Kansas City, Mo. ? Doctors everywhere from Children’s Mercy Hospital to an Independence, Mo., eye clinic were scouring records after learning patients may have received watered down drugs from pharmacist Robert Courtney.

Missouri health officials on Friday publicly released a list of about 400 doctors and clinics possibly affected by the dilutions. The list of Kansas patients was released earlier this week.

Dr. Carrie Lehr was one of the doctors who received a letter from Missouri health officials notifying her of possible dilutions. But, in an unusual twist, Lehr’s letter listed her as the potential victim.

Lehr, now in private practice, also expects she’ll soon learn that some of the patients she treated while working at Kansas City Internal Medicine received watered down drugs.

“Being affected as a patient isn’t nearly as upsetting as being involved as a doctor,” Lehr said. “I feel I did receive a good dose of the medicine because it had the effects it should have. What’s much more devastating as a physician is to find out that patients were affected.”

The mailings follow an announcement from federal officials that Courtney now has admitted diluting 72 drugs, dating to at least 1992 and affecting about 400 doctors and 4,200 patients. He originally admitted diluting two chemotherapy drugs beginning in November of 2000 and intensifying in March through May of 2001.

Courtney, 49, is being detained at a private jail for federal prisoners in Leavenworth, Kan. He pleaded guilty in February to 20 charges of tampering with, adulterating and misbranding chemotherapy medications. He faces a sentence of between 17 1/2 and 30 years.

No sentencing has been set.

Children’s Mercy Hospitals and Clinics confirmed Friday that two patients were identified as possibly receiving diluted drugs from Courtney.

“We haven’t found anything in looking over patients’ records that causes concern,” said spokesman Thomas McCormally.

Officials at the Business and Industry Clinic in Kansas City were baffled to receive a letter from the state. The clinic, now called Employer Health Services, treats Health Midwest employees who are injured or get sick on the job.

“Here’s why they’re so puzzled,” said Chris Whitley, spokesman for Health Midwest. “Because of the nature of services provided, no one gets IV drugs there.”

Whitley, a former spokesman for the U.S. Attorney’s Office, speculated the clinic’s appearance on the list may be a result of the Kansas City pharmacist’s poorly kept records.

The disorder of the records has been a common complaint. Sometimes the names of doctors were typed into spots where patients’ names belonged, said FBI spokesman Jeff Lanza.

“What it comes down to,” Lanza said, “is he diluted virtually every dose that were intravenous or injectable. If you’re wondering whether you received diluted drugs, there’s a good chance you did if you got them from Courtney’s pharmacy during that time.”