Problems handling medicine prompted switch at UT, Jacobs says

Dr. Roger Kruse, right, examines the throwing hand of former University of Toledo quarterback Bruce Gradkowski. In 2004, Dr. Kruse was named Ohio s physician of the year by the state s athletic trainers. He has been involved in four Olympics.

An internal investigation to reorganize the University of Toledo has revealed possible violations of rules and regulations regarding medical controls in the athletic department.

UT President Lloyd Jacobs has called for a more thorough look at what types of laws might have been violated and has ordered that oversight of medication be moved outside the athletic department.

Suffice it to say we re still investigating, but preliminary data suggest that not all of those rules have been followed perfectly and I want them followed perfectly, he said. So we ll be following up on that.

There are hundreds of regulations, both state and federal, that govern the handling of medication such as where it is stored, how records are kept, and requiring prescriptions to be written legibly, Dr. Jacobs said.

At this point it s not clear how many or whether these infractions were major or minor, he said. As you can imagine, some could be minor, like a signature looks a little bit illegible, right? Some could be major. I have no idea at this point what kind of infraction we re dealing with; we re sorting that out.

In a letter written to UT Athletic Director Mike O Brien dated June 13, Dr. Jacobs outlined organizational changes to be effective immediately that would improve the university s accountability, efficiency, and student centeredness.

One of those changes includes having the inventory, storage, and dispensing of medications immediately moved under the direction of UT s Director of Pharmacy Joel Tavormina.

The letter also calls for the possible replacement of team physician Roger Kruse, but Dr. Jacobs yesterday said he did not say the physician should be fired.

No I didn t say that, and I don t say that, and I don t think that, he said. What I said is that needs to be looked at, and that s what we ll be doing.

That s a backtrack from the letter he sent to Mr. O Brien Wednesday that states: Strong consideration should be given to the replacement of the team physician who is currently under contract, by a full-time university employee physician in an effort to improve the conformity to applicable laws concerning the control of medicine.

Dr. Kruse is the medical director of Sportscare for the ProMedica Health System and is a contract employee with the university.

UT s merger with the former Medical University of Ohio adds more physicians to the university payroll.

Dr. Kruse gave a statement to The Blade yesterday.

I ve had a strong relationship with the University of Toledo athletic department for 26 years, 18 as head physician. During this time, I have not been aware of any mishandlings of medications, the statement said.

As of this time, I have not been contacted by anyone at the University of Toledo regarding the audit being conducted. If contacted, I will cooperate fully, he said in the statement.

Dr. Kruse, who is prominent in the local and national medical communities, declined further comment. He has been involved in the Olympics four times and was in Detroit for the U.S. Figure Skating Association Championships in January, 1994, when Nancy Kerrigan was attacked.

In 2004, Dr. Kruse was named Ohio s physician of the year by the state s athletic trainers association.

Locally, he is co-chairman of Toledo Mayor Carty Finkbeiner s Get Fit Toledo campaign.

Mr. O Brien yesterday said that Dr. Kruse remains the team physician and he is discussing the replacement aspect of the letter with Dr. Jacobs and Dr. Jeffrey Gold, UT s provost and executive vice president for health affairs and dean of the college of medicine.

I think the issue, it involved the reorganization that s taking place on this campus, whether it be athletics or another department, he said. I think Roger s done a fine job and I just feel that Dr. Jacobs wants us to look at the possibility of another team physician. That s what we ll do.

Mr. O Brien said Dr. Kruse has done a good job and that he didn t know of any medication-control issues until speaking with Dr. Jacobs this week.

Dr. Kruse has done a good job for our institution, been very loyal, he said.

Both Dr. Jacobs and Mr. O Brien said they are not aware of anybody being harmed by any problems with the control of medications in the athletic department.

Dr. Jacobs also said he doesn t anticipate any criminal charges.

I don t think there is any evidence of any criminal wrongdoing. No one s been injured, no wrong prescriptions, he said. It s more a matter of making sure that the record keeping and the appropriate handling of lot number reportings is just absolutely perfect.

The Ohio State Board of Pharmacy licenses any organization that purchases and possesses prescription drugs, including colleges and universities, Assistant Executive Director Tim Benedict said.

The University of Toledo has four licenses through the board and all are current.

The board is responsible for administering and enforcing laws governing drug distribution to keep a uniform system.

Once you start to get sloppy, it s sort of a downhill slide, Mr. Benedict said. That s why a lot of things for accreditation are put in place.

He said the board also is responsible for investigating any wrongdoing and presenting evidence to courts for prosecution of offenders. Usually the board would get involved with issues of someone stealing or giving out medication, Mr. Benedict said.

The board has not investigated UT, he said.

UT Medical Center Pharmacist Russ Smith, who is not involved with the athletic department, said there is a 4-inch binder with about a thousand pages relating to laws aimed at patient safety that pharmacists must follow.

The Drug Enforcement Administration regulates controlled substances and most other medication regulations fall under state control.

Rules regarding handwriting and other such issues are typically handled in house and more serious regulations would involve the DEA or state organization, said Mr. Smith, coordinator of managed care pharmacy services.

Dr. Jacobs said yesterday that the university s investigation into the athletic department and anywhere else within UT will be held up to public scrutiny as details become available.

We are doing the public s business here and we want to do it in public, he said.

Contact Meghan Gilbert at: mgilbert@theblade.com or 419-724-6134.