Who must sign the controlled substance accountability form?

• A. The patient.
• B. The EMS supervisor.
• C. The paramedic and a representative from the receiving hospital.
• D. The hospital pharmacist.

Answer: (C)

Controlled-substance accountability relies on maintaining a clear chain of custody for every drug used. The sign-off should come from the paramedic who administered the drug and from a representative at the receiving hospital who takes custody and can account for what was sent and what remains. This pairing ensures the hospital accepts responsibility for the substance on arrival and allows accurate reconciliation of inventory and usage.

The patient would not sign because they’re not part of the custody or inventory process. An EMS supervisor isn’t the required signatory for each transfer, though in some systems they may be involved in other paperwork. The hospital pharmacist isn’t automatically the required signatory either—the essential point is that a representative from the receiving hospital signs to acknowledge receipt, and this could be a nurse, pharmacist, or other authorized staff.