If a lack of insulin killed Kevin Houdeshell, a lack of regulatory common sense contributed.
Kevin’s parents, Dan and Judy, don’t want that to happen to anyone else. The Avon Lake, Ohio, residents have been advocating for “Kevin’s Law” to protect diabetics, such as their son, and those with other chronic diseases for whom access to medications is imperative.
This is what Dan knows about his son’s last week: On New Year’s Eve 2013, Kevin, who lived in Sheffield Lake, Ohio, visited his regular pharmacy to get a refill of his insulin scripts. Since his script was expired, the pharmacist told him to contact his doctor. He tried, for three days, unsuccessfully.
“(He) went to work (as head bartender at a TGIFriday’s) and with his phone on speaker on the work counter he attempted to contact his doctor. The voice recorder would answer (stating) someone will be with you shortly, then cut him off after 15 minutes,” Dan said. This went on for three days. “We are assuming with each passing day he went deeper into DKA which one of the signs is you do not think straight or logically.”
DKA is diabetic ketoacidosis. Without insulin, diabetics are unable to convert carbohydrates to energy for cells and the blood essentially acidifies due to a build-up of ketones. Symptoms include frequent urination, extreme thirst, nausea or vomiting, abdominal pain, confusion and fatigue, among others.
His son, Dan Houdeshell believes, experienced most of those. He isn’t certain because he wasn’t there. He and Judy were in Florida, where they would spend winters. They had just arrived when their world forever changed.
“All of our other children were sending all kinds of messages trying to reach us. The message is one no parent wants to ever hear they told us Kevin was dead and at that time no one knew why yet,” Dan remembers.
“When we got home the coroner’s report (said) death by DKA. We had to try and go back and find out how this happened as Kevin did a good job of taking care of himself. Kevin lived alone and was head bartender at TGIFridays, so worked nights mostly.
“We spoke with his friends and co-workers and checked his phone messages. For several days Kevin was very sick – flu-like symptoms. They finally sent him home from work and he was texting everyone how sick he was and convinced he had a very bad case of the flu. Not aware his body was shutting down from lack of insulin and he was dying.”
The text messages would stop. On Jan. 8, a friend went to check on Kevin and found him on the kitchen floor with a sliding glass door open and snow and cold blowing over his body. His parents believe he may have been trying to go somewhere for help.
Dan spent much of the next year searching for answers – reasons why his son was left to die by a health system supposed to protect him.
“I spent many late night hours on the computer this just wasn’t making sense,” he said.
Finally, he discovered that Ohio had a law regulating emergency prescription refills. Specifically, the law limited pharmacists to filling no more than a 72-hour supply when doctors were not available. Since insulin comes in vials, 72-hour supplies are difficult if not impossible to determine. Pharmacists who exceed the 72-hour limit could lose their license.
They approached Ohio State Sen. Gayle Manning during a town hall meeting and their cause began to gain momentum.
“In this time frame there was a critical local TV news piece that helped spark the movement in Columbus. We got phone calls the next day including the Ohio Pharmacy Association. They were also so supportive in this effort and still are. There were also some interviews and articles starting to come out. Slowly people picked up on this and it started moving across the country,” Dan said.
Here is a closer look at “Kevin’s Law,” as explained by Dan Houdeshell:
What is “Kevin’s Law”?
“’Kevin’s Law’ is the expansion of the pharmacy ‘emergency refill law.’ These are state laws apparently that never considered how chronic disease meds are packaged.
“Most states prior to 2016 had similar state refill laws that were as restrictive as Ohio’s and tied the hands of the pharmacists. So we have no way of knowing how many T1 deaths or trips to ER were as a result of this inadequate law.
“Further, Ohio allows a one-time refill in 12 months. Ohio was first to change this law. Since then several states took a more progressive approach and allow one time in six months, three times a year, and one or two states just placed no limit on insulin refills until you can get to see your doctor. This law is easy, as it only requires a change to the existing state laws.
“Kevin’s Law is not only for the patients, it also helps the pharmacists do their job better with no fear of repercussions. Pharmacists want to help their customers and many took chances and put their license on the line. Doctors today are very difficult to contact and pharmacists spend countless hours on the phone. Now in a potential life-threatening situation they can do their job.”
What is the current status of the law? How many states have adopted it?
“’Kevin’s Law’ has much momentum going into 2020. The current count for states that we know of that have a version of Kevin’s Law is 18 and nine of those happened in 2019. Some of these states have laws that are still ineffective and need tweaking. The remainder of the states we are not sure about and still investigating. Each state has their own version, which is interesting.”
How do you go about advocating for the law? With whom do you work? Who supports you?
“I work for myself totally grassroots and no monetary support required or needed. The reason 2019 was so successful is because of T1International. This is an organization based in London and works the insulin availability issue around the world. This past year T1International established a movement #insulin4all and each state will have their own group so they can address state legislators to garner support for affordable/accessible insulin.
“Advocating for this law is a matter of getting the info basically from me and now #insulin4all chapters and taking it to your legislators.”
What kind of response do you get from lawmakers and others when you share your story?
“The response is incredible. Lawmakers call it a sensible law, easy-to-pass law and helps quality of life plus saving lives. It has been totally bipartisan in all states with one exception. South Carolina is quibbling over some minor amendment proposal. Other organizations and individuals are in total support of it. How many times have people walked away from their pharmacy without their script?
“Now insurance coverage is another issue sadly and does not play into this. Depends on each individual’s coverage and company. We tried to get it included, but not yet. Although I think Oregon just got their insurance companies on board. It really costs them less to fill an occasional vial of insulin than pay for a trip to ER/ICU.”
For more information on “Kevin’s Law,” contact Dan Houdeshell at firstname.lastname@example.org, or visit the “In memory of Kevin ‘Howdy’ Houdeshell” Facebook group.