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The concentration of those two drugs in her system was double the therapeutic range level, according to the coroner’s report.“She was just addicted to the pain pills, and she would go to different doctors, and they would prescribe her what she wanted,” her sister, Angela Adkins, said. “I’m just furious about this whole thing. Whoever gave my sister these drugs, they had to know she was an addict.“She had went to the doctor a day before and got all that medication, and she just thought she could just handle it and take however much she wanted and it killed her. That’s exactly what happened.”Sakkal's defense argued that the patients themselves were responsible for their overdoses because they either took too many prescribed pills or mixed them with street drugs. Prosecutors, however, placed the blame on Sakkal, who ignored red flags such as failed urine screens and visible signs that his patients were high when they came to see him, such as slurred speech and unsteady balance. “Sakkal is responsible for the prescriptions that he wrote. All doctors are,” Glassman said. “If you’re writing prescriptions to addicts because you’re trying to push pills, and that’s how you make your living, that’s not being a doctor. That’s a drug dealer.”After large chain pharmacies at Kroger and Walgreens stopped filling Sakkal’s prescriptions, he posted a list of pharmacies that had not yet blacklisted him in Lindenwald’s waiting room. He led patient protests outside the pharmacies, demanding that they fill his prescriptions. 1529

The Cuyahoga County Board of Health and Summit County Public Health are both applying for state funding, as is the Cleveland Department of Public Health."I think that the funds show a commitment by the state level health department to aggressively address this outbreak," said Andrew Heffron, clinic supervisor at the Cuyahoga County Board of Health.Heffron said the number of hepatitis A cases statewide has been steadily increasing since the outbreak began more than a year ago.Hepatitis A is a virus that affects the liver, according to Heffron, who described some of the common symptoms as "abdominal pain, very dark yellow urine, nausea and the most common symptom that people think about is jaundice, which is yellowing of the skin."The virus is commonly foodborne, but according to Persis Sosiak, commissioner of health at the Cleveland Department of Public Health, that's not the case in this outbreak."In this particular outbreak, it is much more associated with intimate contact and risky behaviors," Sosiak said.County and local health departments are trying to reach at-risk populations through vaccination and education."That includes individuals incarcerated, the homeless population, men who have sex with men," Heffron said.It also includes people traveling to developing countries and people who use illicit drugs, whether the drugs are injected or not.The number of cases in this outbreak is much higher than in a typical year, Heffron said, and those who are most in need of vaccination are very young children and people with liver diseases such as hepatitis B or hepatitis C."Historically, Ohio has about 40-some cases a year, so it’s a little concerning that we’re at the numbers we’re at," Heffron said."The hepatitis A vaccine consists of two doses, one of which is 94 to 95% effective on its own," Sosiak said."We would always recommend two doses, but if even getting one, you are giving yourself or your family a high degree of protection against the infection," Sosiak said.While medication can be given to help with hepatitis A symptoms, Heffron said the virus usually clears itself from someone's system with rest and fluids. 2154

The decision to send her to South Korea did not sit well with some senior officials in the West Wing, two people familiar with the situation told CNN. The nuclear threat from North Korea and the tensions already boiling across the Korean Peninsula made any US delegation far more than ceremonial. 296

The board of Help the Animals Inc. released a statement Monday that said they decided to place their manager on administrative leave and each of the dogs were put down because of a “bite risk.”The entire statement can be read here.? 237

The first phase of implementation at schools throughout the county is a site walk-through with emergency personnel to identify and lay out a plan to protect lives, property, and significant infrastructure. 206