A San Diego‑based doctor and a pharmacist are facing state accusations of improperly manufacturing, labeling and administering popular GLP-1-type weight-loss and diabetes drugs in an unsafe and unclean manner. In a June 2026 accusation by the Medical Board of California, investigators claim San Diego pain specialist Dr. Ronald Cohen allowed pharmacist Bernard Gramlich to use his Sorrento Valley office to produce semaglutide and tirzepatide — GLP‑1‑based injectable medications widely used for diabetes and weight loss.Cohen’s facility, however, did not have a certified cleanroom with required hygiene equipment, cleanable surfaces, air filtration, or written operating procedures typical of medical facilities and laboratories.
Office where alleged improper compounding occurred. (Photo by Dorian Hargrove/Times of San Diego)The drugs were then often mislabeled, weren’t dispensed in child-resistant vials, and did not include tracking numbers or expiration dates, according to the Medical Board’s accusation. Cohen allegedly administered the drugs to some of his patients, despite the lack of safeguards.The pharmacist behind the compounding operation, Gramlich, from Rancho Santa Fe, had already been under investigation by the California State Board of Pharmacy. In 2023, the board placed his license on probation for multiple violations, some of which were for compounding drugs, at Fairbanks Pharmacy in Rancho Santa Fe, which he had run since 2017.“Despite never being licensed as a sterile compounding pharmacy, Respondent Gramlich conducted sterile compounding from at least December 23, 2019, through August 16, 2023, and failed to review the compounding policies and procedures annually,” reads the 2023 Board of Pharmacy accusation.Following his 2023 probation, Fairbanks Pharmacy closed. Gramlich, through his new company, Gram Peptides, began compounding the GLP-1s out of Cohen’s Sorrento Valley pain clinic.The accusation, however, did not dissuade Gramlich from seeking new compounding ventures.In February 2023, pain doctor Cohen and Gramlich entered into an agreement, which allowed Gramlich to use space in Cohen’s Sorrento Valley office to compound semaglutides.In exchange for allowing Gramlich to use the space, the pharmacist, according to the Medical Board complaint, agreed to “leave some of the compounded drugs at [Cohen’s] medical office for [Cohen} to administer and/or dispense to [his] patients, and [Gramlich] would take the remaining compounded drugs to another location where [Gramlich] would provide them to [Cohen’s] patients.”As the Board of Pharmacy and the FDA look into the Rancho Santa Fe pharmacist, the Medical Board has turned its attention to Dr. Cohen. According to the Medical Board accusation, Cohen admitted that compounding was taking place at his Sorrento Valley facility under his direction. Cohen also told investigators he did not keep any records of the drugs Gramlich manufactured at his facility.“[Cohen] admitted he relied on [Gramlich] to oversee and operate the compounding process taking place in [Cohen’s] clean room and relied on [Gramlich] to obtain all the materials necessary for the compounding process,” reads the board’s accusation.The Medical Board is now seeking to revoke Cohen’s medical license. On July 16, 2025, Gramlich surrendered his pharmacy license, agreeing to wait at least three years before applying for reinstatement. If Gramlich seeks reinstatement, he must also pay nearly $60,000 for the cost of the pharmacy board’s investigation.And while Gramlich surrendered his license, his company’s website is still up and running.“Gram Peptides is a U.S.-based peptide company founded by a pharmacist with over 20 years of compounding experience,” the website reads.In March 2026, the Food and Drug Administration sent Gramlich and Gram Peptides a warning letter for manufacturing and administering weight loss and diabetes compounds.“These products are especially concerning from a public health perspective because injectable drug products can pose risks of serious harm to users,” wrote representatives from the Center for Drug Evaluation and Research.Neither Cohen nor Gramlich responded to emails or voice mails left by Times of San Diego. This article will be updated if or when they respond.
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