At the end of 2015, the Los Angeles County Fire Department got some challenging news: The pharmacy director at L.A. County/USC Medical Center, the department’s largest hospital supplier of controlled substances, announced it wasn’t going to supply them any longer. With the liability of medical directors being held personally accountable in cases of diversion, providing a supply to distribute across the department’s 76 paramedic squads and 3,000-square-mile jurisdiction wasn’t worth the risk.
More than just requiring a new supplier, the decision provided an inflection point for L.A. County Fire to reexamine its whole pharmaceutical-procurement process. “The system was so broken,” medical director Clayton Kazan, MD, told viewers of the National Association of EMS Physician’s annual conference Thursday, “that it made us reconsider the whole process from the beginning.”