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Pharmacist held without bail
in cancer-drug case

By MATT CAMPBELL and JULIUS A. KARASH - The Kansas City Star
Date: 08/15/01 22:15

Robert R. Courtney

Kansas City pharmacist Robert R. Courtney was ordered held without bail Wednesday as federal agents continued to scour records to find cancer patients who may have received diluted medicine from him.

As the FBI and health officials fielded hundreds of calls from concerned Kansas Citians, Courtney faced a federal judge on Wednesday on a charge of adulterating and misbranding drugs used to help chemotherapy patients.

The government alleges Courtney provided dosages that contained just a fraction of their prescribed potency.

One sample that was tested had less than 1 percent of the drug ordered within the dosage provided, the government alleged. In one instance, there was a nearly $800 difference between the value of the drug that was ordered and what was provided for treatment, the government alleged.

Courtney's attorney, Jean Paul Bradshaw, said his client would plead not guilty and was cooperating with investigators.

Late Wednesday, Kansas City physician Verda Hunter said that she had used chemotherapy drugs from Courtney's pharmacy and that she was cooperating in the government's investigation. She issued this statement through her attorney, Diana Jordison:

"We have cooperated with the authorities in their investigation in every possible way. However, our sole focus is our patients. We are attempting to contact all of our patients about the situation, and I will meet personally with each of them to answer their questions."

Jordison declined to say if Hunter was the unnamed physician the government credited with helping in the case. She said Hunter had recently obtained chemotherapy drugs for her patients from Courtney's Research Medical Tower Pharmacy, but had stopped using the pharmacy "the minute there was a question raised."

Authorities say the case poses a serious public health issue.

"All of us as citizens have a right to expect when we receive medicine from a pharmacy that what we are getting is what the doctor ordered," said Chris Whitley, a spokesman for the U.S. attorney's office.

Cancer-fighting drugs

The drugs involved are Taxol and Gemzar, trade names for medicines mixed in solutions that are given intravenously. They are used mainly for certain types of ovarian, lung and pancreatic cancer.

The drugs are not sold directly to patients by a pharmacy but are ordered by an oncologist to be provided during outpatient chemotherapy treatments.

Investigators have said there is a possibility that hundreds of cancer patients received diluted dosages.

But Bradshaw, Courtney's attorney, repeating that his client will plead not guilty, said the scope of the government's case deals with the patients of just one physician and that they probably number "fewer than 50."

Courtney turned himself in Wednesday and was interviewed by the FBI and the Food and Drug Administration.

The charge against him involves drugs sold from his pharmacy at 6420 Prospect Ave. Courtney also is a licensed pharmacist in Kansas, where he owns and operates Courtney's pharmacy at 8901 W. 74th St. in Johnson County. The Kansas pharmacy also is licensed to be a distributor to doctors and hospitals.

The government's criminal charge does not mention the Kansas pharmacy.

Courtney, 48, made his first appearance before U.S. Magistrate Robert E. Larsen.

Although the government's attorney, Gene Porter, did not request that Courtney be held without bail, Larsen issued a detention order noting that the defendant had more than $10 million in assets and posed a serious risk to flee.

"... There is a risk that defendant may flee to avoid dealing with those who received the altered drugs or members of their families," Larsen wrote in his detention order.

Bradshaw, a former U.S. attorney in Kansas City, said that Courtney had cooperated with investigators and suggested his detention might hamper further cooperation.

But FBI spokesman Jeff Lanza discounted that concern. "We interview lots of people in jail," he said.

The complaint against Courtney alleges one criminal count in violation of the Food, Drug and Cosmetic Act. The maximum penalty is up to three years in prison without parole and a $250,000 fine.

"A complaint is simply a mechanism to get the defendant charged as quickly as possible and get the case brought into the system," Whitley said.

The next step is a detention hearing at 2 p.m. Monday before Larsen. At that time Courtney may request or waive a preliminary hearing. Eventually the case would go to a grand jury, which could issue a multicount indictment, Whitley said.

Courtney did not speak in court and sat with his back to the gallery, which included several supporters.

Todd Morris, who described himself as a friend for 10 years, said Courtney was a philanthropist who does not like attention drawn to his good deeds. Morris described Courtney's character as impeccable.

"He is one of the most generous, loving, caring people I know," Morris said.

Steps in the case

Court records detail how the investigation unfolded:

A sales representative of Eli Lilly and Co. contacted the office of a local physician who treats ovarian cancer. The representative said Courtney had purchased only a third as much Gemzar from Eli Lilly as the pharmacy had ostensibly provided -- and billed -- to the physician's office.

The physician did not have a Gemzar sample, but had a sample containing Taxol from Courtney's pharmacy tested. The results showed it contained less than one-third the amount of Taxol the doctor had ordered.

The physician contacted the FBI, and a criminal investigation started July 27. Further samples of Taxol and Gemzar were tested and were found to contain between 39 percent and less than 1 percent of the amount of the drug ordered by the physician.

On Monday investigators searched Courtney's Research Medical Tower Pharmacy.

Cancer drugs are expensive.

The government's complaint states that one order of 1,900 milligrams of Gemzar had a value of about $1,021. But the sample tested for that order indicated the mixture Courtney provided had just 24 percent of the amount ordered, worth about $242. The difference for that one order is about $780.

It also states that the physician's office ordered about $100,000 worth of the cancer drugs each month from Courtney's pharmacy.

Today federal authorities planned to resume their search of records to find patients who may have received diluted drugs.

To reach Matt Campbell, call (816) 234-4905 or send e-mail to mcampbell@kcstar.com.

To reach Julius A. Karash, health-care reporter, call (816) 234-7728 or send e-mail to jkarash@kcstar.com.