The White House Medical Unit improperly distributed prescription and non-prescription drugs during the Trump administration, according to a report published earlier this month.
The White House Medical Unit had "severe and systemic problems" with its pharmacy operations, according to the report from the U.S. Department of Defense's Office of Inspector General.
The unit stored and dispensed controlled substances without sufficient record-keeping and occasionally to staff who were legally ineligible to receive them, according to the report. The unit, which is comprised of multiple clinics in the D.C. area and overseen by the Defense Department, also misused department funds by dispensing brand-name drugs instead of generic equivalents.
By doing so, employees raised "the risk for the diversion of controlled substances," the report added.
Department, which did not comment on the report's findings. The Trump campaign did not immediately respond to a request for comment.
The report also said the White House Medical Office spent tens of thousands of dollars during the Trump administration on brand name medications instead of less expensive generic equivalents.
From 2017 to 2019, the unit spent about $46,500 on Ambien, a sleeping medication, which the report says is “174 times more expensive than the generic equivalent.” The clinic also spent nearly $100,000 during that period on Provigil, a stimulant that is “55 times more expensive than the generic equivalent,” the report said.
In 2019, investigators tried to obtain earlier records, but White House Medical Unit officials said they kept pharmaceutical records for only two years, according to the report.
“Without oversight from qualified pharmacy staff, the White House Medical Unit’s pharmaceutical management practices may have been subject to prescribing errors and inadequate medication management, increasing the risk to the health and safety of patients treated within the unit,” the report said.
It also detailed the dispensing of medication to ineligible White House staff members, which meant some staffers “received free specialty care and surgery at military medical treatment facilities.” The unit also dispensed medications like Ambien and Provigil “without verifying the patient’s identity,” the report said. Part of the report cited interviews with employees who worked in the White House dating to 2009, without specifying when such incidents took place.
The Pentagon IG’s office recommended a series of policy changes, including developing a pharmaceutical oversight plan for the White House Medical Unit, developing procedures for medication storage, prescribing and dispensing, and improving methods for establishing patient eligibility.
"Without oversight from qualified pharmacy staff, the White House Medical Unit’s pharmaceutical managementpractices may have been subject to prescribing errors and inadequate medication management, increasing therisk to the health and safety of patients treated within the unit," the report says.Other alleged issues include breaking federal regulations that require records for Schedule II drugs to be separated from other medications, the report found. Instead, records for the Schedule II drugs like fentanyl, morphine, hydrocodone and oxycodone were held in the same inventory as any other medication.
The report added that there was no pharmacist on the staff of the medical unit. Staff testified that the unit had requested to bring on a pharmacist technician but said the request had never been filed at the time of the investigation.
The inadequate dispensing of medications could be explained by the lack of oversight over the pharmacy. Interviewed staffers were unable to explain which division was in charge of the medical unit, the report added.
Unit only provided medication history from Trump's presidency
In order to list all medications ordered by the White House Medical Unit, investigators requested data from the unit, the Walter Reed National Military Medical Center and the National Capital Region Medical Directorate.
In 2019, investigators requested data from the medical unit from the previous five years but only received data from 2017 to 2019 because the medical unit said they only maintain records for two years
Investigators also only received data from 2017 to 2019 from the Walter Reed National Military Medical Center and data from 2018 to 2020 from the National Capital Region Medical Directorate due to similar policies.
The multiyear investigation included the interviews of more than 120 officials from hospital administrators, military medical providers and pharmacists. Investigators also evaluated transcripts from former White House Military Office employees between 2009 and 2018.
"We found that the White House Medical Unit maintained historical patient eligibility practices that did not follow DoD guidelines," the report says. "One former White House Medical Unit medical provider stated thatthe unit worked "in the gray ... helping anybody who needs help to get this mission done."
It also provides new context to systemic problems in a clinic that made headlines when Rep. Ronny Jackson (R-Tex.), who was Donald Trump’s personal doctor until 2018, was accused by almost two dozen colleagues of improper activities, including providing prescription drugs without proper paperwork — a habit that allegedly earned him the nickname “Candyman.” A 2021 Defense Department inspector general report later corroborated some of those claims, which Jackson denied and described as politically motivated.
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