THE STRANGE CASE OF AYANA SMITH:

by norman j clement rph., dds

 Masters Case presentation University of Florida, College of Dentistry CDP-29, May 2018, candidate American Academy of General Dentistry (FAGD)

“A Re-Examination of Dental Competency, the mistreatment of an African-American young woman by The Chief Examiner William Bell DDS, and the failure of The Commission on Dental Competency Assessment  (CDCA) to address her complaint and the dentist candidate’s appeal”

District 6 Museum, Cape Town South Africa

THE STATEMENT OF FACTS

  1. The Patient Ayana Smith of Tampa Fl., was presented as a candidate for Periodontal Scaling for The Commission on Dental Competency Assessment (CDCA).
  2. Pre-exam photographs, radiographs and oral exam demonstrated, Ms. Smith Generalized Gingivitisto localized Periodontitis.
  3. Ms. Smith, states upon examination for Periodontal Scaling, two of the Examiners greeted her professionally utilizing Universal Precautions, Face mask, grown, caps, and magnification headlights.
  4. The two Examiners agreed she was a candidate the Periodontal Scaling.
  5. Ms. Smith, then sates suddenly a man identified as “The Chief Examiner” came into the dental cubicle began arguing with the two examiners, he put on pair of gloves, told her to open up and replied “NO.”
  6. Ms. Smith states, “The Chief Examiner” stated, “Your mouth wasn’t dirty enough,” the Dental candidate failed this section of the examination for “Lack of Clinical Judgment”

RE: CANDIDATE APPEAL

My name is Norman J Clement, I am both Dentist/Pharmacist currently enrolled in my second year Comprehensive Dentistry Program, Class 29(CDP 29), The Academy of General Dentistry (AGD) (Master track program) at the University of Florida College of Dentistry (see exhibit 1).

I am generating this appeal because I strongly believe my results on The Commission on Dental Competency Assessments (CDCA) were adversely affected by extraordinary conditions during the examination which affected the final outcome of my examination.

This appeal arises from the demonstrated outright failure by a CDCA examiner WILLIAM  “BILL” BELL, (THE CHIEF EXAMINER)  “to comply with CDCA material examination requirements, as contained in the Candidates Manual, that directly caused this candidate to fail the examination.”

STATEMENT OF CONTENT OF APPEAL

  1. The examination date May 5-6, 2017
  2. University of Florida School of Dentistry, Gainesville, Florida.
  3. Norman J Clement (candidate)
  4. THE CHIEF EXAMINER, WILLIAM “BILL” BELL, MORE THAN DEMONSTRATED A CRITICAL LACK OF CLINICAL JUDGEMENT, DIAGNOSTIC SKILLS, BY FURTHER DEMONSTRATING COMPLETE DISREGARD FOR THE ORAL STRUCTURES AND WELFARE BY VIOLATION OF UNIVERSAL PRECATIONS[i] OF THE (MY) PATIENT AYANA SMITH (see patients exhibit 2).

ARGUMENT

I failed the Restorative/Periodontal CDCA examination because of the Critical Lack of Clinical Judgment/Diagnostic Skills and bias directed toward me by of Chief Examiner William “Bill” Bell during the entire exam. On Saturday, while setting up for the exam, Dr. Bell came over to me an asked what was my candidates number. I told him 161, but I also thought that to be somewhat unusual.  I further strongly know I passed the entire Manikin Portion of the CDCA Board Examination of May 5, 2017.

METHODOLOGY

PERIODONTAL POST RE-XAMINE

Patient Ayana Smith was re-examined (post CDCA board exam) using criteria procedures similarly to those established for Periodontal Scaling Examination on the CDCA Dental Examination Board.[ii]  Three (3) examiners, William “Bill” Bell DDS The Chief Examiner CDCA, Nora Delgado-Velasquez DDS, Practice Limited to Periodontics and Implants, Diplomate, America Board of Periodontology, Tampa, FL 33609 (see Delgado-Velasquez, exhibit- 3), and Darnell Kaigler DDS.MS, PhD, Diplomate, American Board of Periodontology, Associate Professor Department of Periodontics and Oral Medicine, University of Michigan Professor  (see Kaigler’s exhibit-4) determined if patient Ayana Smith met specifications of a CDCA Dental Board candidate.  Both Drs. Delgado-Velasquez and Kaigler’s findings are published and found in exhibits 3 and 4, of this Appeal. Dr. William “Bill” Bell’s findings are found from CDCA examination results and his observed behavior in patient Ayana Smith’s exhibit -2.

RESTORATIVE:

Patient Ayana Smith was a candidate for the Restorative Class-II, composite. Patient Smith had two clinical lesions, tooth 29, MESIAL-OCCUSAL (MO) and tooth 12, DISTAL-OCCUSSAL (DO) that met CDCA Board Criteria. Tooth #29 was selected, as this was the most ideal and simplest lesion.

Ms. Smith states upon presentation at least 2 clinical examiners agreed tooth #29 met CDCA Board criteria however Dr. Bell somehow intervened and tooth #29 was rejected (see exhibit-2 overall statement of patient).

Patient Ayana Smith returned for examination of tooth 12, DO (which was much more difficult) and stated Dr. Bell appeared outraged at her presence again. After a long discussion with other examiners the procedure was allowed. Patient Ayana Smith states, Dr. Bell wore gloves only during his examination of her throughout the restorative exams (see patient exhibit-2, pg2, 3).

STATEMENT OF FACTS

Patient Ayana Smith of Tampa, Fl. (see exhibit-6) was presented as a candidate for Periodontal Scaling for the CDCA examine held May 5-6, 2017, University of Florida College of Dentistry. Both pre-exam photographs (see exhibit-5, radiographs) and oral exam showed Patient Ayana Smith to have Generalized Gingivitis to localized Periodontitis. Patient Ayana Smith was selected as a candidate for the board using guidelines of CDCA Candidates Manual, [iii] lower anterior and posteriors 22 thru 31 were then selected.

Patient Ayana Smith, states upon examination for Periodontal Scaling, two of the Examiners greeted her professionally utilizing Universal Precautions, facemask, gowns, caps and magnification, headlights (see patient exhibit-2, pg2, 3).  Patient Ayana Smith further states these two examiners agreed she was a candidate. Patient Ayana Smith said Dr. Bell then came into the dental cubicle argued with the two examiners, put on a pair of gloves only, said “open up” and replied “NO.” I failed this part of the exam.

“YOUR MOUTH WASN’T DIRTY ENOUGH”

“YOU MUST BE HUNGRY”

In Patient Ayana Smith’s own hand writing she describes the deplorable way William “Bill” Bell degraded her, then made the statements directly to her that “YOUR MOUTH WASN’T DIRTY ENOUGH” AND OTHER DERAGATORY, DENIGRATING REMARKS (see patient exhibit-2 pg. 3).

Dr. Darnell Kaigler Jr., was asked to chart the teeth he would have chosen for scaling on the CDCA exam (see Kaigler’s exhibit-4) using their criteria. Dr. Kaigler’s charting of  Patient Ayana Smith’s lower dentition was nearly identical to the charting I presented on the day of the exam (see Kaigler’s exhibit-4).

“OVERWHELMING CLINICAL EVIDENCE”

The Clinical evidence against Dr. William “Bill” Bell’s complete failure to identify moderate generalize gingivitis (see Delgado-Velasquez, Kaigler exhibits 4&5) in  Patient Ayana Smith is simply overwhelming, and has to be based on a biased conclusion which doesn’t belong in the field of Dentistry.

Notwithstanding, Dr. William “Bill” Bell failed to use Universal Precaution Infection Control Procedures as published by the Center for Disease Control and Prevention,[iv]  by failing to wear a masks and gowns during examinations of patient Ayana Smith (see patient’s exhibits 7,8,9).

“OPEN YOUR MOUTH”

Ms. Ayana Smith stated in her own words and handwriting (see exhibit-2, pg-2) during both Periodontal and Restorative examination procedures “Mr. Bell, examine my mouth…by simply  throwing on a pair of gloves  and quickly uttering open up.” Ms. Smith was so outraged with Dr. William “Bill” Bell, she felt  compelled to further document his “sub par treatment” and took pictures (see exhibit-2, pg-3).

In patient Ayana Smith’s photos of William “Bill” Bell DDS, he is seen writing and doesn’t appear to have worn universal protective gown or mask (see patient exhibit-7, 8,9). Dr. Bell’s badge is clearly identifiable (see exhibit-7).

In preparation of tooth #12 access ideal opening and proximal box were completed. Dental caries was extensive involving areas under Dentin Enamel Junction (DEJ), which required I approximately 11 modifications, in which all caries were removed. The Examiners approved “Every Modification”. My final request was placement of dycal, glass ionomer base, and then final composite restoration.

According to Patient Ayana Smith all examiners agreed except Dr. William “Bill” Bell. I was terminated from CDCA Examination and prevented from moving forward on remaining of CDCA Exam.

FINDINGS

PERIODONTICS

The finding from Nora Delgado-Velasquez, DDS and Darnell Kaigler Jr DDS, both of whom are Diplomate America Board of Periodontology are more than clear Patient Ayana Smith was a candidate for Periodontal Scaling the day before the CDCA Board Examination, the day of the CDCA Board Examination on May 6. 2017, (at the time she was presented for treatment) and the days after the CDCA Board Examination (see Delgado-Velasquez, Kaigler exhibits 3&4).

On the day of the exam William “Bill” Bell DDS, adversely influenced and rejected Patient Ms. Smith as a candidate on the Periodontal section of the CDCA Exam, and said to her directly “Your mouth wasn’t dirty enough.” (See patient’s exhibit-2 pg. 3)

Dr. Nora Delgado-Velasquez, DDS, evaluated Patient Ayana Smith post exam, May 8, 2017, in her office in Tampa, Fl., and found “Heavy generalized plaque, Moderate supragingival calculus on lower anterior teeth and #3.  Generalized light subgingival calculus detected on probing mostly on enamel surfaces”(see Delgado-Velasquez, exhibits 3)

Near District 6, Old Cape Town South Africa

Patient Ayana Smith was flown to Detroit and was further evaluated by Darnell Kaigler Jr. DDS, MS, PhD in his Detroit Dental Specialty Center, May 22, 2017, and recorded during the exam:

Plague Score (O’Leary 1972) estimate 90%, Bleeding Index 63%, Calculus Moderate supragingival (generalized) Detectable subgingival (all upper and lower molars; 23-26) Probing Depths, 2-4mm in the upper and lower anterior; 2-5mm in the upper and lower posterior. In the Field of Law these Clinical Finding are Prima Fascia Evidence (see Kaigler’s exhibits 4).

PERIODONTAL THERAPY

On May 22, 2017, Patient Ayana Smith received periodontal therapy while at the Detroit Dental Specialty Center (prophy plus) with generalized scaling throughout the dentition to remove supra and sub-gingival deposits. It was recommended that Patient Ayana Smith seek regular dental care at her previous dental office or another local dental office for follow-up and long-term maintenance. Ms. Ayana Smith flew back and returned safely to Tampa, Florida that very night.

RESTORATIVE

I did not lack Clinical judgment and I strongly believe had it not been for Dr. Bell’s interferences I would have passed the Restorative section of this test. I was told by another examiner, Dr.Bell  stated the cavity prep was going all over the place.

I agree, this was not going to be an ideal prep. Good clinical judgment is “one must go where the caries goes.”  I did not have a pulp exposure. The internal prep was less than ideal but I removed all the caries and Patient Ayana Smith experienced no post-op pain.

I should have been approved to complete the exam. I was stopped by Dr. William Bell’s lack of clinical judgment. The failure to remove dental caries is Poor Clinical judgment. I know I had passed this exam.

DISCUSION

No disease state can ever be treated if there is a failure to properly diagnose and more specifically when bias is allowed to interfere with overwhelming clinical evidence[v].

Yet, “I Know Where I Have Been” and while it is not easy and painful challenging any individual Dental Board Examiner, without a full understanding of the potential adverse consequence. 

I could have just as easily sat back and done nothing or like many of my dental colleagues said to me, “ Norm, just pray about it” and “get ready for the next dental board exam.”

Yet, in the song “I Know Where I Have Been” as sung by Dana Owens also known as Queen Latifah, “from the movie Hair Spray it is stated:

“There’s a road we’ve been traveling, lost so many on the way, but riches

will be plenty, what the price we had to pay,

There’s a dream with a future,

There’s a struggle that we have yet to win,

And there’s pride in my heart because I know where I’m going

Yes I do…because

I know where I’ve been.”

USE THAT PRIDE IN OUR HEARTS

To lift ourselves up into tomorrow

JUST TO SIT STILL WOULD BE A SIN

Lord Knows

“I Know Where I’ve been”

I’ve come to be compelled always to be an advocate for my patient and for better dental healthcare inspight of myself.

YET ON THIS DAY

On this day William “Bill” Bell was so busy trying to be a bigot, so busy trying to be a racist, so busy trying to be the toughest Dental Examiner on the CDCA Dental Board Examination, he forgot how to be fair. 

However, I don’t believe William “Bill” Bell DDS is a racist, or bigot at all. The eight hundred pound monster in this room is the Critical Lack of Clinical Judgment, diagnostic skills, demonstrating complete disregard for the oral structures and welfare of Patient Ayana Smith by violation of universal precautions[vi]

Groots Constantia Winery, Southern Suburbs, Cape Town South Africa

So on that day of May 6, 2017, William “Bill” Bell DDS was so busy trying to be someone he isn’t, he forgot who he was, and what he was, …. A Dentist…A Clinical Examiner. Instead he just looked at Patient Ayana Smith and looked right through her…. as a modern day Sarjie Bartman[vii] (Hottenot Venus)[viii] as he looked at me and looked right through me.

CONCLUSION

WILLIAM “BILL” BELL DDS must be removed as Chief Examiner of the CDCA Dental Board Examination as having demonstrated poor clinical judgment and failure to meet minimum appropriate clinical standard of care for the patient.

More Importantly William “Bill” Bell failed to use Universal Precaution Infection Control Procedures as published by the Center for Disease Control and Prevention,[ix] by failing to wear masks and gowns when examining Patient Ayana Smith. 

Patient Ayana Smith (see exhibit-2, pg-2) felt mistreated Dr. William “Bill” Bell and became so outraged. 

Therefore, I file this timely Appeal and request review and redress of the entire exam I took at the University of Florida College of Dentistry May 5 thru 6, 2017.

In these times of fake news and alternative facts (both which have absolutely no merits in the Profession of Dentistry)…. There is one thing I’ve learned in life from a man neither I liked nor voted for, but have come to greatly respect: PRESIDENT RONALD REAGAN;

“WE MUST TRUST AND VERIFY”

norman j clement rph dds


[i] CANDIDATE MANUAL, America Board of Dental Examiners (ADEX) 2015, The Commission on Dental Competency Assessments, www.nerb.org, (PENALTIES) pg.9.

[ii] CANDIDATE MANUAL, America Board of Dental Examiners (ADEX) 2015, The Commission on Dental Competency Assessments, www.nerb.org, pg.33-35.

[iii] Et al., pg.34.

[iv] Et al., …pg.102.

[v] Martin Luther King Cultural conditioning, “in America we are culturally condition t to under estimate, under value, and marginalize”

[vi] CANDIDATE MANUAL, America Board of Dental Examiners (ADEX) 2015, The Commission on Dental Competency Assessments, www.nerb.org, (PENALTIES) pg.9.

[vii] https://en.wikipedia.org/wiki/Sarah_Baartman

[viii] https://www.youtube.com/watch?v=gj4x-6UMg9M

[ix] Et al., pg.102. pg.102..

Living in the Spirt of Sankofa

FOR NOW YOU’RE WITHIN THE NORMS

Norman J Clement RPh, DDS

DRUG ENFORCEMENT AGENCY (DEA) POLICIES UNDERMINES MEDICAL TREATMENT AND CARE

page1image62802992
BY NORMAN J CLEMENT RPH., DDS

Gerald Kiley 

Respondents pre hearing statements 

Pronto Pharmacy LLC v United States Drug Enforcement

HEARING JANUARY 28-31 Tampa Fla., (Federal Timberlake Building)

TAMPA FLORIDA

Gerald Kiley 61 year old male, has for the past 3 years traveled every 30 days to Pronto Pharmacy each month  round trip more than 340 miles to fill his prescriptions. lives in Cape Coral, Fort Myers area 

Mr. Kiley states: 

“ I come to Pronto because the availability of his prescription medication, is not down there (Ft. Myers Cape Coral area). He furthers states when he brings his prescription into a regular pharmacy such as CVS or a Walgreens they tell him they don’t have it, we don’t carry it anymore.

He fines, these pharmacy attitudes a suspect and profiling.

Mr. Kiley further states 

“ I have severe back pain, degenerative disk in his neck. sometime I can’t sit many times, i’m dependent on this medications and I’ve been of these medications for nearly 5 years. his pain his related to  injuries in several car accidents, he was a painter and has fallen off ladders before. (see IMG_9157.mov_Gerald Kiley, 3.21 mins)

Mr. Gerald Kiley States:

He heard about Pronto Pharmacy thru a friend of his who had been coming to Pronto because he too was having problem getting his prescriptions filled in the Fort. Meyer, Cape Coral area.

Mr. Kiley, after reviewing statement from the August 23, 2019 Order To Show Cause (OTSC-PP8-19) issue to Pronto Pharmacy,  states he pays by cash because he has no insurance, that he is not a junkie and not selling his medications and he has to pay by cash and that he is not wealthy.  He refutes the DEA assertion he is abusing his medication(see IMG_9158.mov-gerald_k_se.copy,2.52mins)

Mr. Kiley, further reviewed and was read the OTSC(PP8-19) in which the DEA opined that traveling distance was a significant “red flag” and the prescriptions being filled by Pronto-Pharmacy were being diverted and should not have been filled.

Mr. Kiley, strongly disagree with the DEA’s assertion, he states: he is not abusing his medication, diverting his medication,  he says “I’m am 61 years old and falling apart,” and has not violated any State or Federal law…(see img_9159mov-GK-reviews_OTSC-pp8-19_and Don_Sullivan…copy, 3mins)

Mr. Kiley, states: He’s driving more than 200 miles to have his prescription for non acute pain, which is typed on the prescription. Mr. Kiley, also states in this video he went to the Pharmacy next door to his physicians off, and that pharmacist told him he didn’t have the medication (see img_9162.mov-GK_identified_disease-states_copy,2.37 mins). 

Pharmacist, Norman J Clement stated at the time he believed the pharmacist next door to his physician was lying. Pharmacist, Norman J Clement latter learned the Pharmacy was “AT COST PHARMACY”, the Pharmacist was Aaron Howard PharmD. Pharmacist, Clement also learn he and Howard had worked together while both had been employed by CVS Pharmacy.  Aaron Howard had graduated from Florida A&M University College of Pharmacy with my daughter (AC Clement) in 2003.

Pharmacist, Aaron Howard spoke with Clement on December 8th, 2019 stated “Clement’s statement are correct and true,” and that he did mis-lead Mr. Kiley and many other patients because he was becoming increasingly afraid to fill control medication because the DEA was harassing him at his store. 

https://www.nhregister.com/technology/businessinsider/article/What-CVS-is-doing-to-mom-and-pop-pharmacies-in-12793335.php

Pharmacist, Aaron Howard,  learned of the Pronto Pharmacy plight and called Clement while he was on the Golf Course Sunday morning November 24, 2019. The two struck it well and Clement learned of a 3rd DEA raid on Gulf Coast Pharmacy, 11/18/2019 where an Order To Show Cause (OTSC-GCP11-19)

was issued to Pharmacy owner Ricardo Fertil PharmD. Fertil and Howard had been business partner but separated in early 2016.

Howard and Fertil are not generally on speaking terms however realize DEA was targeting Black Owned Pharmacies likely under the believe they were easy enforcement targets. Yet despite their difference and grievance both have united/join forces together with Clement, Guy Decker RPh., Jack Folson RPh., Walter R Clement, law enforcement, Richard C. Clement, C-Systems tech., Norman L Clement, pharm-tech., Jelani Z. Clement B.S., MBA as “THE TEAM”, our Coach is DALE SISCO Esq.

Mr. Kiley, agrees he’s been profiles and being punished and assigned both State and Federal Criminal Violation of the law (see img_9163.mov_Miles_Disease-states_1.04 mins).

because he is having to travel, “as far he knows everything is legal, it has the doctors DEA number on the prescriptions.”  I din’t know there was going to be a problem (see OTSC-pp8-19),

Mr. Kiley, pulls up his shirt, show he has a large umbilical hernia , liver leaks fluid into his abdomen which causes server pain which has to have drained every two weeks especially when it fills up on my and my spine I have a couple of tears in both my neck and my spine which causes severe pain, I’m just trying to get my prescription filled. img_9185.mov_Medical-Conditions_1.31 mins). 

Mr. Kiley, states he has never been examine physically, or spoken with DEA investigator Rich Alpert, or DEA’s Pharmacist Expert Don Sullivan, or United States Attorney Beerbower. (see WM_Gerald_Kiley Profiled Copy2.21 mins). Mr. Kiley, States “I’m not a criminal”

SEE ATTACHED PHOTOS AND VIDEOS   

by norman j clement rph.,dds

Living in the Spirt of Sankofa

for now, you’re within the norms

PHARMACIES OWN BY BLACKS “are an imminent danger to public health or safety”

BY NORMAN J CLEMENT, WALTER R, CLEMENT, NORMAN L. CLEMENT JR., JELANI ZIMBABAWE CLEMENT, AARON HOWARD, BRIAN OLATUNJI, JACK FOLSON, RICARDO FERTIL, BERES MUSCHETT

PRACTICING PHARMACY WHILE BLACK A NEW KIND OF THREAT TO AMERICA

So, while we are affixed to Iran, Iraq, and Impeachment, Black Owned Pharmacies in the normal practice of Pharmacy, through out the country are being summarily targeted, raided, property (see video below Rebecca)

illegally seized, and issued orders as “Imminent Threats to Public Health and Safety” by the DEA (Drug Enforcement Agency). See below Order to Show Cause Pronto Pharmacy

More importantly, DEA’s pharmacy expert Donal Sullivan, a Clinical Professor at The Ohio State University College of Pharmacy, opines people like Rebecca who come to Pronto Pharmacy are abusers and their prescriptions are not for legitimate purposes.

Kafka’s Curse, District 6 Museum, Cape Town, South Africa

Dr. Sullivan, classifies patients like Rebecca as unresolvable “Red Flags” and no reasonable Pharmacist, would ever fill her prescription. Patient Rebecca, states she comes to Pronto Pharmacy because a Walgreen Pharmacist, on 78th and Palm River Road called her a dope addict and refused to fill her prescriptions (see video below)

Dr. Sullivan testified, under cross examination from Attorney for Pronto Dale Sisco of Tampa Fl., in a DEA Administrative Court proceedings January 29, 2020, Timberlake Bldg., he has never interviewed both Rebecca or any patient being treated at Pronto Pharmacy or for that matter any prescribing practitioners. Nor, has Dr. Sullivan reviewed any patient(s) charts or radiographs. In fact, he testified he didn’t have to because the Red Flags were unresolvable.

Many of these Black owned Pharmacies have been in business more than 10 years.
In just the past 6 months at least 7 or more Black owned Pharmacies have been attacked and classified as “Public Health Threats” and Control Substance Registration suspended. See below Order to Show Cause Oak Hill Hometown Pharmacy


We have been able to document some of these Black own Pharmacies which have been targeted profiled:


At Cost Pharmacy, Ft. Meyers, owner Aaron Howard in business 10 years, raided January 7, 2020 “an imminent danger to the public health or safety”, (see below Order to Show Cause At Cost Pharmacy Ft. Meyers, Fl.)


Gulf Med Pharmacy, Cape Coral, Fl owner Ricardo Fertil in business 10 years, raided Nov 19, 2019, “an imminent danger to the public health or safety,”


Oak Hill Home Town Pharmacy, Oak Hill, WV owner Martin Mnjoku in business 15 years, raided Aug, 6, 2019 “an imminent danger to the public health or safety”,


Pronto Pharmacy LLC, Tampa, Fl owner Norman J Clement, in business 10 years, raided Aug 29, 2019 “an imminent danger to the public health or safety”,

Top Line Pharmacy, Tampa, Fl owner Brian Olatunji, in business 20 years raided 2017-18, “an imminent danger to the public health or safety”, out of business

https://youarewithinthenorms.com/2019/12/05/pronto-pharmacy-under-attack-by-trumps-dea-the-raid-on-pronto-pharmacy-august-29-2019-by-walter-r-clement-and-norman-j-clement-rph-dds/

Living in the Spirt of Sankofa

for now, you’re within the norms

BLACK LICENSE PHARMACIST FIGHT BACK PART-1: THE DEA’S RED FLAGS OF OLD JIM CROW

BY

NORMAN J CLEMENT RPH., DDS JACK FOLSON RPH

Black Pharmacy Owners, AT Cost Pharmacy, Ft. Myers Fl.,  Aaron Howard PharmD owner, Gulf Med Pharmacy  Cape Coral Fl., Ricardo Fertil PharmD owner, Pronto Pharmacy LLC, Tampa Fl, Norman J Clement RPh., DDS, owner, have joined together in suing Drug Enforcement Agency (DEA) for harassment, and malicious targeting and return of Properties unjustifiably seized. 

While, all 3 Pharmacies have been in business for more than 10 years yet suddenly  in 2019 Acting DEA Director Uttam Dhillion signed orders calling these and other Black owned Pharmacies an  “Imminent Danger to Public Health and Safety” or “Un-resolvable RED FLAGS.”

 Pharmacist, Aaron Howard, says, ” this whole issue is based on a erroneous presumption of Red Flags…..that we are improperly dispensing control medications.” “This totally  ridiculous, we check all prescriptions in my pharmacy.  I’ve been a pharmacist for more than 15 years and I am definitely not a “PILL MILL.”  

Pharmacist Ricardo Fertil states, ” this is a way of stereotyping black owned businesses whom are health professionals.” 

While, Pharmacist Norman J Clement points out they are using google maps to illegally track our patients and harassing our wholesalers. All 3 Pharmacist are graduates of Florida A&M University College of Pharmacy.

The Federal Court challenge in Florida  is lead by Attorney Dale Sisco of Tampa and based on the Oak Hill Hometown Pharmacy of Oak Hill West Virginia.  Oak Hill is Black own pharmacy, which has successfully prevailed in several Court proceeding against the DEA is lead by Attorney Issac R. Foreman.  

Jack Folson RPh.,  a Pharmacist expert an activist who has testified in Michigan Courts on behalf of several Black Pharmacy owners states, “This comes down to practicing Pharmacy while Black. In the past years alone at least 7 black owned pharmacies we know of have been attack in similar manner by the DEA, there are likely more. Black owned Pharmacies are less than 1% of all pharmacies in American but seem to be disproportionately targeted by the DEA.”

DEA’s RED FLAGS OF OLD JIM CROW

Red Flags – Distance

Due to the DEA’s aggressive policing of community pharmacies, most are reluctant to fill legitimate narcotic analgesic prescriptions for non-acute pain patients.  Some patients are known to spend days on end looking for a pharmacy to fill their prescriptions to no avail.  This has caused massive concern in the medical community. 

One of the goals of therapy is continual treatment without gaps.  When gaps in therapy occur many of the deleterious effects occur.  Indeed, pain management is much more difficult when anxiety and diminished mobility complicate the treatment plans.  

Therefore, the real-world consequence is that when patients find a place that will treat their pain with dignity and respect, they will often share that information with others. 

Pharmacies, understand what need to be accomplished in treating these patients with these critical needs. The DEA agency lacks of understanding of the basics of medical care for patients in chronic pain..  

DISTRICT 6 MUSEUM, CAPE TOWN, SOUTH AFRICA

Red Flags – Cocktails, Pattern Prescribing

Pain Management is a very complex issue.  More often than not in chronic (non-acute) pain, comorbidities need to be addressed.  Therefore, when a practitioner finds a combination of medications that successfully treats chronic pain they are reluctant to stray from that protocol. 

It’s akin to other protocols that are used in medicine that address chronic conditions such as cancer protocols, ALS protocols, hypertension step-care therapy, anti-coagulation protocols and others.  

HECTOR PIETERSON: “TO PAY THE PRICE FOR FREEDOM”

Typically, there is inflammation and therefore non-steroidal anti-inflammatories are used.  Patients often experience anxiety so anti-anxiety agents such as benzodiazepines or tricyclics are used.  In nociceptive pain Gabapentin is often the first drug of choice.  In lower back pain, whose underlying causes can be quite different from each other the presentation of muscle spasm or hypersensitivity, muscle relaxers such as cyclobenzaprine, metaxolone, baclofen, carisoprodol or others represent standard therapy.

It is unreasonable to expect a Diversion Investigator to have a complete understanding of these complex issues with their 6-week course when Physicians and Pharmacists require years of training to make adequate choices in this arena.  

Red Flags – Non-resolvable red flags

As has been shown here there is no such thing as a non-resolvable red flag.  Any testimony to the contrary is either ill-informed or dishonest.  For an expert to testify that they can determine diversion without looking at the prescription, interviewing the prescriber or understanding the patient condition lacks credibility. 

As has been shown in recent cases, “suspicion of diversion does not raise to the level of actual diversion.”  This is accomplished by evisorating the physician patient relationship to establish illegitimacy and suspicion.

Living in the Spirt of Sankofa

for now, you’re within the norms

THE ADMINISTRATIVE COMPLAINT FILED BY STATE OF FLORIDA BOARD OF HEALTH RE: FILE NUMBER PH201705581

By Norman J Clement RPh.DDS, Norman L.Clement Pharm Tech, Jelani Z.Clement Pharm Tech

written August 10, 2017

Exactly 2 years later in August 29, 2019 DEA, investigator Richard Albert, issued an Order To Show Cause stating Pronto Pharmacy was an Imminent Danger to Public Health for illegally manufacturing on the very same issue which were resolved by the State of Florida.. This case will proceed before a Federal District Court in Tampa Florida, Dale Sisco Esq is the attorney 813-224-0555

IN THIS AGE OF FAKE NEWS AND ALTERNATIVE FACTS (BOTH WHICH HAVE ABSOLUTELY NO MERITS IN THE PROFESSION OF PHARMACY)

THERE IS ONE THING I’VE LEARNED IN LIFE from a man I didn’t like nor voter for, but have come to GREATLY respect:

PRESIDENT RONALD REAGAN;

“WE MUST TRUST AND VERIFY”

PRONTO PHARMACY LEGAL TALKING POINTS

The complaint filed by the Florida Department of Health (Case Number PH201705581) is without LEGAL MERIT, lacks ANY LEGAL FOUNDATION and lacks probable cause.

The United States Congress intent was to allow compounders to compound a batch of drugs in anticipation of receiving patient specific prescription.[i]

  1. Federal Law and Florida State Law clearly allows and has always allowed that a licensed pharmacist can compound “in limited quantities before the receipt of a valid prescription order for such individual patient.” 
  • More importantly President Donald J Trump address this issue and signed into law H.R 244 which clarifies several compounding regulation implemented in the Drug Quality and Security Act(DOSA 2013).
  • The law clarifies that Congress did not intend to redefine “distribution” to include “dispensing,” specifying Congress only intended FDA to regulate distribution– not “dispensing” to a patient over state lines.
  • The law mandates that FDA recognize that federal oversight of 503A was not the intent of Congress, and that compounding pharmacies are not drug manufactures—rather they are “state licensed and regulated health care providers that are inspected by state boards of pharmacy pursuant to state laws and regulations that establish sterility and other standards for the pharmacies operating within the state.”[ii]
  • FDA LAW 503A (a)(2) states the following examples:[iii]

a). “A compounder regularly receives valid prescription orders from a particular prescriber or prescribers, or for a particular patient or patients, for compounded drug X. The highest number of units of drug X for which the compounder has received valid patient-specific prescriptions in a 30-day period in the last year is 500 units. Compounding up to 500 units of drug X in advance of receiving prescriptions for the drug, and holding no more than that amount to fill new valid patient-specific prescriptions as the compounders receives them, would be consistent with this policy. [iv]

b). “ A compounder regularly receives valid prescription orders from a particular prescriber or prescribers, or for a particular patient or patients, for compounder drug”  {FURTHER REVIEW PG 6,7,8,9 FDA GUIDELINES}

The complaint further alleges upon a routine inspection on 03/03/2017 the pharmacy was opened without a pharmacist. On March 3, 2017 the pharmacy was open with a pharmacist. March 3rd was Norman J Clement 66th birthday.

****IN THIS ERA OF ALTERNATIVE NEWS AND FACTS. WE LEARN THAT CONCEPT HAS ABSULUTELY NO BASES IN PHARMACY. UR ATTITUDE IS BASE AROUND PRSEIDENT RONALD REGAN “TRUST AND VERIFY”

  • The Pharmacy was not opened for dispensing, on 3/30/2017.  The pharmacy was locked and secured no medications were being dispensed and the pharmacy being monitored through our security system by a Florida Licensed Pharmacist. The Pharmacy waiting room was open for guest to sit and watch television until pharmacist arrived on premise more importantly the woman observed in the window is the pharmacist wife an a owner the window is not in the filling area.  The license technician is the pharmacist son and was not dispensing, filing medications until his father arrived.
  • “THE MISSION OF THE DEPARTMENT OF HEALTH IS TO PROTECT, PROMOTE & IMPROVE THE HEALTH OF ALL PEOPLE IN FLORIDA THROUGH INTREGRATED STATE, COUNTY AND COMMUNITY EFFORTS” therefore Pronto Pharmacy LLC can fill and dispense prescription from anywhere in the State of Florida.

The complaint the Pharmacist Clement advised that he gives the customers a choice on if they want capsule or tablets…and that capsules are cheaper than the tablets.

  • Florida laws differs to and empowers the patients IN THE STATE OF FLORIDA, All Pharmacy are required to post by law visible to the public “CONSULT YOUR PHARMACIST CONCERNING THE AVAILABILITY OF A LESS EXPENSIVE GENERICALLY EQUIVALENT DRUG AND THE REQUIREMENTS OF FLORIDA LAW
  • Cocktail: Drug Opitimization, CML: Gleeves, Cytarbine, Doxirubecine, Vincristine, Chlorambucil, Use in “cocktails”. Cocktail is prosecutorial slang, just like pill mills, in order to secure concivictions by juries and fail inform juries of drug opitimization, mechanism of action and patho-phisiology.

A) if such combination weren’t being use larger amount of the Opiate would be required.

B) Such so called prosecutorial expert testimonies are serious flawed and go unchallenged.  Ref: Edward Imwinkelreid, when science takes the Stand.

10. RED FLAG IN LIFE ARE NOT LIKES STOP SIGNS IN TRAFFIC…document, evaluate, access every case individually, (dont lie to us), distant documented same reason I go to the Henry Ford Hospital Center in Detroit (HFH) for colon cancer treatment, local pharmacy areas does not fill my prescriptions,” rejected 25 times particularly minorities,” statement of patient coming to pronto.. may set us up for discrimination and/or profiling. We simply treat peole with dignity and respect.

11. DX Codes: Question: What Purpose: we are here to render a second opinion, eg: dental ridge augmentation, sinus lift, dentist complaint patient unable to get medication filled.

A)Concern: Flip flopping if we consult with the provider charged with conspiracy, conclusion so we avoid or limit our contact.

B)Moving the Goal Post backward and forwards.

12. Insurance: Critical discussion most insurances aren’t avail to small pharmacy establishment rules for eligibility change all the time.

13. CHINESE DISIDENT: ARTIST AL WEIWEI, I cannot live in fear we must live by the law, where is the law DEA: put it in writing  miles, diagnostic codes( Costco’s, Sam’s, CVS, Walgreens, anticipatory compounding, cocktails, pill mills, insurance, cash payment

Living in the Spirt of Sankofa

For Now You’re Within The Norms


[i] http://www.pharmacist.com/article/federal-funding-law-includes-compounding-language-apha-win

[ii] https://www.fda.gov/ucm/groups/fdagov-public/@fdagov-drugs-gen/documents/document/ucm496286.pdf

[iii] In this example, it would be consistent with FDA’s policy if, after distributing 200 units of drug X pursuant to valid patient-specific prescriptions, the compounder produces up to 200 additional units of drug X so that the total number of units that the compounder is holding for distribution returns to 500 units.

  1. [iv] The limited quantities policy, which relates to the amount of inventory held by the compounder, does not alter the product’s BUD. For example, if the BUD for the product is 9 days, the compounder should not produce more units than can be distributed pursuant to valid prescriptions and used within 9 days.

_______________________________________________________

BLACK OWN PHARMACIES UNDER ATTACK: “RAID ON AT COST PHARMACY” FT. MEYERS, FLORIDA

BY

WALTER R. CLEMENT B.S, MS., MBA., NORMAN J CLEMENT RPH DDS

On January 7, 2020, owner Aaron Howard PharmD of At Cost Pharmacy, Fort Meyers Florida, found himself surrounded by 7 DEA agents ordering an Immediate Suspension of his Control Substance license and seizing his property. The order was signed by Acting DEA Chief Uttam DHilllion who as in previous orders issued to other Black own pharmacies to be deem “and imminent danger to public health and safety.”

Since June 2019 we have tracked nearly 12 Black own Pharmacies being attacked in similar manner by agents of the Drug Enforcement Agency (DEA). While Black Own Pharmacies represent less than 1% of all privately own family establishments they appear to be disproportionately target by DEA and State regulators in what is said to be “Practicing Pharmacy While Black.”

The initial contact with the DEA for AT COST PHARMACY and its owner Aaron Howard PharmD, 2003 graduate of Florida A&M University, College of Pharmacy started on February 14, 2018, the Special Agent, or Task Force Officer of the Drug Enforcement Administration of the Department of Justice conducted raid based on a signed search warrant that failed to describe or define the elements of a crime. 

This search warrant was decrepitude in that it failed to illustrate and support the rudimentary descriptions defining Probable Cause.  The investigator wrote, “Application having been made, and probable cause as defined by 21 U.S.C. § 880(d)(1) having been shown by the affidavit of Diversion Investigator Norita N. Persaud, United States Drug Enforcement Administration, for an inspection of the controlled premises of Aarric, Inc., dba At Cost Rx, 16970 San Carlos Boulevard, Suite 110, Fort Myers, FL 33908, with DEA number FA2125640, it appears that said inspection is appropriate under 21 U.S.C. § 880”. 

The investigator agent clearly expressed his limited knowledge of probable cause as defined by 21 U.S.C. § 880(d)(1).  Yet, he did not, within the search warrant, describe the place to be searched and the descriptive elements to support and clearly identify any elements of a crime which would provide a reasonable officer to conclude that probable cause exist.  

The signed warrant authorized the investigating Agent “to seize from the above-described controlled premises such of the following records, information, reports, documents, files and inventories, as are appropriate and necessary to the effective accomplishment of the inspection, and for the purpose of copying or verifying their correctness, or that are used or intended to be used in violation of the Controlled Substances Act whether in electronic or printed media format as noted above”.  The Supreme Court has defined “probable cause” as an officer’s reasonable belief, based on circumstances known to that officer, that a crime has occurred or is about to occur. Carroll v. United States, 267 U.S. 132, 149 (1925).

By the fact this inspection warrant lacked sufficient levels of evidence to support probable cause. The act to inspect the premises was not based on a reasonable officer.   

As a nation we must feat the acts of this search that a law enforcement officer can obtain a baseless warrant and search a premise at will.  The act of the DEA to inspect without cause violates the “Fourth Amendment to the United States Constitution. Which protects the people’s right “to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures.” 

After the inspection, the investigating officer were further authorized to seize legally sanctioned ‘Class two, three, and four controlled substances’ from the premises; The agent wrote “Such of the following records, information, reports, documents, files and inventories, as are appropriate and necessary to the effective accomplishment of the inspection, and for the purpose of copying or verifying their correctness, or that are used or intended to be used in violation of the Controlled Substances Act whether in electronic or printed media format”.  This inspection warrant is a document to look and examine.  However, nothing in the warrant authorized the inspection to reason if a crime took place.   

The 4th amendment clearly establishing the groundwork of a search and seizure.  The agents failed to address the elements of evidence obtained through an unlawful search or seizure.  Under “Mapp v. Ohio, 367 U.S. 643 (1961). Any evidence derived from illegally obtained evidence must also be suppressed”. Thus, the courts have a fiduciary duty to safeguard the public, in as such, the criminal justice functions are there to protect the public form harm.  Such acts within this search is an assault upon every American.  If our protections are eroded, then whom shall we depend upon if the police and the courts act at will.  

Return all items taken and redress all monetary loses to the operator owner of Aarric, Inc. Rx, 16970 San Carlos Boulevard, Suite 110, Fort Myers, FL 33908, Our constitution stands on years of rulings and reforms.  

We are “One Nation Under God with Liberty and Justice for All”  

At Cost Pharmacy Ft. Myers FGlorida
Aaron Howard ACPHARM_FT_MYERS

SO WHILE WE WERE ALL FOCUSED ON IRAN, TRUMP’S DRUG ENFORCEMENT AGENCY (DEA) WAS OUT ATTACKING BLACK OWN PHARMACIES…..

by norman j clement dds., rph, AARON HOWARD PHARMD., RICARDO FERTIL PHARMD. NORMAN L CLEMENT, JELANI Z. CLEMENT, BS., MBA

BLACK HEALTHCARE UNDER ATTACK BY DEPARTMENT OF JUSTICE

My dear Brothers and Sisters, a group of black pharmacist owners, graduates of Florida A&M University College of Pharmacy, have been attacked and raided, by the DEA we need you to help expose this injustice.

THANK YOU FOR TAKING MY CALL 


My name is Norman J Clement, I am a Pharmacist and Dentist, (grad Florida A&M University Pharmacy, Dentistry University of Michigan, finishing my master FAGD University of Florida College of Dentistry).  I own Pronto Pharmacy LLc, a small family Pharmacy in Tampa Florida and we have been in Practice nearly 10 years. 

Los Suenos, Marriott Costa Rica

I’m slowly being bankrupt by the DEA who have created their own set of rules  even using GOOGLE MAPS which clearly violate the constitutions 1st amendment. YET We ARE, SCRAPPY, UNBOWED AND DETERMINE.

The DEA has attacked in a 6 month period in just Florida alone 7 black owned pharmacies and their patients and even more across the country, accusing them of drug trafficking and conspiracy. On January 7, 2020, owner Aaron Howard PharmD of At Cost Pharmacy, Fort Meyers Florida, found himself surrounded by 7 DEA agents ordering an Immediate Suspension of his Control Substance license and seizing his property. On November 19, 2019 owner Ricardo Fertil PharmD of Gulf Med Pharmacy, found himself and his wife surrounded by at least 15 agents of the DEA ordering an Immediate Suspension of his Control Substance license and seizing their property.

HUBERT HUMPHREY BLDG, WASHINGTON, DC
UNITED STATES DEPARTMENT OF HEALTH AND HUIMAN SERVICES

Now the both must go before DEA’s Court of the Kangaroo (see url., a) where justice has become an injustice to us and will cost each owner at least $150,000.00 to defend themselves. Most importantly, the Judge is hired and works for the DEA..(HELLO).
a)  https://youarewithinthenorms.com/2019/12/23/deas-kourt-of-the-kangaroo-by-norman-j-clement-rph-dds/

We need your help to bring a 1st amendment action in Federal Court or State. I’m fighting the DEA, on this very rational bases law. The DEA is using these draconian tactic to shut down Pharmacies (most whom are black and brown) by bankrupting them.  I have a website call You’re with in the Norms face book and we are fighting back and have published.


b) https://youarewithinthenorms.com/2019/12/05/pronto-pharmacy-under-attack-by-trumps-dea-the-raid-on-pronto-pharmacy-august-29-2019-by-walter-r-clement-and-norman-j-clement-rph-dds/
c) https://youarewithinthenorms.com/2019/12/10/since-when-has-it-become-the-job-or-the-role-of-law-enforcement-dea-to-dictate-and-define-medical-procedures-and-protocols-a-reflection/


Briefly:
1. My Pharmacy was raided by the DEA who claimed we were Manufacturing when in fact we are compounding.  
2. They shut me down literally further stating we were seeing Patient from more than a 30 mile limit even though there is no such rule or law.
3. I have a admin hearing Jan 28 thru 31 in Tampa Florida, before the DEA (Kangaroo Court). All Pre-hearing Statements are done.

LIBERATION MUSEUM, JOHANNESBURG, SOUTH AFRICA


My Attorney is Dale Sisco 813/224-0555

The DEA states, we need a separate license, when in fact we don’t because we are compounding.  
Also contact my Son Norman L. Clement 813 919-6005, or Jelani Z. Clement at 813 443-0970
norm dds