PRACTICE Pulse Have a question? THE FVMA CAN HELP.

QUESTION: I recently completed the FVMA’s courses about laws and rules. I have a follow-up question regarding DEA licensure.

At the end, the lecture notes stated, “Do all practitioners in a group practice need to be DEA registered? No, a veterinarian who is an agent or employee of another DEA registered veterinarian may, in the normal course of business or employment, administer or dispense a controlled substance.”

I am a full-time relief doctor. Typically, I work alone and independently in the clinic that I'm covering. The regular doctor is not typically present or providing input on the cases. I will see new patients and existing patients who have seen the regular doctor at the practice. Do I need my own DEA license to administer controlled drugs for surgery that I am performing in the clinic, or do I count as an agent of the DEA-registered regular veterinarian at the practice (even if he/she is not present or providing input on the cases)?

A: The non-DEA registered veterinarian can act as an agent of the DEA-registered veterinarian when acting in the regular course of practice. Just like a nurse to her supervising MD. Regular course of practice means that the DEA-registered veterinarian has purchased the controlled substances and has authorized their use in the practice by other veterinarians. That authorization does not need to be in writing. If the DEA-registered veterinarian is aware and keeping the records as required by law, then his/her presence is not required.

QUESTION: I have a few questions about a DVM overseeing CVT appointments. I work with a mobile veterinarian who is going on maternity leave next year. We were wondering if it is possible for me to run testing and give vaccines (not rabies) without her physically being in the van, or if she could be virtually present through FaceTime. I have the same question regarding prescribing medications. Would she be able to do that over the phone?

A: The short answer is no.

The administration of any vaccination by a veterinary aide, nurse, technician, intern, or other employee of a licensed veterinarian, which is not specifically prohibited by Rule 61G18-17.006, F.A.C., requires “immediate supervision” as that phrase is defined in Section 474.202(5), F.S.

(5) “Immediate supervision” or words of similar purport mean a licensed Doctor of Veterinary Medicine is on the premises whenever veterinary services are being provided.

As far as prescribing medications is concerned, it is a far easier answer. If it is for an established patient, the veterinarian can do so. If it is for a new patient, the veterinarian must first establish a veterinarian-client-patient relationship (VCPR) in person.

QUESTION: I have been helping one or two mornings a week at a clinic where the owner was too sick to practice and now has passed away. I don't know what to do about the controlled drugs that are all in her name. The drugs are secure, and I have a DEA license, but the practice is being sold. I anticipate I will only be here a few more mornings until the sale goes through. Any advice?

A: The drugs are now part of the assets of the practice and can be sold with the practice. A detailed inventory must be created with names, quantities, lot numbers, and expiration dates. The selling veterinarian and the purchasing veterinarian must sign the inventory. Because the selling veterinarian is deceased, you can sign in her stead. If there are any Schedule II substances, a DEA for 222 must be created to document the transfer.

One of the benefits of an FVMA membership is our helpline (800-992-3862), which is available to members Monday through Friday from 8 a.m.-5 p.m. Our helpline also provides insight to the FVMA staff of the challenges and concerns of our members. In this feature, we will highlight topics from the questions we received in preceding weeks as a part of an effort to keep our members up to date on current concerns, as well as regulatory and legislative changes.

QUESTION: I am setting up new veterinary software, and my implementer asked me to determine what needs to be on the prescription labels for medication dispensing for Florida. Could you assist with this matter, please?

A: All containers distributed must be labeled with:

- The name of the drug

- Strength and quantity of the drug

- Expiration date

- Instructions as to the use of the drug

- The name and species of the animal for which the drug is intended to be administered

- The last name of the animal’s owner

- The name, address, and telephone number of the veterinarian prescribing the drug

If it is a controlled substance, the following need to be included:

- Practice name and address

- Serial (prescription) number

- The name of the patient

- The name of the prescribing practitioner

- Directions for use

- Cautionary statements such as: “CAUTION: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.”

QUESTION: We have a client who is temporarily out of state. Her dog is on Trilostane long-term and needs to have her prescription refilled within the next several weeks, prior to coming back to Florida. She made a call to a local Costco pharmacy and was told by the pharmacist that our veterinarian could write or call in a prescription to the out-of-state Costco, and they would be able to fill as instructed. We want to be sure this is within Florida's pharmacology regulations.

A: This is absolutely proper. The prescription includes a call-in order, and the pharmacist in the other state is willing to accept and fill it. In the reverse scenario, the Florida pharmacist could do the same thing.

QUESTION: How long should I maintain my liability insurance after retiring if I don't plan to practice any longer?

A: You should contact your insurance company to discuss this. Insurance companies usually offer “tail coverage” that runs for two (2) years, which is the statute of limitations for negligence, after the doctor retires/stops practicing. The premium is much less than the premium during practice because no new possibilities for claims are being generated.

QUESTION: Does a mobile, mixed-practice veterinarian need to have an HCCE permit? I only take my vehicle out into the field for large animal patients.

A: If you are a solo practitioner, you do not need an HCCE permit. However, you may have problems buying drugs from some wholesalers that require the HCCE as part of the transaction.