1. K & H Supplies Patient Safety Prepared for U.S Dept. of Veteran Affairs By: K & H Supplies 15107 Union Ave. S.W Lakewood, WA 98498 By: K & H Supplies 12306 Union Ave. S.W Lakewood, WA 98498

2. Agenda What is the problem? Introduction Problem Identified Patient Safety Product Innovation (Patent) Conclusion & Summary How it benefits the V.F.W

3. Introduction Cross Contamination Issue In Pharmacy Pill Counting Tray. John Smith. President & CEO & Ying Yo Chief Engineer Your Presenters To Agenda

4. John Smith Founded Smith group LLC in 1999 President & CEO of Smith Group LLC Smith Group LLC o Certifications and Contract Vehicles - SDVOB - Veteran owned Business - Small Business - SBA Section 8(a) - Small Disadvantaged Business - HUBZone Provides Professional Government and Commercial Logistics Services To Agenda

5. Ying Yo, P.E., CPhT Pharmacy Technician at Madigan Army medical Center, Ft. Lewis, Tacoma WA Ex-Motorola employee, Semiconductor Product Sector Six sigma trained professional from Motorola University To Agenda

6. Our Vision Transformation Focus in Good Health & Patient Safety to U.S Department of Veterans Affairs, Veterans, Families and Friends. Our Mission To Continuously Process Improvement in Transformation focus on Good Health and Patient Safety to our VA Veterans, Families and friends. To Agenda

7. What is the Problem? The tools that have been used to fill the tablet/capsule prescription drug order has been the pill counting tray and spatula since the beginning The same pill counting tray and spatula is used repeatedly. Even frequent cleanings leave the question of cross contamination. If one prescription contaminates another, the risk of allergic reactions go up, with no idea of the source; hindering in the treatment of such a reaction. This contamination could occur during the filling, counting and dispensing of the patient’s medication. Many patients are not sure if they are allergic to such drugs as penicillin or sulfa drugs. The only source of such an unidentified allergic reaction is that there has been a cross- contamination as evidenced by the patient’s symptoms. Alternatively, the patient may simply feel depressed or cross tempered To Agenda

8. What is the Problem? Pill sorter is used Pill sorter is cleaned Pill sorter is used Pill sorter is cleaned Patient at risk of cross contamination Traditional Pill Sorter To Agenda

9. Patient Safety No one knows better than pharmacy professionals of potential safety issues when prescription drugs are filled in the pharmacies. My concern is regarding cross drug contamination that affects patient safety. An improvement product process is needed to overcome such problem identified in order to eliminate cross drug contamination during filling and dispensed medications in pharmacies. Problem Identified To Agenda

10. Product Innovation What is the product innovation and what is it used for? Our Patented product is the single use disposable pill counting device and it is used to eliminate the risks of cross drug contamination in pharmacy counting tray. Some Novel Features and Advantages are: - A new single use pill counting device is used each time a prescription is filled. - The single use pill counting device is only used once for each prescription. - The single use pill counting device ensures patient safety by ensuring that medications are free from contamination. - The single use pill counting device is easy to manufacture using mold and die technology. - No Landfill - used products are recyclable. - Green Products. Environment Safe. To Agenda

11. What can this do for V.F.W and Families Two interesting articles about contamination, issues and concerns published in Drug Topics dated November 6 th and 20 th, 2006 respectively. Increased government spending on something that can be preventable ( allergic symptoms) such as unnecessary doctor’s office visits and prescription drug costs. To Agenda

12. The positive effects for V.F.W Department of Defense Guidance A 11 May 06 memo entitled “Established of DoD-wide Continuous Process Improvement programs” signed by the deputy Secretary of Defense states “The Secretary and I expect that every DoD organization is focused every day on improving the effectiveness of our support to the War fighter… In so doing, our U.S Department of Veterans Affairs will be the FIRST in the nation to identify and help to resolve this pharmacy contamination issue that affects patient safety and our Lab Report on HPLC test shows and confirm this is so. Even ISMP President Dr. Cohen, when we last talked to him, he was convinced. He also said that he is going to talk to his fellow and hopes to see something turn up. We are waiting to see what he is going to say and publish in his ISMP Alert newspaper. To Agenda

13. Conclusion Quote from ISMP President Dr. Michael Cohen Michael Conahan, The Institute for Safe medication Practices, agreed. “It seems entirely possible that residual dust and other particles from tablets in the counting tray could contaminate the next batch of tablets counted,” he said. “I must say that I have never heard of an actual case in which a patient was harmed as a result. Theoretically, it could happen. In fact, perhaps it has happened but has not been recognized as the actual cause.” To Agenda

14. May 7 th State Board meeting. Below are the meeting Minutes. Ying Yo, P.E, CPhT shared with the board his concern regarding drug cross contamination. Pharmacies are inherently dusty places and cross drug contamination is virtually very high during the process of filling prescriptions. This can lead to grave accidents. The pharmacy counting tray and spatula is the biggest problem. He has had lab tests done to research this issue and believes something needs to be done to prevent cross contamination. He has developed disposable trays. He asked the board to consider this danger and educate on how to prevent cross contamination. To Agenda

15. In Summary We are concerned citizens and we are here to promote public health and patient safety for the U.S Department of Veterans Affairs, Veterans and friends. We need all of your support and encouragement to make this patient safety happen. A lab Report on pharmacy counting trays- cross drug contamination issue. The sooner we take action, the sooner we will establish a safer, more cost effective process for providing prescriptions to millions of patients across the nation and the rest of the world. Prevention is better than a cure Cross Contaminations are largely preventable Remember: To Agenda

16. Thank-You We would like to invite the FDA and Joint Commission to investigate the contamination issue and report the outcomes to the department of Veterans Affairs accordingly. If this turns out to be a risk, and U.S Department of Veterans Affairs will implement the changes to better ensure the safety and quality of lives for our soldiers. The sooner we take action, the sooner we will establish a safer, more cost-effective process for providing prescriptions to millions of patients across the nation. To Agenda

17. Questions To Agenda