Pharmacist reprimanded over “excessive” dispensing

He engaged in unprofessional conduct by dispensing excessive anabolic steroids without question, a tribunal has found

The Pharmacy Board of Australia first brought pharmacist Hayden Swan before the Queensland Civil and Administrative Tribunal in 2015, relating to his dispensing of testosterone to a customer in May 2012.

Registered as a pharmacist in October 2010, Swan was employed at two branches of The Chemist Warehouse in Queensland’s Townsville region between 16 November 2011 and 31 May 2012.

During this period, Swan allegedly dispensed injectable testosterone to a single customer (Customer BL) as follows:

  • 16 November 2011: Primoteston x 12
  • 3 February 2012: Sustanon 250 x 12
  • 13 February 2012: Sustanon 250 x 12
  • 29 March 2012: Sustanon 250 x 12

At the time of the offending conduct, Swan had access to the dispensing history for Customer BL at one of the CWH branches, which showed other pharmacists working there had also dispensed:

  • 30 December 2011: 200 Proviron tablets
  • 20 January 2012: Primoteston x 12
  • 29 May 2012: Sustanon 250

On 31 May 2012, Swan dispensed Sustanon 250 x 9 to Customer BL on multiple repeat prescriptions, although the prescriptions had not been marked “Regulation 24” by the prescribing doctor.

By 31 May 2012, the quantity of testosterone-based medications dispensed to Customer BL had also exceeded the usual dosage detailed in the PI for Sustanon and Primoteston.

The tribunal found that prior to dispensing the Sustanon on that occasion, Swan had failed to:

  1. Speak to the prescribing medical practitioner to obtain approval to dispense a further nine ampoules of Sustanon to Customer BL;
  2. Verify whether the dispensing was reasonably necessary;
  3. Sufficiently assess Customer BL’s therapeutic need; or
  4. Consider the quantity of previously dispensed testosterone to Customer BL and recorded in the CWH dispensing data.

Expert witness, pharmacist Pamela Mathers, said the CWH dispensing history indicated that Customer BL had been supplied with more than two times the amount of testosterone required for treatment as prescribed, and eight times the amount required according to the manufacturer’s recommended dosage.

Mathers considered the supplied quantity of anabolic steroids to Customer BL as “unusual and high” and “excessive to his therapeutic needs”.

“Where drugs are presented with unusual and/or high doses of drugs and in particular, if the drug is known to be subject to abuse, a pharmacist has a responsibility to ensure the appropriateness of the prescription to ensure the welfare of the patient and to maintain the quality use of medicines,” she stated.

She said Swan seemed to have “accepted things at face value” and in doing so failed to meet the Code of Ethics, Professional Practice Standards and the Pharmacy Board of Australia’s guidelines for dispensing of medicines.

Swan admitted he had engaged in unprofessional conduct, and in its decision handed down in December, the tribunal agreed with a finding of unprofessional conduct.

It reprimanded Swan and ordered him to complete a course on professional ethics and dispensing.

He was also ordered to pay the Board’s costs.

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