Inquiry Committee

Mandate

Investigate complaints and concerns regarding a registrants’ conduct, competency and/or ability to practise and decide on an appropriate course of action pursuant to legislation.

Membership

Ming Chang (Chair) (effective May 1, 2017)
John Hope (Vice-Chair) (effective May 1, 2017) (Chair) (ended April 30, 2017) 
Dorothy Barkley (Vice-Chair) (ended April 30, 2017)
David Pavan (staff resource)
Carla Ambrosini
Sally Chai
Michael Dunbar
Norman Embree (ended December 31, 2017)
Sukhvir Gidda
Fatima Ladha
George Kamensek
Patricia Kean
Jim Mercer
Janice Munroe
Alison Rhodes
Alana Ridgeley
Kristoffer Scott
Justin Thind (effective January 1, 2018)
Susan Troesch
Ann Wicks
Cynthia Widder
Joyce Wong
Marco Yeung
Number of Meetings
Number of in-person meetings: 9
Number of teleconferences: 45

Accomplishments of the Year

1. Standards for Medication Review Services

   The Inquiry Committee put forward a recommendation to the Board to direct the Registrar to develop bylaws and/or practice standards for Medication Reviews and require mandatory training for pharmacists who wish to conduct them at the June 23, 2017 Board meeting. It was highlighted to the Board that the Inquiry Committee has seen an increase in number of files relating to medication review services.

   After having reviewed hundreds of Medication Review documents that were subject of complaints, the Inquiry Committee has observed an apparent pattern of the Medication Reviews being abused. The College’s investigations have identified pharmacists being more concerned with determining whether the patient has the requisite number of medications to meet the eligibility criteria to bill for a Medication Review, rather than whether the patient actually has a clinical need for a Medication Review.

   Currently the Inquiry Committee is restricted to enforcing the general language of the Code of Ethics and Section 6(5), 11 and 12 of the Health Professions Act Bylaws. While relevant to documentation and patient counselling standards which are elements of a Medication Reviews, these pieces of legislation do not speak specifically to practice standards relating to an actual Medication Review. The Committee feels that in order to strengthen our position of enforcing the best standards of practice, there needs to be practice standards set specifically for the conducting of Medication Reviews that is in the best interests of the patient.
    

2. Pharmacy Manager’s Requirement and Training

   The Inquiry Committee put forward a recommendation to the Board to direct the Registrar to develop requirements and training tools as it pertains to the role and responsibilities of the pharmacy manager at the June 23, 2017 Board meeting. It was highlighted to the Board that the Inquiry Committee has seen an increase in number of files related to pharmacy managers not fully understanding the responsibilities and obligations that come with the role.

   In the process of reviewing files, the Inquiry Committee has come across situations where it is obvious that many pharmacy managers do not understand their responsibilities and the implications that can ensue when they are not monitoring policies and procedures or understanding all of their obligations to comply with the legislation.  The Committee has noticed that many registrants who hold this position do not fully understand all of their responsibilities or the legislative requirements involved when running the operations of a pharmacy. This results in many complaints that could be avoided if the registrants understood the scope and responsibilities of the role.

   A pharmacy manager’s role holds significant responsibilities and cannot be taken lightly. Without a pharmacy manager, a pharmacy cannot operate. The manager must personally manage and be responsible for the operation of the pharmacy.  A more stringent eligibility process and a more rigorous training requirement will greatly improve the overall operation of the pharmacies in the province and ensure safe and effective pharmacy practices for the public user.
    

3. Pharmacy Software Requirement

   The Inquiry Committee recommended that the Board to direct the Registrar to explore developing new requirements regarding the security of information in the local pharmacy computer systems and to propose that the Ministry of Health consider amending their PharmaNet Professional and Software Compliance Standards document to enhance the software security requirements of the local pharmacy computer systems at the February 16, 2018 Board meeting.

   Through the review of recent complaint files, it has become apparent to the Inquiry Committee that there is a lack of security requirements for the local computer systems and software* of pharmacies, and the Committee finds this to be problematic. In particular, the Committee has noted that certain software options lack appropriate security controls, making local system records vulnerable to user manipulation. In addition, potential manipulations of the system are not recorded; meaning, that it is not possible to track who may have manipulated a record. This lack of tracking limits the College’s ability to investigate such cases of record manipulation, which ultimately limits the College’s ability to protect the public.

   * The local computer system and software refers to the hardware and software a pharmacy uses to maintain patient records and interface with the PharmaNet system.
    

Notable Complaint Outcomes
In the past fiscal year the inquiry committee has made decisions on cases that dealt with a wide range of issues including, but not limited to, self-prescribing, unauthorized PharmaNet access, professional misconduct, and multiple contraventions of pharmacy practice standards.

1. Unauthorized PharmaNet access     

   A registrant was suspended for a period of one month for inappropriately accessing a PharmaNet record for reasons unrelated to health care and without consent. The Inquiry Committee found that this constitutes a “serious matter” and that inappropriate access of personal health information compromises the public’s trust in individual registrants and the pharmacy profession as a whole.
    

2. On a series of occasions during 2015, a registrant made comments to “LC”, an individual posing as an athlete, about the use of banned drugs and their suitability for the purpose. The registrant provided LC a training protocol that was never put into operation. Unbeknownst to the registrant, LC was part of an “undercover” investigation and the registrant’s meetings and other dealings with LC were being videotaped. An edited version of the footage was ultimately broadcast over the Internet.  The Inquiry Committee considers, and the registrant concedes, that this conduct reflected negatively on the Registrant and the profession of pharmacy in British Columbia. It constitutes professional misconduct, a serious matter pursuant to section 26 of the Health Professions Act. The registrant consented to a six-month suspension and to complete an ethics program.
    

3. After an investigation, a registrant admitted to practicing outside of his scope by prescribing and dispensing multiple medications to himself and others without a valid prescription. The registrant prescribed medication to himself over 30 times without any prescription from a physician and inappropriately dispensed medications to himself on various other occasions. In relation to prescribing medications to others, the registrant prescribed and dispensed 26 times without a valid prescription. The registrant listed the wrong prescriber on a prescription and conducted improper adaptations and emergency refills, each not in compliance with the Professional Practice Policies. As a result, the registrant consented to a six-month suspension and to complete the College Jurisprudence Exam before getting reinstated.
    

4. The Inquiry Committee, pursuant to section 35(1)(a) of the Health Professions Act,  for the purposes of public protection, imposed limits and conditions on the practice of a registrant, pending completion of an investigation of his pharmacy practice. Limits and conditions were also imposed on the registrant’s practice. As the pharmacy manager of a pharmacy, the registrant was not fulfilling his responsibilities to operate a pharmacy that meets legislative and practice standards. He had not kept accurate records regarding all purchases and sales of narcotic and controlled drugs. He had not established and/or enforced policies and procedures for inventory management and security and storage of narcotic and controlled drugs, enabling a large quantity of narcotic and controlled drugs at the pharmacy to be unaccounted for, causing potential harm to the public.
    

5. The Inquiry Committee reached an agreement by consent with a registrant to suspend his registration as a pharmacist until he successfully completes and passes the College Jurisprudence Exam. Following an investigation, the Inquiry Committee determined that between January 1, 2011 and December 31, 2012, the registrant, while pharmacy manager and owner of a pharmacy, practiced in contravention of the Bylaws to the Health Professions Act, Schedule F Part 1 Community Pharmacy Standards of Practice and the Bylaws to the Pharmacy Operations and Drug Scheduling Act. The registrant engaged in deficient practice including but not limited to prescriptions filled in excess of authorized quantity, prescriptions filled after the expiry date, and prescription adaptation without adequate rationale or documentation.
    

Inquiry Committee outcomes are publicly available on the College’s website.