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<p class="MsoNormal">HI all, <o:p></o:p></p>
<p class="MsoNormal">A number of you have asked me what information I have uncovered about providing over the counter medications for library staff. I will summarize what I know:<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">A number of libraries have pulled all medications out of their first aid kits and do not have a community bottle of Tylenol or Tums because they have been told that it is a liability. I have not found a law, but I have found a number of
prudent bits of advice that I will share. Our insurance broker was here today and said that we should not
<u>provide</u> any medications for staff or anyone else and suggested the following policy in the HR manual:<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">“Employees may only have in their possession prescription drugs made out to them or over the counter medicines for their personal use. Medicines should be in their original containers or thusly labeled. ”<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Here is some other information you may wish to learn: <o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p style="margin:0in;margin-bottom:.0001pt;line-height:15.0pt;background:white"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">From a legal website sponsored by TMF Attorneys-link below. Since I am not an attorney, I suggest you
check with your own counsel.: <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial","sans-serif";display:none"><o:p> </o:p></span></p>
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<p class="MsoNormal" align="right" style="text-align:right;line-height:12.0pt"><a href="http://www.tmfattorneys.com/index.php?view=article&catid=3&id=36:providing-over-the-counter-medications-at-work&tmpl=component&print=1&layout=default&page=&option=com_content&Itemid=39" title=""Print" "><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#0055A2;text-decoration:none"><img border="0" width="16" height="16" id="Picture_x0020_1" src="cid:image001.png@01CDC3EB.51ECD9A0" alt="Print"></span></a><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333"><o:p></o:p></span></p>
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<p class="MsoNormal" style="margin-left:103.5pt;line-height:12.0pt"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">The use of over-the-counter medications, such as pain relievers and cold medications, may allow an employee to remain
at work despite a nagging headache or a dripping nose. Given the benefit of keeping an employee working productively, should an employer provide over-the-counter medications to employees suffering from minor ailments at work?
</span><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red">We believe the answer is no for several reasons:<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-left:103.5pt;line-height:12.0pt"><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red"><o:p> </o:p></span></b></p>
<p class="MsoListParagraph" style="margin-left:121.5pt;text-indent:-.25in;line-height:12.0pt;mso-list:l0 level1 lfo1">
<![if !supportLists]><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333"><span style="mso-list:Ignore">1.<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">The medication may result in an unintended consequence, triggering lawsuits against the employer. The employee could sustain an allergic reaction to
the medication. The medication could cause drowsiness, resulting in a workplace accident or an accident while traveling after work. The employee could take the wrong dose or choke while attempting to swallow the pills.<o:p></o:p></span></p>
<p class="MsoListParagraph" style="margin-left:121.5pt;text-indent:-.25in;line-height:12.0pt;mso-list:l0 level1 lfo1">
<![if !supportLists]><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333"><span style="mso-list:Ignore">2.<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">The employee may feel pressured by the manager or supervisor into taking the medication, even if the employee does not want to take that particular type
or dose of medicine being offered. <o:p></o:p></span></p>
<p class="MsoListParagraph" style="margin-left:121.5pt;text-indent:-.25in;line-height:12.0pt;mso-list:l0 level1 lfo1">
<![if !supportLists]><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333"><span style="mso-list:Ignore">3.<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">Providing medicine may open the employer to charges that the employer knew the employee was disabled. For example, if an employer regularly gave an
employee pain medication at work, then subsequently terminated the employee, the employee may have a claim of disability discrimination, arguing that the employer knew of the disabling condition by virtue of regularly supplying pain medication to the employee.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:103.5pt;line-height:12.0pt"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">A recent article by an employment consultant counseled against providing over-the-counter medications to employees,
but recommended that employers adopt a policy requiring employees to notify their supervisor if they are taking medications, including over-the-counter medications, that may impair their ability to perform their work or cause drowsiness.
</span><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red">We advise against advising all employees to divulge the medications they are taking.</span></b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red">
</span><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">Generally, an employer may not ask all employees what prescription or over-the counter medications they are taking, because such information is confidential. Asking all employees
about their use of medications is not job-related and consistent with business necessity. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:103.5pt;line-height:12.0pt"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">In limited circumstances, certain employers may be able to demonstrate that it is job-related and consistent with
business necessity to require employees in positions of public safety to report when they are taking medication that may affect their ability to perform the essential functions of their job. Under those limited circumstances, however, an employer must be
able to demonstrate that an employee’s inability or </span><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red">impaired ability to perform the essential functions will result in a direct threat.</span></b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red">
</span><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">It is only in those limited circumstances that an employer should require an employee to provide a list of the medications being taken that present a direct threat. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:103.5pt;line-height:12.0pt"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">That same article also suggested adding one or two basic over-the-counter medications to the company’s first aid
kit that employees may access. </span><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red">This still has the taint of being employer supplied medications, and again we would recommend against doing so.</span></b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:red"> </span><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:103.5pt;line-height:12.0pt"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">We recommend that employees be responsible for maintaining and controlling their own pain and cold medications.
That way the employee is the one controlling when and what is taken. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:103.5pt;line-height:12.0pt"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:#333333">Feel free to contact any of the TMF attorneys to discuss this or any other legal matter.<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Arial","sans-serif"">www.tmfattorneys.com/index.php?option=com_content&view=article&id=36:providing-over-the-counter-medications-at-work&catid=3&Itemid=39<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif""><o:p> </o:p></span></p>
<p align="center" style="margin:0in;margin-bottom:.0001pt;text-align:center;line-height:15.0pt;background:white">
<strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">FDA LOWERS THE ACETAMINOPHEN DOSAGE LIMIT</span></strong><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black"><br>
</span></b><strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">& PROPOSES BLACK BOX WARNING</span></strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black"><o:p></o:p></span></p>
<p style="margin:0in;margin-bottom:.0001pt;line-height:15.0pt;background:white"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">On January 13, 2011 the Food and Drug Administration (FDA) lowered the limit of acetaminophen allowed
to be included in prescription drugs to only 325 milligrams per dose. The FDA also mandated an update to labels of all prescription combination acetaminophen products to warn of the potential risk for severe liver injury. There is a wide array of both prescription
and over the counter drugs that include acetaminophen (see list of drugs at the bottom of this page) and prior to this new limit, many of the prescription medications had up to 750 milligrams of acetaminophen per dose.<span class="apple-converted-space"><b> </b></span></span><strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">The
FDA also now proposes inclusion of their most severe “Black Box” warning on all prescription products that contain acetaminophen.</span></strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black"><o:p></o:p></span></p>
<p style="margin:0in;margin-bottom:.0001pt;line-height:15.0pt;background:white"><strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">TAKING MORE ACETAMINOPHEN THAN YOU KNOW. WHAT IS APAP?</span></strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black"><o:p></o:p></span></p>
<p style="margin:0in;margin-bottom:.0001pt;line-height:15.0pt;background:white"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">“APAP” is an abbreviation for acetaminophen that many drug-makers use as shorthand in the list of ingredients
on their drug packaging.<span class="apple-converted-space"> </span></span><strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">Even if the prior dosage of acetaminophen had been an appropriate amount, it is not uncommon for users
to accidentally exceed recommended dosage limits by taking more than one medication that includes acetaminophen at a time without realizing it because they do not recognize that “APAP” is, in fact, also acetaminophen!</span></strong><span class="apple-converted-space"><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black"> </span></b></span><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">Some
of the most popular drugs that use the abbreviation “APAP” are Percocet, Vicodin, and Tylenol with Codeine, among others.<o:p></o:p></span></p>
<p style="margin:0in;margin-bottom:.0001pt;line-height:15.0pt;background:white"><strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">WHAT IS</span></strong><span class="apple-converted-space"><b><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black"> </span></b></span><strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">ACETAMINOPHEN?</span></strong><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black"><o:p></o:p></span></p>
<p style="margin:0in;margin-bottom:.0001pt;line-height:15.0pt;background:white"><span style="font-size:9.0pt;font-family:"Arial","sans-serif";color:black">Acetaminophen was approved by the United States Food and Drug Administration (FDA) in 1951. Acetaminophen,
known as Paracetamol internationally, is a pain reliever and fever reducer. Acetaminophen is most commonly sold under the brand Tylenol, but it is an ingredient in hundreds of brands both prescription and over the counter (OTC). It is frequently found in cold
and flu medications. Acetaminophen has been linked to liver damage and failure.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif""><o:p> </o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D">Nancy S. Levin<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D">Director<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D">Cleveland Heights-University Heights Public Library
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D">2345 Lee Road<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D">Cleveland Heights Ohio 44118<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D">216-932-3600 ext 240<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D"><a href="mailto:nlevin@heightslibrary.org"><span style="color:#1F497D">nlevin@heightslibrary.org</span></a><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial","sans-serif";color:#1F497D">"Opening Doors, Opening Minds"<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
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