FedEx delivered a package of expensive and vital chemotherapy medicine to a 68-year-old patient's mailbox one morning during the week leading up to Christmas.
About 30 minutes later — before Laura Helling-Christy even knew to retrieve it — the package was gone, removed by a U.S. Postal Service mail carrier.
Ultimately, the shipment was returned just more than a week later to the pharmacy that initially sent it, but not before the Edina woman had to scramble and ultimately rationed her meds as she approached the end of her prescription.
HealthPartners Specialty Pharmacy worked with a local nonprofit group to eventually replace the missing drugs, which cost about $18,000 per month.
"Technically, they put me at some risk," Helling-Christy said of the delivery services after she took half-doses for about five days to stretch her remaining supply. "I think the specialty pharmacy was kind of the hero. They got at it, they understood the seriousness."
While there's no clear data on how widespread the problem may be, other reports have surfaced in recent years of treatment delays due to shipping problems with mail-order medicine.
The concern was cited by the Center for Health Law and Policy Innovation at Harvard Law School in a 2021 filing with the U.S. Supreme Court in a case that challenged mail-order pharmacy mandates.
On Wednesday, FedEx issued an apology.
"The safe and secure delivery of our customers' shipments is of the highest importance," the company said in a statement. "We recognize the sensitivity of the package contents, and working directly with Ms. Helling-Christy, we have assured her that we are thoroughly reviewing the circumstances behind this matter and will take appropriate action to help prevent something like this from happening again."
The Postal Service (USPS) said in a statement mailboxes are intended only for receipt of postage-paid U.S. Mail. In Helling-Christy's case, the Postal Service said the package was returned to FedEx.
"USPS understands the concern of the customer; however, the carrier was following standard procedures," the Postal Service said in a statement.
When the delivery problem first surfaced, pharmacists asked Helling-Christy's health insurer to pay for a replacement prescription, but the carrier "did not have an option for this," said Sarah Theisen, the pharmacist-in-charge at HealthPartners Specialty Pharmacy. "To replace it would have been the full out-of-pocket cost of $18,000, which is not really an option for anyone."
Next they turned to Roundtable Rx, a nonprofit group based in Minneapolis, that had a supply of the medication and shipped it for the patient at no charge.
In general, Theisen said, it's "very rare" for patients to experience serious problems with medication delivery.
"We deliver all of our prescriptions — they all get mailed out from here," she said. "We do utilize tracking numbers for everything and follow-up to make sure that they are delivered, and delivered in a timely manner."
'This wasn't just a Christmas present'
Helling-Christy was found to have advanced pancreatic cancer more than three years ago. It was a difficult diagnosis, Helling-Christy said, but she's done surprisingly well thanks to good care, a bit of luck and a medication called Lynparza. It was approved for use in 2019.
As her monthly supply was winding down in mid-December, she and her specialty pharmacy communicated about the next shipment, as they always do. HealthPartners told her she could expect it on Dec. 20 or 21.
When the package didn't arrive on the 20th, Helling-Christy wasn't concerned until neighbors that evening started sharing messages about a recent FedEx delivery that had gone missing.
The next day, she called HealthPartners to check and was told her medication had just been delivered. But it wasn't there, and a pharmacy worker said there was something strange about the delivery. A photo sent by FedEx showed the package had been placed in the mailbox, not at the doorstep as listed on a shipping report.
"The understanding is, FedEx put it in her mailbox — and the tracking image showed that," Theisen said. "That is unusual. ... This was a new instance for us to deal with."
Helling-Christy learned that her neighbor across the street has a camera that captures video of people approaching the front door, and footage showed FedEx making the Dec. 21 delivery about 10:45 a.m. The video also showed a Postal Service truck stopping by about 30 minutes later.
"You can see and you can hear the mailman reaching into our letter box, before he puts any mail in," Helling-Christy said. "He puts [the medication package] down, puts the mail in and then he tosses [the package] into the back of his truck. You can hear it clunk, and he drives off."
The next day, Helling-Christy's husband talked with the mail carrier, who said unauthorized packages can be removed since federal law reserves mailboxes for Postal Service use. Her husband heard the mailman say removed packages were being placed in a pile at the local post office, where shippers like FedEx can retrieve them.
Helling-Christy called the postal service and pleaded with them to look for her package. She was told it wasn't there. Next she phoned FedEx. They didn't have it, either.
"I said: 'You know, this wasn't just a Christmas present. It was $18,000 of chemotherapy,'" Helling-Christy said.
She had enough medicine to take it as directed through Christmas Day. After being told the replacements might not arrive until Dec. 28, she talked with a doctor and started taking half-dosages to stretch her medication.
Lack of accountability
In the end, the medication arrived on Dec. 26, through a courier service that required a signature when making the delivery.
HealthPartners said the missing package had been delivered to its pharmacy on Dec. 29.
"It would have been a delay in therapy for her if she had just waited this whole time to try to see if it came back to us [so we could] re-send it to her," Theisen said. "Plus, we don't know the storage of it [while missing] ... if it would even be able to be used."
The whole episode has been extremely frustrating, Helling-Christy said.
Without the neighbor's video, she would have thought the package simply had been stolen. She believes the footage is evidence of irritation between the Postal Service and FedEx over the use of mailboxes — and feels neither side has taken responsibility for the consequences she suffered from their dispute.
"FedEx seemed a little alarmed, maybe because they'd have to pay for it," she said. "I don't think the post office was ever that alarmed — they were like: 'No, it's against the law, we're within our rights.' But, again, they didn't even notify us."
She added: "There has been ... no real concern or accountability throughout this whole ordeal."