College registrants have a legal and ethical obligation to promote and protect the best interests of their patients. The majority of College registrants are competent and skilled practitioners who work hard to uphold this obligation and maintain patient confidence by providing safe and effective pharmacy care.
However, there are times when a patient, co-worker, employer or other health care professional may have a concern about the pharmacy care delivered by a pharmacist or pharmacy technician. The College’s complaints resolution process is designed to deal with such circumstances and is grounded in the College’s mandate to protect the public.
Contacting the College about a Complaint
If you have a concern about the care you received from a pharmacist or pharmacy technician, the best place to start is to speak directly with that person about your concern. Simple miscommunications are often at the root of many complaints, and although it may be difficult, a face-to-face discussion is often the best way to resolve an issue.
If you are unable to resolve the concern with the pharmacist or pharmacy technician, it may be appropriate to contact the College’s complaints line 1-877-330-0967.
Learn more about the complaints process at bcpharmacists.org/complaints.
Posting of Discipline Hearing Notifications
In order to enhance transparency, as of September 1, 2019, the College will now publish citations and Discipline Hearing Notifications as individual items in the ‘News’ section of its website. These notifications will also appear on the College’s homepage. The College may include information about upcoming Discipline Hearing Notifications in its monthly ‘ReadLinks Roundup’ email, which is sent to all pharmacists and pharmacy technicians.
Previously, citations for Discipline Committee hearings were published under ‘Discipline Hearing Notifications’ on the College’s website 2-4 weeks prior to a scheduled hearing.
As a Health Professions College under the Health Professions Act, the College’s mandate is to serve and protect the public. Greater transparency assures the public that they can trust their pharmacies, pharmacists, and pharmacy technicians to provide safe and effective pharmacy care.
Section 35 Extraordinary Action
If the Inquiry Committee considers an action necessary to protect the public during the investigation of a registrant or pending a hearing of the discipline committee, it may, by order,
- impose limits or conditions on the practice of the designated health profession by the registrant, or
- suspend the registration of the registrant.
This action is used sparingly in cases where there is an urgent public protection issue. In 2019, the Inquiry Committee made orders to impose limits and conditions or suspension on three registrants’ pharmacy practice pursuant to Section 35(1)(a) of the Health Professions Act (“HPA”), pending investigation into the registrants’ practice or discipline hearing.
While practicing as a pharmacist, it was alleged that the registrant in this case did not comply with the applicable legislation and standards of practice required in order to dispense Opioid Agonist Treatment. Also, it was alleged that the Registrant provided emergency prescription refills without exercising appropriate clinical judgement and supporting documentation.
The registrant was restricted from providing any OAT services, providing emergency prescription refills on narcotic, controlled or targeted drugs as well as zopiclone and zolpidem, and from acting as a pharmacy manager.
While practicing as a pharmacist, the registrant was alleged to have shown a continuing pattern of providing Opioid Agonist Treatment without abiding by the legislative requirements. Also, the registrant was alleged to have prepared and dispensed intravenous drug product under unsanitary conditions.
The Registrant was restricted from dispensing any narcotic or controlled drug substance intended for Opioid Agonist Treatment and from compounding any medication and preparing or dispensing any medication intended for intravenous administration.
In this case, the Inquiry Committee was satisfied that there is a prima facie evidence that the registrant suffers from a substance addiction that rendered him unfit to practice at this time of the Section 35 proceeding. The Inquiry Committee was of the view that the registrant’s continued practice poses a risk to the public, and that this risk cannot be addressed at this time with conditions or limits.
The Inquiry Committee ordered a suspension of the registration of the registrant pending completion of an investigation, unless he provides medical evidence from an addiction medicine specialist, satisfactory to the College, that he is fit to resume practice.
Inappropriate Access and Use of PharmaNet Records
Between January 1, 2014 and November 5, 2017, over 15,000 transactions for over-the-counter (“OTC”) and/or vitamin products were processed on a daily or weekly basis on the PharmaNet records of seven individuals. These seven individuals were not prescribed and had not received any of the OTC and/or vitamin products processed on their PharmaNet records. Most of the seven individuals stated that they had not willingly consented to having these transactions on their PharmaNet records.
These transactions all originated from a pharmacy where a registrant was the pharmacy manager and owner.
The registrant admitted that he had directed pharmacy assistants to process transactions weekly on PharmaNet in order to artificially inflate the pharmacy’s prescription count. The pharmacy assistants used the registration numbers of various pharmacist registrants as the dispensing pharmacist and/or prescriber for each transaction. The majority of pharmacy registrants stated that their registration numbers were used without their willing consent or knowledge. Many of these transactions were also backdated.
The registrant’s actions and direction enabled the inappropriate access and use of PharmaNet records, enabled the inappropriate access and use of pharmacist registration numbers, and caused PharnaNet records to be inaccurate and not current.
The Inquiry Committee considered that the registrant’s intentional directing of weekly transactions which enabled the processing of over 15,000 false prescriptions on PharmaNet involved significant breaches of confidentiality and trust. The fact that his actions led to an inflated prescription count, from which the Inquiry Committee believed he gained financial and personal benefit, made his conduct even more serious.
His actions were considered serious contraventions of legislation involving use and protection of personal information, appropriate use and access of PharmaNet and patient records, supervision of pharmacy assistants, and his role as a pharmacy manager. He also contravened standards of the Code of Ethics involving protecting and promoting the well-being of patients, benefitting society, committing to personal and professional integrity, and participating in ethical business practices.
The Inquiry Committee also considered that the registrant had previously consented to remedial undertakings to fully comply with ethical requirements, and he had breached these undertakings for this current matter. The totality of the Former Registrant’s serious, intentional, and repeated conduct amounted to significant professional misconduct, and the Inquiry Committee considered that the registrant required the above-referred-to remediation and deterrence in order to come into compliance.
The registrant consented the following terms:
- To suspend his registration as a pharmacist for a total of 540 days, to commence upon his reinstatement to Full Pharmacist status;
- To not be a pharmacy manager, director, owner (direct or indirect), shareholder, and preceptor for pharmacy students for a period of five years from the date that his suspension ends;
- To successfully pass the College’s Jurisprudence Exam;
- To successfully complete and pass an ethics course for healthcare professionals; and.
- To pay a $30,000.00 fine.
The College received correspondence from the BC Ministry of Health regarding potential pharmacy practice concerns at a pharmacy, arising from a PharmaCare Audit of the pharmacy that covered the time period of 2 years. Further to the College’s investigation of those practice concerns, the registrant acknowledged that:
- prescriptions were missing date or quantity to dispense,
- prescriptions were filled under the incorrect prescriber,
- a prescription was dispensed for the wrong dose,
- prescriptions were written by the prescriber as daily witness ingestion but were processed under the Drug Identification Number (“DIN”) for methadone given without direct interaction
- a prescription was written by the physician for daily witness ingestion but was processed under the DIN for delivery of methadone, without authorization,
- medication reviews were submitted to PharmaNet that did not have any supporting documentation,
- prescriptions for Hepatitis C medications were not submitted to PharmaNet on the day of claimed dispense,
- prescriptions were written by the physician as daily dispense, but were filled and submitted to PharmaNet as a 7 days’ supply, with no documentation of a prescriber’s authorization to do so,
- a prescription was filled as a verbal authorization with incomplete documentation,
- a methadone prescription was billed on a day marked as “missed” on the ingestion logs,
- a prescription adaptation was conducted without adequate documentation,
- a methadone prescription did not have a part fill accountability log, and
- a methadone prescription was provided as delivery without prescriber authorization.
The Inquiry Committee considered that in this case, the cumulative weight of the practice deficiencies demonstrated inadequate diligence and oversight in the Registrant’s practice, noting that many of the substantiated practice deficiencies were substantive, and not simply administrative. Accurate record keeping and documentation are fundamental to providing safe pharmaceutical care.
The registrant consented the following terms:
- having a Letter of Reprimand placed permanently on his registration record;
- payment of a fine in the amount of $10,000;
- an undertaking to:
- not repeat the conduct to which this matter relates,
- thoroughly review and read legislation, standards and policies relevant to the conduct to which this matter relates, and thereafter submit a Declaration of Understanding regarding the legislation, standards and policies reviewed and read,
- complete the BC Pharmacy Manager Training Course as well as coursework relating to opioid agonist therapy,
- successfully complete the College’s Jurisprudence Exam,
- at all times prior to completing the BC Pharmacy Manager Training Course and successfully completing the College’s Jurisprudence Exam only provide the services of a pharmacist when a least one other full pharmacist registrant is present with him in the pharmacy, and
- at all times after delivering the Declaration of Understanding, completing the BC Pharmacy Manager Training Course and coursework relating to methadone maintenance treatment, and successfully completing the College’s Jurisprudence Exam, be knowledgeable of and abide by all legislation and policy governing the practice of pharmacy.