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Omnicare pharmacists, consulting phannacists, and other Omnicare employees, by changing

physicians' orders for specific antibiotics to Levaquin.

139.

Wholesale switching to Levaquin was often detrimental to patient care.

There is a

myriad of medications within the same antibiotic drug class; however, certain types of antibiotics

are indicated for particular types of infections. Indeed, Levaquin is not indicated for many types

of infections very common to long-term care facilities. For example, nosocomial pneumonia is a

common

problem

in

long-term

care

facilities.

Ciprofloxacin,

not

Levaquin,

is

the

preferred

medication for this condition because it will resolve this condition much more quickly.

Nevertheless, pursuant to the PAL, Omnicare patients were treated with Levaquin regardless of

the antibiotic their physicians prescribed. Levaquin might ultimately cure the infection, but it is

not the most efficacious antibiotic available to heal the infection quickly. Meanwhile, the patient

is forced to suffer from pneumonia for a longer period of time, which is not only paintul, but

dangerous. The lengthened treatment also means more associated costs to the governmental or

private payor.

140.

During

Lisitza's

tenure

at

Omnicare,

the

Omnicare

computer-based

pharmacy

system was designed in such a way that it was unable to flag patients with a medical history

indicating that Levaquin was not a preferred medication.

141.

While

the

confidential

information

and

documentation

that

would

reveal

additional names, dates, times, and places relating to the negotiation and implementation of the

illegal Market Share Agreement is solely within the possession of Ortho McNeil and Omnicare,

Lisitza's superiors conceded the existence, implementation, and financial impact of the Levaquin

Market Share Agreement to Lisitza and instructed him about what he was required to do to

accomplish the tinancial objective of the Levaquin Market Share Agreement.

38

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