Case: 1:17-md-02804 Doc #: 3792 Filed: 07/19/21 1 of 245. PageID #: 514355
`
`IN THE UNITED STATES DISTRICT COURT
`FOR THE NORTHERN DISTRICT OF OHIO
`EASTERN DIVISION
`
`
`
`
`
`IN RE: NATIONAL PRESCRIPTION OPIATE
`LITIGATION
`
`This document relates to:
`
`Case No. 1:19-op-45346-DAP
`
`DURHAM COUNTY,
`
`
`
`
`
`AMERISOURCEBERGEN DRUG
`CORPORATION, ET AL.,
`
`
`
`
`
`
`vs.
`
`
`
`
`
`
`
`
`
`
`
`MDL No. 2804
`
`Case No. 1:17-md-2804
`
`Judge Dan Aaron Polster
`
`
`
`PLAINTIFF DURHAM COUNTY’S
`SUPPLEMENTAL AND AMENDED
`ALLEGATIONS TO BE ADDED TO
`“SHORT FORM FOR
`SUPPLEMENTING COMPLAINT AND
`DEFENDANTS AND JURY DEMAND”
`
`
`
`
`Plaintiff,
`
`Defendants.
`
`

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`Case: 1:17-md-02804 Doc #: 3792 Filed: 07/19/21 2 of 245. PageID #: 514356
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`
`TABLE OF CONTENTS
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`Page
`
`INTRODUCTION ...........................................................................................................................2 
`
`JURISDICTION AND VENUE ......................................................................................................9 
`
`PARTIES .........................................................................................................................................9 
`
`I.  PLAINTIFF..........................................................................................................................9 
`
`II.  DEFENDANTS ...................................................................................................................9 
`
`A.  CVS ................................................................................................................................9 
`
`B.  Walgreens ....................................................................................................................11 
`
`C.  Rite Aid ........................................................................................................................14 
`
`D.  Walmart........................................................................................................................17 
`
`E.  Kroger ..........................................................................................................................18 
`
`F.  Related Entities; Agency and Authority ......................................................................20 
`
`DEFENDANTS’ CONDUCT AND PLAINTIFF’S INJURIES ...................................................20 
`
`I.  COMMON FACTS ............................................................................................................20 
`
`A.  Opioids and Their Effects ............................................................................................20 
`
`B.  Defendants’ Conduct Created an Abatable Public Nuisance .......................................22 
`
`C.  Defendants Deliberately Disregarded Their Duties to Maintain Effective
`Controls Against Diversion ..........................................................................................23 
`
`1.  The Chain Pharmacies Were on Notice of and Contributed to Illegal
`Diversion of Prescription Opioids ...................................................................23 
`
`2.  Defendants Have a Duty to Report Suspicious Orders and Not to Ship
`Those Orders Unless Due Diligence Disproves Their Suspicions ...................26 
`
`3.  Defendants Were Aware of and Have Acknowledged Their
`Obligations to Prevent Diversion and to Report and Take Steps to Halt
`Suspicious Orders ............................................................................................37 
`
`4.  Defendants Were Uniquely Positioned to Guard Against Diversion ...............50 
`
`5.  Defendants Failed to Maintain Effective Controls Against Diversion ............53 
`
`i
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`TABLE OF CONTENTS
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`Page
`a.  CVS ..................................................................................................................53 
`
`i.  CVS Lacked a Genuine Suspicious Order Monitoring System for
`Much of the Relevant Time .......................................................................53 
`
`ii.  CVS Failed to Remedy Fatal Flaws in the System it Slowly
`Developed ..................................................................................................56 
`
`iii.  CVS Failed to Perform Due Diligence ......................................................60 
`
`iv.  CVS Conspired with Cardinal and McKesson to Prevent
`Suspicious Order Monitoring of Its Retail Pharmacies .............................61 
`
`v.  CVS Failed to Maintain Effective Controls Against Diversion in
`the County ..................................................................................................63 
`
`vi.  CVS Failed to Implement Effective Policies and Procedures to
`Guard Against Diversion from its Retail Stores ........................................68 
`
`b.  Walgreens ........................................................................................................69 
`
`i.  Walgreens Dragged Its Feet on Developing a SOM Program,
`Instead Relying on After-the-Fact Reports of “Excessive” Orders
`While Ignoring Red Flags ..........................................................................70 
`
`ii.  Walgreens Knew its After-the-Fact Excessive Purchase Reports
`Failed to Satisfy Its Obligations to Identify, Report, and Halt
`Suspicious Orders ......................................................................................73 
`
`iii.  Walgreens Lacked Meaningful Additional Systems to Address the
`Failures in Its System of After-the-Fact Reporting of Certain
`Orders .........................................................................................................77 
`
`iv.  Even as it Rolled Out its New SOM Program, Walgreens Left
`Significant Gaps and Loopholes in Place and Failed to Report and
`Perform Due Diligence on Orders It Flagged ............................................79 
`
`v.  Walgreens Failed to Put in Place Adequate Polices to Guard
`Against Diversion at the Pharmacy Level .................................................86 
`
`vi.  Walgreens Assumed Greater Responsibility for Controlling
`Against Diversion by Discouraging Outside Vendors from
`Exercising Their Own Oversight ...............................................................92 
`
`vii. Walgreens Failed to Maintain Effective Controls Against
`Diversion in the County .............................................................................94 
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`Page
`c.  Rite Aid ............................................................................................................99 
`
`i.  Rite Aid Failed to Maintain Effective Controls Against Diversion
`at the Wholesale Level ...............................................................................99 
`
`ii.  Rite Aid Conspired with McKesson to Avoid Scrutiny of Outside
`Vendor Orders and Adjust or Avoid Thresholds .....................................102 
`
`iii.  Rite Aid Failed to Guard Against Diversion in Distributing to the
`County ......................................................................................................103 
`
`iv.  Rite Aid Failed to Guard Against Diversion in Dispensing to the
`County ......................................................................................................105 
`
`v.  Rite Aid Failed to Maintain Effective Controls Against Diversion
`and Instead Fueled a Black Market in the County ...................................114 
`
`d.  Walmart..........................................................................................................115 
`
`i.  Walmart Lacked a Suspicious Order Monitoring System for Most
`of the Relevant Time Period ....................................................................116 
`
`ii.  Walmart Failed to Guard Against Diversion in Distributing into the
`County ......................................................................................................119 
`
`iii.  Walmart Failed to Maintain Effective Controls Against Diversion
`from its Pharmacies in the County ...........................................................121 
`
`e.  Kroger ............................................................................................................129 
`
`i.  Kroger Failed to Maintain Effective Controls Against Diversion of
`Opioids It Distributed, Instead Oversupplying Its Stores ........................130 
`
`ii.  Kroger Failed to Implement Effective Policies and Procedures to
`Prevent Diversion from Its Pharmacy Stores ...........................................133 
`
`D.  Defendants’ Performance Metrics Put Profits Before Safety ....................................136 
`
`E.  Defendants Worked Together to Increase Their Profits and Lobbied Against
`Restrictions on Opioid Use and DEA Enforcement ..................................................149 
`
`F.  Defendants Also Entered into Joint Ventures that Further Undermined their
`Outside Vendors’ Incentive to Conduct Due Diligence, While Increasing their
`Own Access to Information. ......................................................................................156 
`
`G.  Defendants Worked with Opioid Manufacturers to Promote Opioids and
`Improperly Normalize Their Widespread Use ...........................................................158 
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`Page
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`H.  Defendants Delayed a Response to the Opioid Crisis by Pretending to
`Cooperate with Law Enforcement .............................................................................181 
`
`I.  Multiple Enforcement Actions Against the Chain Pharmacies Confirm Their
`Compliance Failures ..................................................................................................187 
`
`1.  CVS ................................................................................................................187 
`
`2.  Walgreens ......................................................................................................193 
`
`3.  Rite Aid ..........................................................................................................197 
`
`4.  Walmart..........................................................................................................199 
`
`5.  Kroger ............................................................................................................200 
`
`J.  The Opioids the Defendants Sold Migrated into Other Jurisdictions ........................201 
`
`K.  The Defendants Conspired to Engage In The Wrongful Conduct Complained
`Of Herein and Intended To Benefit Both Independently and Jointly From
`Their Conspiracy. .......................................................................................................205 
`
`II.  NORTH CAROLINA-SPECIFIC FACTS ......................................................................207 
`
`A.  Defendants Breached Their Duties in North Carolina ...............................................207 
`
`B.  The Devastating Effect of the Opioid Epidemic in North Carolina ...........................210 
`
`C.  Facts Specific to Durham County ..............................................................................217 
`
`III. STATUTES OF LIMITATIONS ARE TOLLED AND DEFENDANTS ARE
`ESTOPPED FROM ASSERTING STATUTES OF LIMITATIONS AS
`DEFENSES. .....................................................................................................................226 
`
`A.  Continuing Conduct ...................................................................................................226 
`
`B.  Equitable Estoppel and Fraudulent Concealment ......................................................227 
`
`CAUSES OF ACTION ................................................................................................................228 
`
`PUBLIC NUISANCE (Supplemental Allegations Against Pharmacy Defendants) .............229 
`
`PRAYER FOR RELIEF ..............................................................................................................237 
`
`JURY DEMAND .........................................................................................................................238 
`
`CERTIFICATE OF SERVICE ....................................................................................................240 
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`-iv-
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`Case: 1:17-md-02804 Doc #: 3792 Filed: 07/19/21 6 of 245. PageID #: 514360
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`1.
`
`Plaintiff Durham County, North Carolina, (“County or “Plaintiff”) brings this
`
`action to prevent future harm and to redress past wrongs against the following Defendants (“Chain
`
`Pharmacies” or “Pharmacy Defendants” or “Defendants”): the Walgreens Defendants,1 the CVS
`
`Defendants,2 the Kroger Defendants,3 the Rite Aid Defendants,4 and the Walmart Defendants.5 6
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`2.
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`Plaintiff seeks to hold accountable the Chain Pharmacies that reaped enormous
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`financial rewards by helping to expand the market for prescription opioids beyond all reasonable
`
`limits, by utterly failing to comply with their gatekeeping obligation to protect the public and by
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`
`1 The Walgreens Defendants are Walgreen Co., Walgreens Boots Alliance, Inc.; Walgreen
`Eastern Co., Inc.; and Edc Drug Stores, Inc. f/k/a Kerr Associates, Inc. f/k/a Kerr Drug Stores,
`Inc. f/k/a Kerr Drugs, Inc.
`2 The CVS Defendants are CVS Health Corporation; CVS Indiana L.L.C.; CVS Rx Services,
`Inc.; CVS TN Distribution, LLC; CVS Pharmacy, Inc.; North Carolina CVS Pharmacy, L.L.C.;
`ProCare Pharmacy Direct, L.L.C. d/b/a CVS Specialty; and Caremark, L.L.C. d/b/a CVS
`Specialty.
`3 The Kroger Defendants are The Kroger Co.; Kroger Limited Partnership I; Kroger Limited
`Partnership II; and Harris Teeter, LLC f/k/a Food World, Inc. f/k/s Harris Teeter, Inc. f/k/a
`Harris-Teeter Super Markets, Inc. f/k/a Racc, Inc.
`4 The Rite Aid Defendants are Rite Aid Corporation, Rite Aid of Maryland, Inc., d/b/a Rite Aid
`Mid-Atlantic Customer Support Center; Rite Aid Hdqtrs. Corp.; Rite Aid of North Carolina, Inc.;
`and Eckerd Corporation.
`5 The Walmart Defendants are Walmart Inc., f/k/a Wal-Mart Stores, Inc.; Wal-Mart Stores East,
`LP; WSE Management, LLC; WSE Investment LLC; Wal-Mart Stores East, LLC f/k/a Wal-Mart
`Stores East, Inc.; Sam’s East, Inc.; and Sam’s West, Inc.
`6 The following are newly added Defendants in this pleading: Walgreen Co., Walgreen Eastern
`Co., Inc.; Edc Drug Stores, Inc. f/k/a Kerr Associates, Inc. f/k/a Kerr Drug Stores, Inc. f/k/a Kerr
`Drugs, Inc.; CVS Indiana L.L.C.; CVS Rx Services, Inc.; CVS TN Distribution, LLC; CVS
`Pharmacy, Inc.; North Carolina CVS Pharmacy, L.L.C.; ProCare Pharmacy Direct, L.L.C. d/b/a
`CVS Specialty; Caremark, L.L.C. d/b/a CVS Specialty; The Kroger Co.; Kroger Limited
`Partnership I; Kroger Limited Partnership II; Harris Teeter, LLC f/k/a Food World, Inc. f/k/s
`Harris Teeter, Inc. f/k/a Harris-Teeter Super Markets, Inc. f/k/a Racc, Inc.; Rite Aid Corporation,
`Rite Aid of Maryland, Inc., d/b/a Rite Aid Mid-Atlantic Customer Support Center; Rite Aid
`Hdqtrs. Corp.; Rite Aid of North Carolina, Inc.; Wal-Mart Stores East, LP; WSE Management,
`LLC; WSE Investment LLC; Wal-Mart Stores East, LLC f/k/a Wal-Mart Stores East, Inc.; Sam’s
`East, Inc.; and Sam’s West, Inc.
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`refusing to monitor and restrict the improper sale and distribution of opioids, causing a public
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`nuisance in the County.
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`3.
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`IN ADDITION TO THE ALLEGATIONS SET FORTH HEREIN, THE COUNTY
`
`EXPRESSLY ADOPTS AND INCORPORATES BY REFERENCE THE ALLEGATIONS AND
`
`CLAIMS SET FORTH IN ITS COMPLAINT AND “SHORT FORM FOR SUPPLEMENTING
`
`COMPLAINT AND AMENDING DEFENDANTS AND JURY DEMAND,” (“SHORT FORM
`
`COMPLAINT”) INCLUDING ALL CLAIMS AND ALLEGATIONS AGAINST OTHER
`
`DEFENDANTS NAMED IN THAT SHORT FORM COMPLAINT.
`
`INTRODUCTION
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`4.
`
`This case arises from the worst man-made epidemic in modern medical history—
`
`an epidemic of addiction, overdose and death caused by Defendants’ flooding the United States,
`
`including Plaintiffs’ community, with prescription opioids.
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`5.
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`By now, most Americans have been affected, either directly or indirectly, by the
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`opioid epidemic.
`
`6.
`
`This crisis arose not only from the opioid manufacturers’ deliberate marketing
`
`strategy, but from distributors’ and pharmacies’ equally deliberate efforts to evade restrictions on
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`opioid distribution and dispensing, while also helping spread the manufacturers’ false marketing
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`messages about prescription opioids and encourage their widespread use. These distributors and
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`pharmacies acted without regard for the lives that would be trammeled in pursuit of profit.
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`7.
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`Plaintiff Durham County has been deeply affected by the opioid crisis. From 2010
`
`through 2019, there were 221 opiate-related deaths in the County, which had a population of
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`approximately 228,300 residents in 2010.7 This number rose from 15 opioid-related deaths in 2010
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`to a high of 40 in 2017.8 In addition, in Durham County, the number of emergency department
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`visits emergency department visits due to opioids almost tripled from 60 in 2016 to 177 in 2019.9
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`The Durham EMS responded to 335 opioid overdoses in 2019 and 481 opioid overdoses in 2020.10
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`Many residents Durham County who need addiction treatment do not receive it.
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`8.
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`This devastation in the County was created by opioid manufacturers, distributors,
`
`and Chain Pharmacies, who worked together to systematically dismantle the narcotic conservatism
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`that had existed around prescription opioids for decades, opened the floodgates to an unreasonably
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`large and unsafe supply of opioids, improperly normalized the widespread use of opioid drugs,
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`violated laws and regulations designed to protect the public from the dangers of narcotic drugs like
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`opioids, and worked to dismantle protections designed to protect the public so more opioid drugs
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`could be sold and the manufacturers, distributors, and Chain Pharmacies could reap the profits
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`therefrom.
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`9.
`
`Since the push to expand prescription opioid use began in the late 1990s, the death
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`toll has steadily climbed, with no sign of slowing. The number of opioid overdoses in the United
`
`
`7 See NCDHHS, County-level Overdose Data Tables, All Intents Opioid Poisoning Deaths by
`County, N.C. Residents, 2010-2019, https://www.injuryfreenc.ncdhhs.gov/DataSurveillance/
`Poisoning.htm, (information for Durham County, Death Data Any Opioid).
`8 Id.
`9 See NCDHHS, County-level Overdose Data Tables, All Intents Opioid Poisoning Deaths by
`County, N.C. Residents, 2010-2019,
`https://www.injuryfreenc.ncdhhs.gov/DataSurveillance/Poisoning.htm, All Intents Opioid
`Poisoning Deaths by County, N.C. Residents, 2010-2019 (information for Durham County,
`Emergency Department Data, Any Opioid).
`10 ‘Opioid, Substance Use, and Addition Services,’ Public Health, Durham County, NC at
`https://www.dcopublichealth.org/services/health-education/opioid-substance-use-and-addiction-
`services#:~:text=From%202017%2D2019%2C%20103%20people,by%20the%20COVID%2D1
`9%20epidemic.
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`13.
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`In the words of Robert Anderson, who oversees death statistics at the Centers for
`
`Disease Control and Prevention, “I don’t think we’ve ever seen anything like this. Certainly not
`
`in modern times.” On October 27, 2017, the President declared the opioid epidemic a public health
`
`emergency.
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`14. Most of the overdoses from non-prescription opioids are also directly related to
`
`prescription pills. As soon as prescription opioids took hold on a population, the logical and
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`devastating progression to illicit drugs followed. Many opioid users, having become addicted to
`
`but no longer able to obtain prescription opioids, or trapped in a cycle of addiction that causes
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`those who suffer from the disease to need stronger and more potent drugs, have turned to heroin,
`
`fentanyl, and other illicit drugs. According to the American Society of Addiction Medicine, 80%
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`of people who initiated heroin use in the past decade started with prescription painkillers—which,
`
`at the molecular level and in their effect, closely resemble heroin. In fact, people who are addicted
`
`to prescription painkillers are 40 times more likely to become addicted to heroin, and the CDC
`
`identified addiction to prescription pain medication as the strongest risk factor for heroin addiction.
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`15.
`
`The conduct of the manufacturers, distributors, and Chain Pharmacies caused the
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`nation, and the County, to be awash in a flood of prescription opioids. This has had a profound
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`impact on both morbidity and mortality, and these drugs have created an epidemic of addiction
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`that has had severe and wide-ranging effects on public health and safety in the County and in
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`communities across the country. Indeed, from those suffering with the disease of addiction
`
`themselves, to children whose parents who suffer from addiction, to employers who employ an
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`addicted population, to the first responders, law enforcement, the court system and the prison
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`system who cannot handle the burdens placed on them, there is almost no area of the community
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`that has not been significantly impacted.
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`16.
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`This suit takes aim at a substantial contributing cause of the opioid crisis: the Chain
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`Pharmacies, the last link in the opioid supply chain and the critical gatekeeper between dangerous
`
`opioid narcotics and the public, who utterly failed in their gatekeeper role, flouted their duties to
`
`protect the public, violated the laws designed to protect the public and dismantled and disregarded
`
`measures designed to protect the public health and safety. The Chain Pharmacies failed to design
`
`and operate systems to identify suspicious orders of prescription opioids, maintain effective
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`controls against diversion, and halt suspicious orders when they were identified, and instead
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`actively contributed to the oversupply of such drugs and fueled an illegal secondary market. They
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`also played an active role in helping the manufacturers promote their false marketing about opioids
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`to health care providers, their own pharmacists, and the public.
`
`17.
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`The mission of pharmacy practice is “to serve society as the profession responsible
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`for the appropriate use of medications, devices, and services to achieve optimal therapeutic
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`outcomes.”11 Defendants subverted that role and instead played a significant role in a public health
`
`epidemic in the County.
`
`18.
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`Defendants have contributed substantially to the opioid crisis by helping to inflate
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`the opioid market beyond any legitimate bounds and by flooding that market with far greater
`
`quantities of prescription opioids than they know could be necessary for legitimate medical uses,
`
`while failing to report, and to take steps to halt suspicious orders and sales, thereby exacerbating
`
`the oversupply of such drugs and fueling an illegal secondary market.
`
`19.
`
`In 2014, almost two million Americas were addicted to prescription opioids and
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`another 600,000 to heroin. From 1999 to 2015, more than 183,000 people died in the U.S. from
`
`
`11 Vision and Mission for the Pharmacy Profession, American Pharmacists Association, adopted
`by the APhA House of Delegates (March 1991).
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`overdoses related to prescription opioids—more than the number of Americans who died in the
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`Vietnam War. From 1999 to 2016, more than 200,000 people died in the U.S. from overdoses
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`related to prescription opioids. Overdose deaths involving prescription opioids were five times
`
`higher in 2017 than 1999. The number of drug overdose deaths increased by nearly 5% from 2018
`
`to 2019.
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`20.
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`As millions became addicted to opioids, “pill mills,” often styled as “pain clinics,”
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`sprouted nationwide and rogue prescribers stepped in to supply prescriptions for non-medical use.
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`These pill mills, typically under the auspices of licensed medical professionals, issue high volumes
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`of opioid prescriptions under the guise of medical treatment. Prescription opioid pill mills and
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`rogue prescribers cannot channel opioids for illicit use without at least the tacit support and willful
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`blindness of the Defendants, if not their knowing support.
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`21.
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`As a direct and foreseeable result of Defendants’ conduct, cities and counties across
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`the nation, including Plaintiff, are now swept up in what the Centers for Disease Control (“CDC”)
`
`has called a “public health epidemic” and what the U.S. Surgeon General has deemed an “urgent
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`health crisis.”12 The increased volume of opioid prescribing, not all of which is for legitimate use,
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`correlates directly to skyrocketing addiction, overdose and death; black markets for diverted
`
`prescriptions opioids; and a concomitant rise in heroin and fentanyl abuse by individuals who
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`could no longer legally acquire or could not afford prescription opioids.
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`22.
`
`This explosion in opioid use and Defendants’ profits has come at the expense of
`
`patients and residents and has caused ongoing harm to and a public nuisance in the County. As
`
`
`12 Examining the Growing Problems of Prescription Drug and Heroin Abuse, Ctrs. For Disease
`Control and Prevention (Apr. 29, 2014), http://www,cdc,give.washington/testimony/2014/
`t20140429.htm; see also, Letter from Vivek H. Murthy, Surgeon General, Tide RX (Aug. 2016),
`http://turnthetiderx.org.
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`the then CDC director concluded: “We know of no other medication routinely used for a nonfatal
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`condition that kills patients so frequently.”13
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`23.
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`Defendants’ conduct in promoting opioid use and fueling diversion has had severe
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`and far-reaching public health, social services, and criminal justice consequences, including the
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`fueling of addiction and overdose from illicit drugs such as heroin. These necessary and costly
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`responses to the opioid crisis include the handling of emergency responses to overdoses, providing
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`addiction
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`treatment, handling opioid-related
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`investigations, arrests, adjudications, and
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`incarceration, treating opioid-addicted newborns in neonatal intensive care units, burying the dead,
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`and placing thousands of children in foster care placements, among others.
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`24.
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`The burdens imposed on Plaintiff are not the normal or typical burdens of
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`government programs and services. Rather, these are extraordinary costs and losses that are related
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`directly to Defendants’ illegal actions. The Defendants’ conduct has created a public nuisance and
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`a blight. Governmental entities, and the services they provide their citizens, have been strained to
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`the breaking point by this public health crisis.
`
`25.
`
`Defendants have not changed their ways or corrected their past misconduct but
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`instead are continuing to fuel the crisis and perpetuate the public nuisance.
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`26. Within the next hour, six Americans will die from opioid overdoses; two babies
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`will be born addicted to opioids and begin to go through withdrawal.
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`27.
`
`Plaintiff brings this suit to bring the devastating march of this epidemic to a halt
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`and to hold Defendants responsible for the crisis they caused.
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`
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`13 Id.
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`JURISDICTION AND VENUE
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`28.
`
`This Court has subject-matter jurisdiction of this action under 28 U.S.C. § 1331
`
`because it arises under the Racketeer Influenced and Corrupt Organizations Act (“RICO”), 18
`
`U.S.C. § 1961 et seq.
`
`29.
`
`This Court has supplemental jurisdiction of the County’s state-law claims under 28
`
`U.S.C. § 1367 because those claims are so related to the RICO claim as to form part of the same
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`case or controversy.
`
`30.
`
`31.
`
`This Court has personal jurisdiction over all Defendants.
`
`Venue is proper in this district under 28 U.S.C. § 1407.
`
`PARTIES
`
`I.
`
`PLAINTIFF
`
`32.
`
`The County is a political subdivision of the State of North Carolina which may sue
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`and plead in its own name.
`
`II. DEFENDANTS14
`A.
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`CVS
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`33.
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`Defendant CVS Health Corporation (“CVS Health”) is a Delaware corporation with
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`its principal place of business in Rhode Island. CVS Health, through its various DEA registered
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`subsidiaries and affiliated entities, conducts business as a licensed wholesale distributor and also
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`14 The County has made its best efforts, based on the information available, to identify all of the
`corporate entities with responsibilities related to the sale and distribution of opioids in or
`affecting the County. If information that becomes available to the County alters its
`understanding or discloses additional entities, the County reserves the right to seek to join any
`such entities as defendants. Furthermore, the County recognizes that corporate entities affiliated
`with the Defendants may possess discoverable information relevant to the County’s claims, even
`though those entities have not been named as defendants. The County reserves the right to seek
`all information relevant to these claims.
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`Case: 1:17-md-02804 Doc #: 3792 Filed: 07/19/21 15 of 245. PageID #: 514369
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`operates retail stores, including in and around Plaintiff’s geographical area, that sell prescription
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`medicines, including opioids.
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`34.
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`Defendant CVS Indiana L.L.C. is an Indiana limited liability company with its
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`principal place of business in Indianapolis, Indiana. For much of the period the identification of
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`and due diligence on suspicious orders for the entire country was to be performed at CVS Indiana
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`L.L.C.
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`35.
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`Defendant CVS Rx Services, Inc. is registered to do business in North Carolina as
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`a New York corporation with its principal place of business in Woonsocket, Rhode Island.
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`36.
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`Defendant CVS TN Distribution, LLC is registered to do business in North Carolina
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`as a Tennessee limited liability company with its principal place of business in Woonsocket, Rhode
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`Island.
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`37.
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`Defendant CVS Pharmacy, Inc. is a Rhode Island corporation with its principal
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`place of business in Woonsocket, Rhode Island. CVS Pharmacy, Inc. is a wholly owned subsidiary
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`of CVS Health. Defendant CVS Pharmacy, Inc. is both a DEA registered “distributor”15 and a
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`DEA registered “dispenser”16 of prescription opioids and cocktail drugs and is registered to do
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`business in North Carolina.
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`38.
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`Defendant North Carolina CVS Pharmacy, L.L.C. is registered to do business in
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`North Carolina as a North Carolina limited liability company with its principal place of business
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`in Woonsocket, Rhode Island. During the relevant time period, CVS entities also owned and
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`operated pharmacies in the County through Defendant North Carolina CVS Pharmacy, L.L.C.
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`15 21 U.S.C. § 802(11) and § 822(a)(1).
`16 21 U.S.C. § 802(10) and § 822(a)(2).
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`Case: 1:17-md-02804 Doc #: 3792 Filed: 07/19/21 16 of 245. PageID #: 514370
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`39.
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`ProCare Pharmacy Direct, L.L.C. d/b/a CVS Specialty (“ProCare Pharmacy
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`Direct”) is registered to do business in North Carolina as an Ohio limited liability company with
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`principal place of business in Woonsocket, Rhode Island. ProCare Pharmacy Direct has an active
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`wholesaler license with the North Carolina Department of Agriculture & Consumer Services Food
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`& Drug Protection Division.
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`40.
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`Caremark, L.L.C. d/b/a CVS Specialty (“Caremark”) is registered to do business in
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`North Carolina as a California limited liability company with a principal place of business in
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`Woonsocket, Rhode Island. Caremark has an active wholesaler license with the North Carolina
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`Department of Agriculture & Consumer Services Food & Drug Protection Division.
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`41.
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`Defendants CVS Health Corporation; CVS Indiana L.L.C.; CVS Rx Services, Inc.;
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`CVS TN Distribution, LLC; CVS Pharmacy, Inc.; North Carolina Pharmacy, L.L.C.; ProCare
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`Pharmacy Direct; and Caremark, are collectively referred to as “CVS.” CVS conducts business as
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`a licensed wholesale distributor and dispenser. At all times relevant to this Complaint, CVS
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`distributed and/