.

I also found out today that (according to the state/federal laws & procedure handbook that is available in my store) as an employee of the store, I am not considered a 3rd party & that it is assumed that I have access to this information, as stated before it only becomes an issue if a 3rd party becomes privy to this information, through my actions. I never disclosed any information about anything to anyone. The only thing I know is the patients name & I honestly forgot the last part of her name that very day.

What it boils down to is, I looked in a bag, straightened it's contents, did what I was trained to do by contacting my manager & making sure that no one had tampered with the contents of the bag & waited on a managers response. That's it! It's very simple & has been made into a huge deal, the only momentary lapse of judgment was not taking the bag directly to the store manager or the pharmacist. I was not trained to do this, I understand that my training should have gone out the window at this point, but I was also thinking of the response I would have gotten if I'd left my area unattended. I assumed that the bag was safe, behind my counter, & it really was, it never left my sight.

It should also be noted, that according to my lawyer, whom I have contact with on a regular basis, the patient herself, left the bag. Even though it was an accident, it then became public domain in a way. Anyone could have seen that bag in the buggy & taken it or tampered with it. Anyone could have read the information on the papers & used it in anyway they pleased. As a store employee, my obligation was to secure the contents of the bag as soon as I knew it was left unattended. In my opinion, I did that. I did not however secure the bag according to proper company procedure, but I was never properly trained on that particular company procedure.

I am not worried at all at this point, I did not tamper with the medication, I did not read or become aware of any personal information, & I followed the procedure I was taught to follow in any situation where the employee is not sure what actions should be taken. It's not my fault the Managers never trained me on how to handle s situation like this. Thank you again for all your responses!

To clear this up, no I didn’t feel anything in the bag, except for a bunched up ball of paper. The medicine was in 3 or 4 separate, white paper bags, stapled together, with paperwork stapled to the bags, as well as a sales paper. All of this was bunched up inside a plastic store bag. The plastic bag & all of it’s contents were bunched up, because they were in a buggy that was 3 buggies deep in the rack, it had literally been stuck in a part of the buggy! There was no significant damage to the contents of the bag, only the papers stapled to the bag itself. In fact, I never even heard a rattle you’d expect from a bottle of pills or the like.

I straightened it, because I felt like I needed to see if there was any other merchandise in the bag, along with the prescriptions. I also wanted to see exactly what damage had been done, so if anything had damaged the contents of the bag (medicine or not), I could take the proper actions to repair it. I ignorantly assumed that my every action was being caught on tape, because we were told, “you’re always on camera”.

If this were true, I really would be in the clear & the management would have undisputable proof that the medicine NEVER left the stapled paper bags they left the pharmacy in. Now I know that the management lied about the cameras & only part of my actions were caught on tape.


I also found out today that (according to the state/federal laws & procedure handbook that is available in my store) as an employee of the store, I am not considered a 3rd party & that it is assumed that I have access to this information, as stated before it only becomes an issue if a 3rd party becomes privy to this information, through my actions. I never disclosed any information about anything to anyone. The only thing I know is the patients name & I honestly forgot the last part of her name that very day.

What it boils down to is, I looked in a bag, straightened it’s contents, did what I was trained to do by contacting my manager & making sure that no one had tampered with the contents of the bag & waited on a managers response. That’s it! It’s very simple & has been made into a huge deal, the only momentary lapse of judgment was not taking the bag directly to the store manager or the pharmacist. I was not trained to do this, I understand that my training should have gone out the window at this point, but I was also thinking of the response I would have gotten if I’d left my area unattended. I assumed that the bag was safe, behind my counter, & it really was, it never left my sight.

It should also be noted, that according to my lawyer, whom I have contact with on a regular basis, the patient herself, left the bag. Even though it was an accident, it then became public domain in a way. Anyone could have seen that bag in the buggy & taken it or tampered with it. Anyone could have read the information on the papers & used it in anyway they pleased. As a store employee, my obligation was to secure the contents of the bag as soon as I knew it was left unattended. In my opinion, I did that. I did not however secure the bag according to proper company procedure, but I was never properly trained on that particular company procedure. I am not worried at all at this point, I did not tamper with the medication, I did not read or become aware of any personal information, & I followed the procedure I was taught to follow in any situation where the employee is not sure what actions should be taken. It’s not my fault the Managers never trained me on how to handle s situation like this. Thank you again for all your responses!


Glad it worked out for you - I have to say I don't agree with your Attorney about the points I've already covered, including the "public domain" aspect, as well as whether your duty to secure the package and turn it over included looking inside it. However, again, glad it worked out for you and now that you've gone through this I am going to ask our Pharmacy's Attorney to take a second look at our policies and procedures.

If I am too tough on the employees, then I'd like to know - I have been taught and other employees have been taught that no one but the Pharmacist or a licensed Pharmacy Tech is allowed prescription info by any means. I can only access the info for billing purposes.

I'll be curious to see what the answer is - it's always good to learn (on these boards) if I'm operating under the wrong info.

Thank you, now I know & I don’t ever want to come into contact with anyone’s prescription-medicine-information- or anything ever again! Let me back-track a little. I didn’t explain that well.

According to my companies procedure guidelines, when I looked in the bag & saw it was medicine, I should have immediately taken it to the pharmacist on duty or the store manager. I should not have touched anything in the bag, even to straighten it, unless there was a chance of spillage (I assume this means pills or medicine falling out of the containers). This is what I wasn’t properly trained on.

If I had looked in the bag & saw that it was other merchandise, I should have contacted the shift manager, let him/her know that the items were left & then secured them behind my counter. Since I was never trained on proper handling of prescriptions, I treated it like any other situation.

According to the law, after the patient left her meds in the buggy, it was almost the same as putting them in a trash can. Anyone could have taken them, but if Joe Blow off the street did take them & use the medicine or information in an illegal way, he would be responsible, not my company.

The only knowledge that was accessible to me from the packaging, was nothing that I don’t have the legal right to know. It was only the patients name & partial address. All of the information about the medicines themselves was INSIDE the white paper pharmacy bags. I never opened them to see that information, therefore I was not in breech of the law. If I had opened the bags & looked at the more detailed information, that might have been a little iffy, but I am not clear on that.

In short, the medicine should have never been in my possession in the first place, but since I did have the meds & was unsure on the companies procedure & the laws pertaining to this situation, I handled it according to what I did know. Which was obviously wrong according to my companies procedures, but not in breech of the law.

I am so glad that I’m taking all my law classes in the next year or so, I hope that will clear up any misinformation I have, because at this point, I am confused as to what is fact & fiction. My store manager is not as educated as he should be on the laws or the pharmacy’s procedure, so he misinformed me o a lot of things during this whole debacle!