‘Bags and bags’ of drugs in notification pics

A pharmacy owner’s immediate suspension was set aside after she appealed the 2020 decision

The owner of a Queensland pharmacy faced the Queensland Civil and Administrative Tribunal in an appeal against immediate action to suspend her registration by Ahpra.

The pharmacist had been accused of unsafely providing a large volume of medication – including morphine and temazepam – to a customer, and inappropriately discarding scheduled medicines.

In June 2020, a confidential notifier alleged that in late 2019, the pharmacy owner had given a person, identified in the court transcript as Ms D, medications including morphine and scripts belonging to other patients, to be destroyed.

Ms D had previously worked at the pharmacy part-time on a cash in hand basis but was later “let go”.

The notifier was a person, identified as Ms Z, who was an employee of the pharmacy.

She said she had “received a call” from Ms D that day in which Ms D told her that the owner had given Ms D the medicines.

In the notification Ms Z said she had photos of the drugs, scripts and syringes on her phone, which she had taken at Ms D’s house.

“There are bags and bags of them, none of which were actually prescribed to the consumer,” Ms Z had told the Office of the Health Ombudsman.

Ms D told the Office that her son, who was living with her, had been receiving bags of used scripts from the pharmacy owner.

While the Tribunal noted that the transcript of the interview was hard to follow and heavily redacted, Ms D had appeared to suggest that it was her son who was burning scripts for the owner, resulting in a callout from fire officers, who saw unburnt scripts in the yard and the neighbour’s yard.

In late June, Ahpra spoke to Queensland Health’s Public Health Unit, which said it was investigating the matter.

The PHU said it had seized the medications provided to Ms D, who confirmed the allegations.

The unit provided a copy of the receipt for the medication seized: eight morphine syringes and one ampoule; five syringes and eight ampoules of Haliperidol as well as 84 x 0.5 mg tablets; five syringes and two ampoules of Midazolam, two syringes and eight ampoules of Hyoscine Butyl Bromide; Propranolol 78 x 10 mg tablets; Temazepan one 10 mg tablet; Spironolactone 12 x 25 mg tablets; and Glycerol Trinitrate pump spray by 200 doses.

The medication was mostly dispensed to patient JK.

In July 2020, the pharmacist received notice from Ahpra of proposed immediate action to suspend her registration.

She responded in writing, saying that the allegations against her were false, and made by a disgruntled employee or employees.

The next week, Ahpra told her that it had decided to take immediate action, and suspended her registration.

“On the basis of the evidence before it, the Board reasonably believes that because of (your) conduct and/or performance, (you) pose a serious risk to persons and it is necessary to take immediate action to protect public health or safety,” she was told.

It said the risk was heightened given the pharmacist had allegedly given the prescriptions to Ms D to destroy, “representing a significant breach of confidentiality and privacy of the patients for whom those prescriptions were issued and/or dispensed”.

The pharmacy owner had said she managed the destruction of paper scripts at her pharmacy herself, shredding or burning them.

But she had not shown objective evidence of this, it said, did not outline the usual process, and did not explain how Ms D got the scripts.

“The Board continued to consider that it is the responsibility of (you) as a pharmacist and proprietor of the pharmacy, to ensure any confidential material is safely destroyed or disposed of.”

 The pharmacist appealed the suspension.

She argued that the Board had “no reasonable basis” for its decision, among other grounds which were not pursued.

In considering whether to put the suspension aside, the Tribunal noted that she had a disciplinary history already, having engaged in unsatisfactory professional conduct in the past over labelling and recordkeeping of controlled drugs. This happened in early 2014.

In 2008, she had pleaded guilty in a Magistrate’s Court to 76 separate counts of contravening the Health Act. The offences related to inadequate and improper labelling of controlled drugs, using improper containers for controlled drugs, inadequate recordkeeping of controlled drugs, failure to report certain matters about controlled drugs to the Chief Executive and improper storage of controlled drugs.

The Tribunal also noted that Ms Z, the notifier, had left her employment in July 2020, days before the owner was told of the allegations.

It observed that by the time Ms Z left the job, “the relationship between them had broken down completely”.

Both women had “articulated in very strong terms the reasons why they say that had occurred,” the Tribunal noted – and the reasons are disputed.

The pharmacy owner has made her own allegations to the Office of the Health Ombudsman, particularly about Ms Z’s attitude towards staff members and customers, which were found to be unsubstantiated in January 2021.

A patient had also complained to Ahpra about Ms Z, about her “attitude to him” over a flu vaccination arrangement.

After taking into consideration this and conflicting evidence about the exact roles played by Ms D and her son, the Tribunal concluded that it was “inclined at this stage” to not accept the proposition that the pharmacy owner had supplied dangerous drugs and sharps to Ms D.

As a result, it was not inclined to accept that she now posed a serious risk to persons.

With some hesitation, the Tribunal was not inclined to accept that the owner had been using Ms D to dispose of scripts by burning.

“It follows that there is presently no basis for taking immediate action,” it said.

It set aside the suspension.

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