Electro Optical Pill Counting and Cross Contamination.

What would pharmacy customers say if they knew that the prescription they just picked up was counted out on a machine that utilized electro optics such as LED illumination and optical semiconductor detectors, where all drugs came down a common path for counting and wound up in a common tray, and that 100 different drugs had used that path since the last time the machine was cleaned?

What would the pharmacy customers do if they knew that the manufacturer recommended cleaning the machine to prevent pill dust build up so severe that it caused mistakes in counting by blocking the optics windows, not because the customer just got trace amounts of 20 different drugs along with the prescribed drug that was purchased?
What would they think if they knew that the 3 extra pills that went down the chute were put back in the supply bottle, thereby cross contaminating the entire supply bottle?

What they should do is hand the script back to the pharmacist and ask that the script be filled from a fresh supply bottle using a non cross contaminating counting technique.  Most pharmacy customers would be loathe doing this, as they respect the pharmacist and trust the pharmacist’s judgment.  However, in this instance they would be doing their fellow customers a great service by calling a very real problem to the pharmacist’s attention.

Cross contamination at this level is an insidious problem as it is almost invisible to the naked eye in the customers vial.  It is, however, very plainly visible on the optics in the counting machine, after hundreds of scripts are filled.  The problem is being exacerbated by the increasing number of uncoated generic drugs that are entering the market.  These drugs powder easily and coat everything they touch with microscopic particles of the drug.

There are many drugs that are known to be dangerous because small amounts of these drugs can cause severe allergic reactions, such as antibiotics.  There are others that are so potent that very small amounts can cause reactions.  Pharmacists are aware of these drugs and are usually very careful with them.  On the other hand, nobody knows what type of reaction multiple drugs taken in trace amounts might cause.  No one associates the sudden nausea they feel with the drug they have been taking for a year without problems, but they just refilled the script yesterday and may have gotten more than they paid for.

Cleaning these machines is a time consuming and non-productive process, but it is a very necessary process if cross contamination is to be avoided.  It needs to be done far more frequently than is required to keep the optics clean enough to avoid miscounts.  By the time the optical path becomes so coated with pill powders that the unit malfunctions, the unit may have filled many scripts that caused people to malfunction.
One day an ad like this may appear on TV or the radio, “Have you or a loved one experienced a sudden illness shortly after filling a prescription for pills at a pharmacy that uses a high speed pill counter which can cause cross contamination between drugs?  If so you may be entitled to compensation, contact the law firm of…”