WASHINGTON — The White House Medical Unit had “severe and systemic problems” with its pharmacy operations and provided health care to ineligible staffers before the Biden administration, according to a scathing report by the Defense Department’s Office of Inspector General.

The multiyear investigation was prompted in 2018 by complaints alleging that a senior military medical officer in the White House clinic had “engaged in improper medical practices.” The probe included on-site visits and focused on a three-year period during the Trump administration, as well as employee interviews dating to 2009.

“The White House Medical Unit dispensed prescription medications, including controlled substances, to ineligible White House staff,” said the report, which was released this month.

The unit also kept records for Schedule II drugs — such as fentanyl, hydrocodone, morphine and oxycodone — in the same inventory that housed records for other medications, according to the report, even though federal regulations require them to be kept separate.

The clinic’s handwritten records from the Trump administration “frequently contained errors in the medication counts, illegible text, or crossed out text that was not appropriately annotated,” the report said.

The White House Medical Unit, which consists of multiple clinics in the Washington area, is staffed by military and civilian employees and overseen by the Defense Department.

Rep. Ronny Jackson, R-Texas, was the White House physician to Presidents Barack Obama and Donald Trump before he left in 2018. His congressional office did not immediately respond to a request for comment.

The inspector general’s report did not name Jackson.

A separate Pentagon inspector general report, from 2021, said Jackson had engaged in “inappropriate conduct” when he was the White House physician.

The White House referred requests for comment to the Defense Department, which did not comment on the report’s findings. The Trump campaign did not immediately respond to a request for comment.

The report also said the White House Medical Office spent tens of thousands of dollars during the Trump administration on brand name medications instead of less expensive generic equivalents.

From 2017 to 2019, the unit spent about $46,500 on Ambien, a sleeping medication, which the report says is “174 times more expensive than the generic equivalent.” The clinic also spent nearly $100,000 during that period on Provigil, a stimulant that is “55 times more expensive than the generic equivalent,” the report said.

In 2019, investigators tried to obtain earlier records, but White House Medical Unit officials said they kept pharmaceutical records for only two years, according to the report.

“Without oversight from qualified pharmacy staff, the White House Medical Unit’s pharmaceutical management practices may have been subject to prescribing errors and inadequate medication management, increasing the risk to the health and safety of patients treated within the unit,” the report said.

It also detailed the dispensing of medication to ineligible White House staff members, which meant some staffers “received free specialty care and surgery at military medical treatment facilities.” The unit also dispensed medications like Ambien and Provigil “without verifying the patient’s identity,” the report said. Part of the report cited interviews with employees who worked in the White House dating to 2009, without specifying when such incidents took place.

The Pentagon IG’s office recommended a series of policy changes, including developing a pharmaceutical oversight plan for the White House Medical Unit, developing procedures for medication storage, prescribing and dispensing, and improving methods for establishing patient eligibility.

The Pentagon agreed with the recommendations, according to a letter attached to the report.