COMMONWEALTH OF MASSACHUSETTS

SUFFOLK COUNTY                                                                    BOARD OF REGISTRATION
                                                                                                        IN PHARMACY

______________________________
In the Matter of                                   ) 
KAREN L. RAMIREZ, R.PH.        )                                          Docket No. PHA-2010-0183
Pharmacist Registration No. 16431	)
______________________________)

CONSENT AGREEMENT

The Board of Registration in Pharmacy ("Board") and Karen L Ramirez, (“Registrant”), a pharmacist registered by the Board (Pharmacist Registration No. 16431), do hereby stipulate and agree that the following information shall be entered into and become a permanent part of the file of Registrant which is maintained by the Board:

1.  The parties enter into this Consent Agreement ("Agreement'') in resolution of the above-referenced complaint Docket No. PHA-2010-0183 (“Complaint”).

2.  The parties agree that this Agreement has been entered into relating to the Board’s concerns regarding certain conduct of Registrant during a February 9, 2010 appearance before the Board: Registrant’s positive toxicology screen results during a period when Registrant’s primary care physician reported to the Board that Registrant was not taking any medications; and Registrant’s failure to timely respond to the Board’s request for follow-up monitoring, in violation of CMR 10.03(1)(g) and 10.03(1)(q).

3.  Accordingly, Registrant acknowledges and agrees that Registrant’s pharmacist registration shall be placed on probationary status by the Board for a minimum one year period commencing on the Effective Date of the Agreement (“Probation Period”) and that during the Probation Period, Registrant shall be subject to the following terms and conditions:

     a.  may not act as a pharmacist manager of record in any pharmacy setting;

     b.  Registrant shall be required to provide a copy of this Agreement to each employer where
          she is employed as a pharmacist or other pharmacy support position in any pharmacy
          setting. Registrant’s employer(s) must provide written verification of receipt and review
          of this Agreement to the Board. Registrant shall provide notice to the Board of any
          change in employment status and information regarding the change in status, including
          voluntary (resignation) and involuntary (termination) changes in employment in any
          employment setting within twenty-four (24) hours of any change in employment. It shall
          be Registrant’s responsibility to ensure all verifications (employers and prescribers) are
          provided to the Board as required hereafter; 

c.	During the initial twelve months of the Probation Period, or such longer period as may be required by the Board, Registrant must undergo Board-approved monitoring,       including random drug/alcohol screening, such monitoring to commence as of the
      Effective Date of this Agreement. Registrant must arrange for the results of random,
      supervised urine tests for substances of abuse, collected for the Registrant no less than
      fifteen (15) times per year during the initial twelve months of the Probation Period, in
      accordance with and as set forth in Attachment A, all of which tests must be negative.
      Registrant may apply in writing to the Board for termination of the random drug/alcohol
      screening requirement following twelve contiguous months of negative screenings.
      Registrant may not terminate screenings without prior approval of the Board;

  d.   Registrant must refrain from the use of any “PRN” medication (including all
        benzodiazepines, opiates and opioids) during the Probation Period;

  e.   Registrant must refrain from the use of all other controlled substances unless, specifically
        prescribed by a treating physician and approved by the Board, for the purpose of
        prescribing for a legitimate medical purpose and in the usual course of physician's
        practice;

f.	If prescribed any controlled substance, Registrant shall notify the Board within three (3)
      days and arrange for the prescriber to submit directly to the Board a written statement of
      the identity and amount of each controlled substance prescribed, and medical necessity
      for said prescription; Registrant hereby waives any privileges concerning and all
      information, reports and records, which release includes the Registrant's waiver of any
      privileges and immunities she may possess regarding all material covered by 42 CFR Part
      2, and the Criminal Offender Records Information (CORI) Act (G.L. c. 6, §§ 167-178)
      and authorizes the Board to have access to all such information and records; and

  h.   Registrant must notify the Board in writing within ten (10) days of any change in the
        Registrant’s name and/or address.

4.   Registrant agrees that the termination of the Probation Period shall be granted only if she has met the following conditions: 

a.	Registrant must apply	in writing to the Board for termination of the Probation
Period. The Board may request a conference to discuss the merits of such request and request documentation regarding employment status; and
b.	Registrant has fully complied with all terms and conditions of the Agreement
and meets all other requirements for licensure.

5.   Registrant acknowledges that this Agreement shall be incorporated into the records maintained by the Board, is a matter of public record, and subject to disclosure without limitation to public and equivalent state licensing boards.

6.   The Registrant understands and agrees that, at any time during the Probation Period, upon a determination by the Board of any violation of any of the terms and conditions of this Agreement, or any violation of the applicable laws, rules and regulations governing the practice 

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of pharmacy, the Board may seek to immediately suspend or otherwise discipline the Registrant’s license to practice pharmacy without the requirement of further proceedings pursuant to M.G.L. c. 30A for a period of time deemed necessary by the Board.

7.   The Registrant understands and agrees that any of the following may be considered by the Board to be a violation of this Agreement and a basis for disciplinary action by the Board:

a.	A toxicology screen is found to contain any evidence of any controlled
substance and alcohol in violation of this Agreement;

b.	the Board has other reliable evidence that the Registrant has used any controlled
substance and alcohol in violation of this Agreement; or

c.	the Registrant withdraws any waiver or release provided and/or filed in
connection with this Agreement.

8.   The Registrant understands and agrees that her decision to enter into this Agreement is a final act and is not subject to reconsideration or judicial review.

9.   The Registrant states that she has used legal counsel in connection with her decision to enter into this Agreement or if she did not, that she had an opportunity to do so.

10.   The Registrant certifies that she has read this document entitled “Consent Agreement.” The Registrant understands that, by executing this Agreement, she is agreeing to the terms and conditions pursuant to which the Board will and place her license on probationary status and the terms and conditions pursuant to which the Board will terminate the Probation Period as set forth herein.

Karen L. Ramirez, R.Ph.

Effective Date: 10/24/10

BOARD OF REGISTRATION
IN PHARMACY

								Joanne M. Trifone, R.Ph.
								President
Date: __10/21/2010__
Dec. No.  2419
Attachment A

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