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NIH opens inquiry into management, workplace issues at troubled pharmacy

National Institutes of Health Director Francis S. Collins, shown May 7 at the White House, overhauled the NIH Clinical Center leadership structure in 2016 after a review determined patient safety had become “subservient to research demands.”
National Institutes of Health Director Francis S. Collins, shown May 7 at the White House, overhauled the NIH Clinical Center leadership structure in 2016 after a review determined patient safety had become “subservient to research demands.” (Jabin Botsford/The Washington Post)

The National Institutes of Health has temporarily removed four senior officials at the pharmacy that serves its world-renowned hospital and launched an inquiry into management and personnel issues in the often-troubled department.

Unlike a leadership shake-up at the 200-bed Clinical Center that followed reports of contaminated drugs in 2015, this investigation does not appear to involve patient safety problems in the pharmacy, which prepares drugs for patients treated at the hospital. Rather, it focuses on complaints against managers and a difficult workplace culture.

James Gilman, who runs the Bethesda, Md., hospital, told pharmacy staff at a meeting Friday that the inquiry focuses on allegations of “potentially discriminatory and inappropriate conduct in the pharmacy,” according to a recording of the meeting shared with The Washington Post.

Gilman acknowledged “this is a very serious step to take” but stressed that no conclusions have been reached about the managers, including the head of the pharmacy, or other issues. He said he decided to sideline them so they could not influence the interviews that will be conducted with the entire pharmacy staff.

“The issues are very clear,” Gilman told the employees. “We have trouble keeping staff. Too many good people have left. Too many good people that we wanted to come didn’t, because they’re not sure it’s a good place to work.”

Gilman’s office referred questions to the NIH communications office. An NIH spokeswoman declined to name the managers, or say how many were removed. In an email, she said “the Clinical Center is working through some individual personnel matters in the Pharmacy Department . . . The reviews are not related to clinical quality or safety. There will be no impact of this workplace situation on patient safety or quality of care, which are our highest priorities.”

Gilman used the first names of all four managers during the meeting, and The Post was able to ascertain their roles.

The inquiry, which must be completed within 120 days, is being conducted by the NIH Civil Program, which is part of its Office of Human Resources. On its website, the Civil Program urges employees to contact the program if they “become aware of a workplace situation involving uncivil behavior, such as harassment, sexual harassment, inappropriate conduct, intimidation, bullying or other unproductive, disruptive, and/or violent behaviors.”

A second inquiry of the pharmacy appears to be underway, conducted by NIH’s Office of Management Assessment. That unit “provides broad management oversight and advice to the NIH Director on program integrity, risk management, and management support systems,” according to its website. The spokeswoman said she would neither confirm nor deny that review, but Gilman and staff discussed it at Friday’s staff meeting.

“The issues are not quite the same that they’re addressing,” Gilman said, “but they’re not completely unrelated.”

The Clinical Center, opened in 1953, is where many desperately ill people come to be treated with cutting-edge, experimental protocols conducted by NIH’s on-campus health-care providers, who study them and healthy volunteers in their research. About 25 percent are cancer patients.

In 2016, NIH Director Francis Collins removed John Gallin, who had led the government hospital for 22 years, and replaced him with Gilman after a review determined patient safety had become “subservient to research demands.” Collins also overhauled the hospital’s leadership structure.

The task force that found the safety problems was originally appointed to look into contamination of drugs in the Clinical Center. A whistleblower’s complaint in 2015 triggered an investigation by the Food and Drug Administration that resulted in suspension of some drugmaking operations in the pharmacy.

In 2017, Collins wrote on his blog that NIH had spent about $50 million on “improving patient safety, a considerable amount of which has gone to much needed infrastructure improvements at the Clinical Center and aseptic manufacturing facilities.” Renovations are continuing at the pharmacy, according to the spokeswoman.

In Friday’s staff meeting, Gilman repeatedly drew sharp contrasts between the 2015 shake-up and the conflicts that prompted the current inquiry. “This is not — not — 2015,” he said emphatically. “We have made a lot of progress since 2015. This is not 2015, and don’t you let anybody say that,” he added.

Nevertheless, he acknowledged personnel problems and urged every employee to tell reviewers what they know.

“We have to improve the workplace climate,” he said. “We have to improve our ability to get along with each other. We have to improve our trust and respect for one another if we’re going to keep going.”

Alice Crites contributed to this report.

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