Reprimand after self-prescribing

tribunal hearing legal case

A pharmacist decided it was too inconvenient to get to a doctor for scripts – so he prescribed S4 medicines to himself instead

A pharmacist with 20 years’ experience as a principal of a pharmacy provided restricted drugs to himself and two family members without prescriptions on 14 occasions over nine months in 2015 and 2016, a Tribunal has heard.

The pharmacist appeared in front of the Queensland Civil and Administrative Tribunal facing these allegations as well as allegations that in the course of providing the medicines, he generated false dispensing records.

He provided S4 medicines to himself on six occasions, to one family member on four occasions and to a second family member on four occasions.

QCAT deputy president Judge John Allen said it was important to note that the medicines involved were not “particularly inherently dangerous,” nor were they drugs of concern when it comes to abuse.

Instead, they were antibiotics, antiviral medicines and topical medicines usually prescribed for the treatment of relatively minor ailments.

Judge Allen said that there was no allegation that the provision of the drugs had endangered anybody’s health, or even potentially endangered it.

“When interviewed by investigators from the Office of the Health Ombudsman, the respondent attributed his misconduct to ‘laziness’ in failing to get doctor’s prescriptions,” he noted.

“It seems the respondent was motivated by being able to avoid the inconvenience in the time required by, and perhaps the expense involved in, he and the family members attending doctor’s appointments to obtain the necessary prescriptions.”

On dates between 15 June 2015 and 5 January 2016, the pharmacist also generated false records in the pharmacy’s computerised dispensing database, relating to 12 of the 14 incidents.

He said that the records generated were false because each entry recorded that the S4 medicine was provided in accordance with a prescription written by a GP, though no lawful script had been written by a GP at all.

He said he entered the medicines into the software database for stocktake purposes, but mainly in order to generate a label providing instructions on how to take the medicine.

He said a consequence of this process was that the database entry was automatically pre-populated with the name of a doctor who commonly prescribed for that patient, but he did not make any effort to change this – thus the name of the GP was included in the database entry.

The pharmacist denied deliberately choosing a particular doctor’s name intending to make it appear as though that doctor had indeed prescribed the medicine. The Health Ombudsman decided not to persist with an allegation that the pharmacist knew the records were false, due to this.

The pharmacist said he has now changed the pharmacy software program and database system so that a prescribing doctor’s details need to be manually entered, and cannot be pre-populated.

The Tribunal decided that the pharmacist had behaved in a way which constituted professional misconduct, though the behaviour was at the lower end of seriousness.

“The provision of medications on fourteen occasions over a nine month period constituted a deliberate course of conduct exhibiting wilful disregard for one of the most fundamental requirements of the profession,” noted the judge.

“Whilst not every failure by a pharmacist to ensure the existence of a valid prescription before supplying a medication would amount to professional misconduct – a mere mistake or oversight would not warrant such characterisation – the wilful and repeated disregard of the requirement by the respondent is such as to be properly characterised as professional misconduct.

“Furthermore, the creation of false records was a breach of a fundamental requirement of the profession.”

He noted significant “anxiety and stress” suffered by the pharmacist over the incident, and that the pharmacist had expressed remorse and had insight into his behaviour.

“The respondent has been otherwise blameless in the conduct of his profession,” he said.

The pharmacist was reprimanded and conditions imposed on his practice.

These include that he must undergo mentoring, and complete an accredited course on appropriate dispensing of medicines within 12 months.

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