Content area
Full Text
I. INTRODUCTION
Over the past five years, there have been over 140 reported incidents of counterfeit and mislabeled drugs being sold by legitimate pharmacies in the United States.1 Thousands of patients have consumed these medications, sometimes with dire consequences.2 The extent of counterfeits in the legitimate market, however, is unknown. It is certain that the detected incidents of fakes are a fraction of the total number of incidents.3
How did these drugs wind up in the bloodstreams of unsuspecting patients? Despite elaborate safety precautions, strict regulations and battalions of enforcement personnel, the stream of phony pharmaceuticals continues unabated. This article will consider the practical and legal dimensions of trade in Trojan drugs.4
This paper will not consider the two major sources of counterfeit medications in the U.S. - direct importation and internet pharmacies. These routes are the subject of numerous scholarly articles5 and the field is so vast that they deserve separate consideration. It is difficult to consider Trojan Drugs without some reference to these sources, but the reader is cautioned that the treatment of these topics in this paper is necessarily cursory.
II. THE CARLOW CASE
Michael Carlow is a scoundrel. The twice-convicted felon6 had a penchant for the good life as defined by the standards of South Florida. After his release from prison, Carlow embarked on a new career as a pharmaceutical wholesaler. Over a five-year period, he amassed a fortune of many millions, purchased a mansion in Weston, FL, owned a garage full of exotic automobiles, and spent weekends on his yacht.7 Pretty good for a down-and-out loser from Ohio.
Carlow had stumbled into one of the most lucrative criminal enterprises in America: drug counterfeiting. During his brief career, Carlow literally poisoned hundreds of desperately ill patients, caused drug companies millions in losses, and damaged the reputations of some of the best-known pharmacies in the country. How did he get away with it for so long? More importantly, how many of his ilk are practicing this trade today, undetected by any watchdogs of the nation's drug supply? The Carlow case is a study of the ease with which criminals can exploit the gaps in the regulatory regime governing America's drug distribution network.
Carlow started his career in the black market with brute...