Report Lost or Stolen Prescription Pads

Incident Date

Date Reported to Board

Prescriber's Name

Prescriber's Specialty

11/14/2021

11/22/2021

Umu Coomber Benjamin

PSychiatry

Umu Coomber Benjamin 7033329209 P O box 730 Haymarket VA 20168

Maryland County: Montgomery

Zip Code: 20852

Medical prescription pads, last used in 2018, are suspected to have been stolen from their location in my home office - desk drawer address 13850 Carriage Ford Rd, Nokesville VA 20181. A police report filed with Prince Williams Police department on Sept 13th , ref #265120 was filed with the local law enforcement on 11/13/2021. Theft was noticed on 11/13/2021, directions to file via online reporting was provided by local law enforcement recently. Individuals who had/have access to my home and the location of the prescription pads include my estranged husband, two sons (ages 16 and 10), Home contractors for repairs, handy man for work and numerous realtors and prospective home buyers (starting October 9th, 2021) Please note that any prescriptions written using these prescription pads after 2018 were not written by me.

10/19/2021

Jeanine Albert, CRNP Patricia DeHaven, CRNP Tracey Dixon, CRNP Rebecca Gresh, CRNP Courtenay McDonough, CRNP Devon Munley, CRNP Vito Zaccheo, CRNP

Hospitalist

tcornejo@adfinitashealth.com

Maryland County: Howard

Zip Code: 21076

RX Pads lost in fed ex trasit from vendor (IronMark) to recipients in PA. Tracking number of fed ex is: 9/7 tracking 1Z2731470393938776 9/27 tracking 284338107800 Below are the codes on the bottom of the missing scripts: PAS2814610921A PAS2814610921B PAS2814610921C PAS2814610921D PAS2814610921E PAS2814610921F PAS2814610921G PAS2814610921I PAS2814610921J PAS2814610921K group of providers on pads were: Jeanine Albert, CRNP Patricia DeHaven, CRNP Tracey Dixon, CRNP Rebecca Gresh, CRNP Courtenay McDonough, CRNP Devon Munley, CRNP Vito Zaccheo, CRNP Please feel free to reach out with additional questions: Tiya Cornejo, email tcornejo@adfinitashealth.com