L.A. County’s Antidote for Illegal Pharmacies

Pharmacist Daniel Hancz knows all about the foreign-made medications sold without prescriptions at outdoor swap meets, party supply stores and butcher shops.

He assists other members of Los Angeles County’s Health Authority Law Enforcement Task Force in an effort to stop over-the-counter sales of the potentially dangerous pharmaceuticals, some of which are banned in the United States.

On a recent raid, Hancz and other task force members confiscated prescription drugs labeled in Spanish from two botanicas near downtown Los Angeles.

Among the illicit items they seized in the raid last Friday was a small round case of penicillin cream. For someone who is allergic to penicillin, just a touch, officials said, could cause a severe reaction, even death.

Health officers and sheriff’s deputies also removed vials of ready-to-inject penicillin and a 1-liter bottle of a vitamin mixture prepared for infusion from Botanica Guacamu on West 3rd Street near Vermont Avenue.

Five people were cited Friday at four separate Los Angeles storefronts for allegedly dispensing dangerous drugs without a license, a misdemeanor offense.

The task force, known as HALT, has seized an estimated $5 million worth of illegal pharmaceuticals, mostly in immigrant communities, during its nearly three-year existence, said Donald Ashton, the deputy health officer in charge.

“We have found these illicit pharmacies everywhere, from South Bay to Lancaster, from East Los Angeles to Santa Monica,” he said.

Most of the medications are manufactured in other countries with fewer government restrictions, officials said. Some drugs commonly found in the United States, such as vitamins, antibiotics and birth control, are sold in injection form, which requires a prescription. Others, like the painkiller Neo-Melubrina, which can harm the immune system, are banned in the United States.

Task force members are assisting police and prosecutors investigating the death of a 54-year-old Anaheim man, Roberto Caceres, last month after he allegedly received injections of vitamin B-12 and the steroid B-Methasone, used to treat allergic disorders, from two women now charged with involuntary manslaughter.

Ashton said it’s impossible to know how many people have become sick or died from black-market pharmaceuticals. Caceres’ death is the first such reported fatality in L.A. County in about four years, he said.

And four years ago was about the time county Supervisor Gloria Molina began a campaign to empower county health officers to close illegal pharmacies and increase the monetary penalties for selling pharmaceuticals without a prescription.

A 13-month-old boy, Christopher Martinez, had died in April 1998 after he received five injections over three days at a storefront in a Santa Ana strip mall. News reports showed a widespread problem. Molina said she had not realized until then how many illicit pharmacies were operating, or how potentially lethal their products were.

“We were seeing potential disasters appear throughout our neighborhoods,” she recalled. And county officials were almost powerless to respond.

So Molina asked state legislators for help. Under a 1998 law, county health officers may now inspect businesses suspected of selling illegal pharmaceuticals without search warrants, and may call in law enforcement to seize the contraband.

The legislation also increased penalties for sales of illegal pharmaceuticals. First-time offenders may now be fined up to $5,000 and sentenced to a year in jail; the fine increases to as much as $10,000 for repeat violations.

To enforce the new law, the Los Angeles County Board of Supervisors created the health authority task force in February 1999 as part of its Department of Health Services. The seven-member task force includes a full-time Los Angeles police officer and three sheriff’s deputies, in addition to Hancz and two health officers. It has an annual budget of $500,000.

Like a drug agent, Ashton measures success by results in the community. About 350 people have been arrested, roughly 50 of them in 2002, he said.

“The people who didn’t know it was against the law or didn’t think they would get caught aren’t doing it anymore,” Ashton said.

A few years ago, the task force shut down a swap meet booth whose operator had hung a shower curtain for customer privacy. “Someone would ask for an injection, go behind the curtain, drop their pants and get an injection,” Ashton said.

Although he cannot speak Spanish, Ashton once made undercover buys at Latino storefronts. Back then, he said, he could walk into a botanica, where many of the illegal items were on display, ask for penicillin and buy it.

Now, he said, sellers are more sophisticated, hiding their merchandise in back rooms or, in one instance, inside false walls. They also are more cautious, asking potential customers for a reference.

“A lot of them I don’t think are bad people,” Ashton said. “I think some of them actually think they are trying to help.”

Roberto Caceres had been desperate to get rid of an irritating rash that doctors had been unable to cure, said his son, Luis Caceres. He was on the verge of losing his job because he was sick so often, the son said.

With nowhere else to turn, Caceres sought help from a woman he had heard about on a popular Spanish-language talk-radio show.

Caceres paid Reina Isabel Chavarria $310 for an initial consultation. When the pills and ointment she had given him didn’t help, he returned to Chavarria’s house Oct. 28 for two injections that cost $140, authorities said.

After receiving the shots, Caceres went into convulsions and died minutes later at Valley Presbyterian Hospital, police said.

Authorities charged Chavarria, 48, and her 28-year-old assistant, Margarita Montes, both of Van Nuys, with involuntary manslaughter and practicing medicine without a license in connection with Caceres’ death.

Neighbors said they saw people line up at Chavarria’s house in the 15700 block of Marlin Place as early as 4:30 a.m., and they occasionally complained to police when children were left unattended in vehicles while adults went inside.

Task force members, who respond solely to complaints, said they were unaware of Chavarria’s business until Caceres died.

Since his death, members have been working with Los Angeles police detectives and Deputy Dist. Atty. Karen Rizzo, who is prosecuting the case.

At first, authorities had trouble even identifying what substances had been injected. The bottles were in Spanish and their English-language equivalencies were not listed in medical reference books.

Hancz found them in the Mexican edition of the Physicians’ Desk Reference, a popular pharmaceutical reference. He also is providing other expertise to the prosecution and is expected to testify in the criminal proceedings.

To report illegal pharmaceutical sales, call HALT at (213) 989-7039 and leave a message in English or Spanish. It should include information about the location of illicit pharmacies and types of drugs being sold there.