(The Center Square) – “Severe and systemic problems” at the White House Medical Unit, which serves top government officials and their families, put patients at risk.
That’s according to a new report from the U.S. Department of Defense Office of Inspector General, which “concluded that all phases of the White House Medical Unit’s pharmacy operations had severe and systemic problems due to the unit’s reliance on ineffective internal controls to ensure compliance with pharmacy safety standards.”
“Without oversight from qualified pharmacy staff, the White House Medical Unit’s pharmaceutical management practices may have been subject to prescribing errors and inadequate medication management, increasing the risk to the health and safety of patients treated within the unit,” according to the report. “Additionally, the White House Medical Unit’s pharmaceutical management practices ineffectively used DoD funds by obtaining brand‑name medications instead of generic equivalents and increased the risk for the diversion of controlled substances.”
The 80-page report also found that the White House Medical Unit provided a wide range of health care and pharmaceutical services to ineligible White House staff in violation of federal law; dispensed prescription medications, including controlled substances, to ineligible White House staff; and did not follow guidelines for verifying patient eligibility, and the Defense Health Agency Director and Service Surgeons General did not provide oversight of the White House Medical Unit’s eligibility practices.
The White House Medical Unit had about 60 medical employees in 2019 including doctors, physician assistants, nurses, clinical psychologists, administrators, and medics. The White House Medical Unit’s primary mission is the health and safety of the president and vice president, but its secondary mission is to ensure the health and safety of all people on the White House 18‑acre compound.
The White House Medical Unit Executive Medicine Program provides special medical access to the Presidential Cabinet and Assistants to the President under the Secretarial Designee Program. Executive medical care includes annual physicals, preventive medical care, acute medical care, travel medicine, vaccinations, wellness evaluations, pharmaceutical services, diagnostic procedures, and specialty consultation services, according to the report.
“In our analysis of the White House Medical Unit’s controlled substance records, we found that medications, such as opioids and sleep medications, were not properly accounted for,” according to the report. “In addition, the White House Medical Unit used handwritten records to track the inventory of controlled substances. These records frequently contained errors in the medication counts, illegible text, or crossed out text that was not appropriately annotated.”
The White House Medical Unit also failed to follow DEA guidelines when prescribing controlled substances.
“White House Medical Unit medical providers wrote prescriptions for controlled substances that often lacked the medical provider and patient information mandated by DEA policy,” according to the report.
The unit also gave out prescription medicine and controlled substances without checking the identity of the patient.
“The White House Medical Unit dispensed non‑emergency controlled medications, such as Ambien and Provigil, without verifying the patient’s identity,” according to the report.
Ambien is a prescription sleep aid with a well-documented list of side effects. Provigil is a prescription stimulant used to treat sleepiness caused by narcolepsy, obstructive sleep apnea, and shift work.
For those two drugs in particular, the White House often overpaid for name brand drugs instead of using generic medications as required.
Over a three-year period, the White House Medical Unit spent an estimated $46,500 for brand name Ambien, which is 174 times more expensive than the generic equivalent. Over the same period, the White House Medical Unit also spent an estimated $98,000 for brand name Provigil, which is 55 times more expensive than the generic equivalent.
