Missouri officials acted properly when they imposed probation for one year on Uldis Pironis' pharmacist's license and on the operating permit for Jefferson City Apothecary, a three-judge panel of the state appeals court ruled Tuesday.
The court's 15-page ruling upheld decisions by the state Board of Pharmacy and the Administrative Hearing Commission, which found cause and imposed the contested discipline.
Cole County Circuit Judge Dan Green ruled in the state agencies' favor on Aug. 25, 2015, prompting the appeal to the Kansas City court.
The opinion, written by Chief Judge Mark Pfeiffer, noted state regulations require a pharmacist to be on duty and in the pharmacy before any prescriptions are "compounded, dispensed or otherwise provided and the public will be advised that no pharmacist is on duty."
On April 29, 2011, Pironis was in Chicago for a continuing education seminar and had arranged for another pharmacist to fill in for him at the Jefferson City Apothecary.
The other pharmacist did not report for work due to his wife's illness, and Pironis authorized a pharmacy technician to fill a prescription called in for a cancer patient that needed to be filled that day according to the doctor.
In their appeal, both the Apothecary and Pironis raised several issues about the original decision:
They did not violate any drug laws.
Pironis did not neglect his duties as a pharmacist.
The AHC's decision was issued by a commissioner who did not hear the case.
The discipline was unsupported by competent and substantial evidence.
The discipline was arbitrary, capricious and unreasonable; was an abuse of discretion; and violated their constitutional rights to due process and equal protection of the laws.
The board's orders didn't follow state law requirements.
The appeals court rejected all of those arguments.
Although admitting the violations occurred, the appeals court found, "The Apothecary and Pironis attempt to justify these violations by arguing that Pironis was exercising his professional judgment as a pharmacist when he decided to have (the technician) compound the chemotherapy medication, that he had the patient's interest in mind, and that no one complained about the product or was harmed by his decision."
However, the court ruled the regulations in question are not suggestions but mandatory rules established and designed to protect the public.
"There is no excuse for Pironis's flagrant disregard of the regulations," the opinion said. "Pironis's decision to pick and choose which mandatory regulations he believes himself to be bound by in his expertise is nothing short of the sort of arrogance that the regulations are designed to guard the public against."
The appeals court rejected the complaint about the Administrative Hearing commissioner who decided the case, since state law says that kind of decision can be made by someone who has read the full record, including all the evidence.
The court noted the final punishment is up to the board.
Quoting a 2014 opinion in a different case, Pfeiffer wrote: "The reason professional license discipline laws exist is to protect the public served by those who have been granted such licenses."