I take the drug Eliquis, a blood thinner, to prevent formation of blood clots. I have previously developed at least two blood clots, and since I have two conditions (lipedema and lymphedema) that make me prone to them, my doctor tells me I will be on a permanent dose.

I have my prescription registered at the Rite Aid Pharmacy in Van Nuys, California, at Saticoy and Louise streets. My doctor has written the prescription so that I get three months’ worth at a time, which is three bottles of 60 pills each (I take a 5mg dose twice per day). Because I am disabled, and because I live alone and have no one to assist me, I pay $4 extra to have the drugs delivered to my home. Rite Aid uses an outside service that will deliver next-day if you place the order.

Yesterday afternoon, after a five-day wait (the pharmacy typically doesn’t keep the drug on hand and has to order it, plus it was the Thanksgiving holiday weekend), I finally received my delivery. I opened one bottle, took my evening pill, and put the bottle on the coffee table, where I take my night-time dose. This morning I retrieved a second bottle from the delivery package and took it into my kitchen; I keep a second bottle there to take my morning dose. This has proven to work out best for me, because if I forget to grab the next dose from wherever it is, I put it off until I’m getting up to walk again (since I do that with a fair amount of difficulty), and may forget to take it. It needs to be taken every 12 hours, so I have recently changed to doing it this way to optimize my routine.

When I unscrewed the lid on the second bottle, the manufacturer’s seal had already been broken and peeled away from the mouth of the bottle. The bottles come with a cotton ball “plug” inside on top of the pills, and it’s hard to reach the pills unless you either remove that completely or push it aside with your finger so you can shake some pills to the top of the bottle. This had obviously been done, because the cotton was moved to one side and there were pills on top of it.

I was not willing to risk taking medication from an open bottle of pills, so I called the Rite Aid pharmacy. I told the clerk who answered the phone that I had received my delivery yesterday and that when I went to open one of the bottles, the seal was gone, and I wanted to receive a new bottle with the seal intact. His response was to ask me if I had counted the number of pills. I said, No, why would I do that? And he said, Because sometimes we open a bottle, to give an emergency dose to someone waiting on their prescription, so it might be short a few pills, or they might all be there. I said I was not willing to accept a bottle that had been opened, because I had no idea who had opened it or whether the drugs had been tampered with. He got more insistent that I should just count the number of pills. I refused and said that it was beside the point how many pills were there, that the manufacturer’s seal was broken and that should be enough reason to replace it. He put me on hold and transferred me to the pharmacist.

I explained the situation to her, and she also asked me if I had counted the pills. I replied that I didn’t understand why this was so hard to comprehend, that the bottle had been tampered with, the seal was gone, someone had obviously been into the bottle because of the appearance of the cotton plug, and that I wanted a fresh (sealed!) bottle.

She then said that she would have to have this bottle back, could I please bring it in so she could examine it. I said no, I’m disabled and that’s why I have the pills delivered. She reiterated that she must have the bottle of pills back; wasn’t there anyone else who could bring it? I said No, I live alone, I have no siblings, no parents, no children, and I don’t go out. If you want the bottle, send your delivery service to get it. No, she said, that’s not policy, that’s not the way it works, you have to bring it in. I said, That’s not happening, I can’t bring it. If you want it, someone will have to retrieve it. She said, That’s an expensive drug, I can’t just replace it because you claim the bottle was opened. I said, Why in the world would I ask for a replacement if I had opened it? I don’t want to keep it, I want you to take it and replace it, but I can’t bring it to you. At this point, without another word, she put me on hold, and 30 seconds later I was disconnected.

I called back twice, only to be immediately put on hold; the third time, I managed to say to the person who answered that I had been disconnected by the pharmacist, and they finally put her back on the line. At this point she said that she would order more Eliquis, and when the bottle arrived they would mail it to me. I said thank you, that is acceptable.

So let me ask: If you received a bottle of pills that had been opened, and you didn’t know why or by whom, would you be willing to accept the pharmacist’s word that it was okay to take the pills? Would you expect the pharmacist and her staff to argue with you over it, to tell you it “should” be safe, to demand you bring the bottle back to them (with the implication that they themselves might put it back into their stock and dispense it), to insist they can’t replace it even though the manufacturer’s seal is broken, to expect you to count the pills and then speculate on who took them out of the package? Or would you expect them to react with concern, and to say “Of course we will replace it immediately—so sorry for the mistake”?

Yeah, that’s what I thought, too. I’m finding another pharmacy.