Business Law and The Legal Environment Ohashi Case Discussion Questions

questions.

2. The name and link of the book you will need to use

Business Law and the Legal Environment | OER Commons

3. The links you will need

Star gymnast Katelyn Ohashi says NCAA rules ‘handcuffed’ her at UCLA | Fox Business

A Rival to Botox Invites Doctors to Party in Cancun, With Fireworks, Confetti and Social Media Posts – The New York Times (nytimes.com)

Houston Doctor Fired for Giving Away Doses of Covid Vaccine – The New York Times (nytimes.com)

Please remember that spelling and grammar are important in this class. 2 points of the
possible 10 points for this assignment are for spelling and grammar. If you feel you
need help, there are online writing tutors available or tutors in the Writing Center. See
the student resource module.
The required text reference is worth 2 points. This is the text and not an outside
source. An outside source or incomplete reference to our textbook will earn -0points. Here is a suggested way to reference the text: Chapter 5/section 5.1 . It is
important that business students pay attention to the details.
Questions 1, 2, and 3 are worth 1 point each. Question 4 is worth 2 points.
The overall brief analysis is worth 1 point.
The videos are in the Quiz itself.
Watch these two videos and the one companion article. They are about three highly publicized
incidents where actions by employees forced each company to take a drastic and unusual
action. As you watch, think about the ethics of what is happening. Then in 1-2 sentences per
number, answer the questions. Spelling and grammar count. There must be at least one text
reference (page/chapter/edition).
There is no right or wrong answer. There is only a complete answer that is supported by a
complete reference to the text.
https://www.nytimes.com/2021/02/10/us/houston-doctor-fired-covidvaccine.html?action=click&module=RelatedLinks&pgtype=Article (Links to an external site.)
https://www.nytimes.com/2019/05/15/health/evolus-wrinkles-toxinjeuveau.html?action=click&module=MoreInSection&pgtype=Article®ion=Footer&contentC
ollection=Health (Links to an external site.)
https://www.foxbusiness.com/sports/katelyn-ohashi-ucla-ncaa-rules-pay (Links to an external
site.)
1. Do you think Dr. Gokal was acting ethically in the way he administered the vaccine? Why?
2. Should the doctors disclose this event to anyone and, if so, to whom? Why?
3. Read and watch the video on Katelyn Ohashi. Who do you see exhibiting unethical
behavior? Explain?
4. Think about the Approaches to Ethical Reasoning, such as Duty-Based Ethics, Outcome
Based Ethics etc. . Which approach do you think the doctors should use when handling their
attendance at the NewTox event? Which approach did Judge Bynum use in regards to the
vaccine situation? Which approach should have been used by the unethical party in the Ohashi
case? Explain?
Download Houston Doctor Fired over Covid Vaccines
Download Rival to Botax
A Rival to Botox Invites Doctors to Party in
Cancun, With Fireworks, Confetti and Social
Media Posts
Plastic surgeons’ Instagram accounts of the weekend trip didn’t note the drug company’s By
Katie Thomas
May 15, 2019
Top plastic surgeons and cosmetic dermatologists gathered at the Ritz-Carlton in Cancun one
weekend this month to learn about a wrinkle-smoothing injection, Jeuveau, that goes on sale this
week.
Jeuveau’s manufacturer, Evolus, billed the event as an advisory board meeting. But it also
appeared to double as a lavish launch party for Jeuveau, which the company is hoping will
compete against Botox in a crowded market that also includes two other products.
More than a dozen top doctors gushed about the event on social media — using the company’s
preferred hashtag, #newtox — without disclosing that Evolus had paid for their trips. The
Federal Trade Commission requires social media users to disclose relationships with companies
when promoting their products on social media, which has emerged as a potent platform.
Medical experts also said the tactics carried echoes of an earlier, anything-goes era of
pharmaceutical marketing that the industry largely abandoned after a series of scandals and
billion-dollar fines.
There was poolside socializing, free gifts and an oceanfront dance party, an atmosphere that one
Manhattan plastic surgeon told her 187,000 followers was “everything Fyre Fest was supposed to
be.”
“Everything is coming up BUTTERFLIES,” Dr. Melanie Petro, a plastic surgeon in Alabama,
told her 74,000 followers, beside a photo of her posing on a runway that featured Evolus’s
butterfly logo.
The Manhattan plastic surgeon, Dr. Lara Devgan, addressed her followers from the RitzCarlton’s oceanfront pool. “It’s the new tox on the block,” she said as she jiggled a pink Newtox
bracelet for the camera. “I’m here making a splash with Newtox,” she said later.
Bonnie Patten, the executive director of Truth in Advertising, a nonprofit watchdog group, said
that F.T.C. rules would most likely require disclosure of compensation for paid trips or hotel
stays on social media posts promoting products. A spokesman for the F.T.C. said the commission
did not typically comment on individual cases.
“It’s incredibly problematic, because health care providers in general are considered very
trustworthy,” Ms. Patten said. “And especially by their followers, who are looking for their
expertise.”
In an interview, Dr. Devgan said it was standard practice for pharmaceutical companies to cover
her expenses to medical meetings, and she did not think it was necessary to disclose this. She
said she would not favor Jeuveau over competitors, and noted that she said as much in her video.
“I’m always trying, with my social media and traditional media presence, to be very neutral,” she
said.
Dr. Petro said she traveled to Cancun to learn about the product and came away impressed. She
said she didn’t think she was endorsing Jeuveau, but would consider disclosing to followers that
Evolus had paid for her trip. “I never would want to be dishonest with them,” she said.
David Moatazedi, the Evolus chief executive, said in an interview that the Cancun event was a
standard advisory board meeting, similar to those that the company’s competitors hold, and that
the doctors were not paid or given incentives to promote the company. The company also noted
that the doctors sometimes used the hashtags of competing products, like #botox, in their posts.
However, Mr. Moatazedi did say the company offered doctors what he called “social media
moments,” like the Evolus-themed runway or a confetti-throwing station.
“We wanted to make the break periods of this meeting productive as well for doctors, and many
of them like to inform their patients around the newest technologies,” Mr. Moatazedi said.
To Wall Street investors, Evolus has pitched its unconventional approach as a way to distinguish
its product from Botox, made by Allergan, which commands about 70 percent of the more than
$1 billion market for wrinkle-smoothing injections. Jeuveau, which was approved by the Food
and Drug Administration in February, is Evolus’s only product.
selfie generation — which is increasingly interested in cosmetic procedures — with advertising
featuring fresh color schemes and an emoji-filled social media campaign. Mr. Moatazedi has told
Wall Street analysts that Evolus should be viewed as more of a “performance beauty” company
rather than a traditional drug maker.
Botox and its competitors — including Dysport, sold by the Nestlé subsidiary Galderma, and
Xeomin, sold by Merz — are used virtually interchangeably by doctors, who buy the products
from the companies and charge patients for the procedures.
Mr. Moatazedi, told investors last November that his company did not have to report payments it
makes to doctors to the federal Open Payments database, because Evolus does not sell any
products that are reimbursed by government programs like Medicare or Medicaid. (Botox is also
approved for migraines and other uses, which are covered by government health programs, while
Jeuveau is not.)
“That means that the representatives and the sales managers can be very closely involved in high
touch and customer-centric, and engage with these practices outside of their traditional business
hours,” Mr. Moatazedi told Wall Street analysts during a conference call last November.
“They’re not hiding anything, not trying to subvert the law,” said Michael Moretti, the chief
executive of Medical Insight, a market research firm for the aesthetics industry. “They’re just
doing marketing in the way they can, and that their competitors cannot.”
Others said the company and doctors were treating the product too casually, especially since it is
an F.D.A.-approved drug that carries a serious boxed warning. Like Botox, Jeuveau is a form of
botulinum toxin and when injected, it can spread to other areas of the body, potentially causing
swallowing and breathing problems in rare cases.
“I don’t think that it’s fair to call it a purely aesthetic agent,” said Dr. Aaron S. Kesselheim, a
professor of medicine at Harvard Medical School. “It seems to diminish the risks to the product
and overestimate or oversell the benefits.”
Drug companies do pay for doctors to attend advisory committee meetings and cover meals
during educational events, but their practices are more limited than they once were, after several
companies paid billion-dollar fines to settle charges they had inappropriately marketed their
products.
Most companies now say they follow an industry code that prohibits extravagant trips,
“recreation or entertainment” and the distribution of gifts for personal use. Any meals provided
must be “modest.”
At the Cancun weekend, doctors posted photos of the Evolus-branded items they were given,
including flip-flops, beach towels and water bottles.
They posted videos that offered a panoramic view of the thumping dance party that featured a
giant video screen, neon water drums and fireworks. (Dr. Pantea Tamjidi, a Maryland
dermatologist who posted a video of herself playing drums at the event, did not return a call and
Instagram message for comment.)
Doctors who attended the event said that the company’s marketing would not affect their medical
decisions and that they had been invited for a working weekend to provide expert advice.
“I use my knowledge and experience to research and evaluate a product and to determine
whether it’s something I can use for my practice,” said Dr. Christopher Zoumalan, a Beverly
Hills plastic surgeon who posted about the event to his 21,500 Instagram followers. “This has
nothing to do with whether the company takes me to dinner or Cancun or whatnot.”
A dermatologist, Dr. Jeffrey Fromowitz of Boca Raton, Fla., said his post was not intended to be
an endorsement. “I try to post variable topics of interest to our followers, which of course would
include something new coming to market,” he said.
Some doctors described Jeuveau as “the happy toxin” on Instagram. One, Dr. Kaye Riolo of
Fresno, Calif., used the hashtag #latestandgreatest to describe the product. She did not return
calls and emails for comment.
The F.T.C. requires disclosure when a company pays someone or provides something for free —
like a trip to Cancun. In 2017, the F.T.C. sent letters to 90 social media influencers and
companies reminding them that they should “clearly and conspicuously” disclose relationships to
sponsors.
Ms. Patten of the truth in advertising group said the positive posts about the product that lack
disclosures about financial incentives like trips would be considered endorsements.
Promotion of prescription drugs carries an added layer of scrutiny because drug makers are
required to balance a drug’s benefits with its risks in any advertising. In 2015, the F.D.A. sent a
warning letter to the drug company Duchesnay after the celebrity Kim Kardashian posted on
Instagram about its morning-sickness drug, Diclegis. Ms. Kardashian did not adequately describe
the drug’s risks, the agency concluded.
Evolus said that it did not believe it was violating any F.T.C. rules and that doctors were
compensated only for their expert medical advice.
Mr. Moatazedi said all promotion of Jeuveau included the required balance of risks and benefits,
and said terms like “happy toxin” and “latest and greatest” were not part of Evolus’s marketing
efforts. “That’s likely something the doctors are doing on their own,” he said.
The Texas doctor had six hours. Now that a vial of Covid-19 vaccine had been opened on this
late December night, he had to find 10 eligible people for its remaining doses before the precious
medicine expired. In six hours.
Scrambling, the doctor made house calls and directed people to his home outside Houston. Some
were acquaintances; others, strangers. A bed-bound nonagenarian. A woman in her 80s with
dementia. A mother with a child who uses a ventilator.
After midnight, and with just minutes before the vaccine became unusable, the doctor, Hasan
Gokal, gave the last dose to his wife, who has a pulmonary disease that leaves her short of
breath.
For his actions, Dr. Gokal was fired from his government job and then charged with stealing 10
vaccine doses worth a total of $135 — a shun-worthy misdemeanor that sent his name and mug
shot rocketing around the globe.
“It was my world coming down,” Dr. Gokal said in a telephone interview on Friday. “To have
everything collapse on you. God, it was the lowest moment in my life.”
The matter of Dr. Gokal is playing out as pandemic-weary Americans scour websites and cross
state lines chasing rumors, all in anxious pursuit of a medicine in short supply. The case opens
wide to interpretation, becoming a study in the learn-as-you-go bioethics of the country’s
stumbling vaccine rollout.
Late last month, a judge dismissed the charge as groundless, after which the local district
attorney vowed to present the matter to a grand jury. And while prosecutors portray the doctor as
a cold opportunist, his lawyer says he acted responsibly — even heroically.
“Everybody was looking at this guy and saying, ‘I got my mother waiting for a vaccine, my
grandfather waiting for a vaccine,’” the lawyer, Paul Doyle, said. “They were thinking, ‘This guy
is a villain.’”
Dr. Gokal, 48, immigrated from Pakistan as a boy and earned a medical degree at SUNY Upstate
Medical University in Syracuse. After working at hospitals in Central New York, he moved to
Texas in 2009 to oversee the emergency department at a suburban Houston hospital. His
volunteer work has included rebuilding homes and providing medical care after Hurricane
Harvey in 2017.
In recent years, Dr. Gokal split his time between two area hospitals. But when the pandemic hit
in early 2020, he lived for a month in a hotel and an apartment rather than risk infecting his wife,
Maria, 47, who has pulmonary sarcoidosis, a disease in her lungs that leaves her winded after
even minimal activity.
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“I was petrified to go home and bring Covid to my wife,” he said.
Fortunately, he said, the Harris County Public Health department recruited him in April to
become the medical director for its Covid-response team. The job paid less, but he was eager to
protect his wife by limiting his exposure to the coronavirus in emergency rooms.
On Dec. 22, Dr. Gokal joined a conference call in which state health officials explained the
protocols for administering the recently approved Moderna vaccine. The 10 or 11 doses in a vial
are viable for six hours after the seal is punctured.
Dr. Gokal said the advice was to vaccinate people eligible under the 1(a) category (health care
workers and residents in long-term-care facilities), then those under the 1(b) category (people
over 65 or with a health condition that increases risk of severe Covid-related illness).
After that, he said, the message was: “Just put it in people’s arms. We don’t want any doses to go
to waste. Period.”
On Dec. 29, a mild Tuesday, Dr. Gokal arrived before dawn at a park in the Houston suburb of
Humble to supervise a vaccination event intended mostly for emergency workers. In part because
of minimal publicity, the pace was slow, with no more than 250 doses administered. But this was
the county’s first public event, he said. “We knew there would be hiccups.”
Around 6:45 at night, as the event wound down, an eligible person arrived for a shot. A nurse
punctured a new vial to administer the vaccine, which activated the six-hour time limit for the 10
remaining doses.
The chances of 10 eligible people suddenly showing up were slim; by now, workers were
offsetting the darkness with car headlights. But Dr. Gokal said he was determined not to waste a
single dose.
He said he first asked the event’s 20 or so workers, who either refused or had already been
vaccinated. The paramedics on site had left, and of the two police officers, one had been
vaccinated and the other declined the doctor’s offer.
Dr. Gokal said he called a Harris County public health official in charge of operations to report
his plans to find 10 people to receive the remaining doses. He said he was told, simply: OK.
He said he then called another high-ranking colleague whose parents and in-laws were eligible
for the vaccine. They weren’t available.
The hours were counting down.
The doctor figured that if he returned the open vial to his department’s almost certainly empty
office at this late hour, it would go to waste. So as he started the drive to his home in a
neighboring county, he said, he called people in his cellphone’s contact list to ask whether they
had older relatives or neighbors needing to be immunized.
“No one I was really intimately familiar with,” Dr. Gokal said. “I wasn’t that close to anyone.”
When he reached his home in Sugar Land, waiting outside were a woman in her mid-60s with
cardiac issues, and a woman in her early 70s with assorted health problems. He inoculated both.
Eight doses to go.
The doctor got back in his car — his wife insisted on going with him — and drove to a Sugar
Land house with four eligible people: a man in his late 60s with health issues; the man’s bedbound mother, in her 90s; his mother-in-law, in her mid-80s and with severe dementia; and his
wife, her mother’s caregiver.
He then drove to the home of a housebound woman in her late 70s and administered the vaccine.
“I didn’t know her at all,” he said.
Three doses remained, but three people had agreed to meet the doctor at his home. Two were
already waiting: a distant acquaintance in her mid-50s who works at a health clinic’s front desk,
and a 40-ish woman he had never met whose child relies on a ventilator.
As midnight approached, Dr. Gokal said, the third would-be recipient called to say that he
wouldn’t be coming: too late.
Tired and frustrated, Dr. Gokal said that he turned to his wife, whose pulmonary sarcoidosis
made her eligible for the vaccine. “I didn’t intend to give this to you, but in a half-hour I’m going
to have to dump this down the toilet,” he recalled telling her. “It’s as simple as that.”
He said his hesitant wife asked whether it was the right thing to do. “It makes perfect sense,” he
said he answered. “We don’t want any doses wasted, period.”
With 15 minutes to spare, Dr. Gokal gave his wife the last Moderna dose.
The next morning, he said, he submitted the paperwork for the 10 people he had vaccinated the
previous night, including his wife. He said he also informed his supervisor and colleagues of
what he had done, and why.
Several days later, the doctor said, that supervisor and the human resources director summoned
him to ask whether he had administered 10 doses outside of the scheduled event on Dec. 29. He
said he had, in keeping with guidelines not to waste the vaccine — and was promptly fired.
The officials maintained that he had violated protocol and should have returned the remaining
doses to the office or thrown them away, the doctor recalled. He also said that one of the officials
startled him by questioning the lack of “equity” among those he had vaccinated.
“Are you suggesting that there were too many Indian names in that group?” Dr. Gokal said he
asked.
Exactly, he said he was told.
Elizabeth Perez, the director of communications for Harris County Public Health, said the
department was unable to comment on its protocols, the Dec. 29 vaccination event or the Gokal
case.
On Jan. 21, about two weeks after the doctor’s termination, a friend called to say that a local
reporter had just tweeted about him. At that very moment, one of his three children answered the
door to bright lights and a thrust microphone. Shaken, the 16-year-old boy closed the door and
said, “Dad, there are people out there with cameras.”
This was how Dr. Gokal learned that he had been charged with stealing vaccine doses.
Harris County’s district attorney, Kim Ogg, had just issued a news release that afternoon with the
headline: “Fired Harris County Health Doctor Charged With Stealing Vial Of Covid-19
Vaccine.”
Image
Kim Ogg, the Harris County district attorney, whose case against Dr. Gokal was dismissed by a
judge.Credit…Yi-Chin Lee/Houston Chronicle, via Associated Press
It alleged that Dr. Gokal “stole the vial” and disregarded county protocols to ensure that vaccines
are not wasted and are administered to eligible people on a waiting list. “He abused his position
to place his friends and family in line in front of people who had gone through the lawful process
to be there,” Ms. Ogg said.
But Dr. Gokal said that no one from the district attorney’s office had ever contacted him to hear
his version of events. And when his lawyer requested copies of the written protocols and waiting
list referred to in the complaint, a prosecutor told him by email that there were no written
protocols from late December; nor had a written wait list yet been found.
Harris County had received the vaccine faster than anticipated, the email said, and public health
officials “immediately jumped from testing to vaccinating.”
As news of his alleged crime spread, Dr. Gokal heard from relatives and friends in Singapore,
the United Arab Emirates and Pakistan. “Many were calling me for support, telling me, ‘We
know you better than that,’” he said. “But there were a lot of people who didn’t call.”
Days later, a criminal court judge, Franklin Bynum, dismissed the case for lack of probable
cause.
Franklin Bynum, a criminal court judge, rebuked the district attorney’s office for filing charges
against the doctor.Credit…Todd Spoth for The New York Times
“In the number of words usually taken to describe an allegation of retail shoplifting, the State
attempts, for the first time, to criminalize a doctor’s documented administration of vaccine doses
during a public health emergency,” he wrote. “The Court emphatically rejects this attempted
imposition of the criminal law on the professional decisions of a physician.”
Both the Texas Medical Association and the Harris County Medical Society recently issued a
statement of support for physicians like Dr. Gokal who find themselves scrambling “to avoid
wasting the vaccine in a punctured vial.”
“It is difficult to understand any justification for charging any well-intentioned physician in this
situation with a criminal offense,” the statement said.
Dane Schiller, the district attorney’s director of communications, declined to answer questions
about the case. He said in an email that when the matter is presented to a grand jury,
“representatives of the community can vote on whether an indictment is warranted.”
Meanwhile, Dr. Gokal said, he continues to pay a price for not wasting a vaccine in a pandemic.
His voice broke as he counted the toll.
He lost his job. His wife struggles to sleep. His children are worried. And hospitals have told him
not to come back until his case is resolved.
He spends his time volunteering at a nonprofit health clinic for the uninsured, haunted all the
while by the realization that no matter what, it will still be out there: the story about that
Pakistani doctor in Houston who stole all those vaccines.
“How can I take it back?” that doctor asked.