A pharmacist has had his registration suspended for six months after he dispensed up to 15 tablets of alprazolam and 17 tablets of diazepam per day to a patient
The pharmacist, who is now in his early 70s, was the co-owner of a pharmacy in Melbourne in 2012 and 2013, which is when the conduct took place.
In August 2015, the Department of Health and Human Services told the Pharmacy Board that it had been investigating a patient, described in a Victorian Civil and Administrative Tribunal hearing as Ms AD, who had obtained significant quantities of drugs of dependent from at least 14 pharmacies in 2012 and 2013.
She had done so by presenting forged or fraudulently altered scripts.
An analysis of pharmacy records conducted by DHHS showed that directions for the administration of the medication in question, in genuine prescriptions presented to various pharmacies by Ms AD, varied between two and six tablets of alprazolam and diazepam per day.
“In contrast, by the end of the relevant time, the calculated daily rate of supply from [the store co-owned by the pharmacist] was 11 tablets of alprazolam 2mg (alprazolam) and 13 tablets of diazepam 5mg (diazepam) per day,” the Tribunal noted.
“Between approximately April and August 2013 the calculated daily rate of supply from [the pharmacy] was approximately 15 tablets of alprazolam and 17 tablets of diazepam per day.”
The DHHS investigation concluded that had the pharmacist contacted Ms AD’s purported prescriber, or reported the excessive prescribing to the Department as he admitted he should have done, the fraudulent nature of the scripts would have been discovered, and/or the extent of the unlawful supply would have been of a magnitude that might have been explained as an honest and reasonable mistake.
In December 2015, the pharmacist was convicted of a number of charges relating to these scripts, including failure to notify DHHS that the diazepam and alprazolam had been obtained from him by means of a false pretence; failing to notify DHHS when he was asked to dispense alprazolam to a person in greater frequency than was reasonably necessary; and supply of alprazolam and diazepam other than on the original prescription of a registered medical practitioner.
He was convicted and ordered to pay a $20,000 fine and $15,000 in costs.
The same month, his legal representatives told AHPRA that the pharmacist had pleaded guilty to the charges.
The Pharmacy Board, feeling that the pharmacist had behaved in a way which constituted professional misconduct as defined in the National Law, referred the case to the Tribunal.
The Tribunal heard that the pharmacist had made changes to his practice since the events of 2012 and 2013, including by record keeping, utilising dispensing software and recording of communication with patients and prescribers.
He also now reminds pharmacists who work with him to ensure they communicate with prescribers where appropriate, and to bear in mind their obligations regarding notifications to the Department.
The pharmacist admitted his conduct constituted professional misconduct, but the Tribunal declared it was not satisfied that he was not a fit and proper person to hold registration as a pharmacist.
“Prescription pharmaceutical products and in particular dangerous ones are the subject of close regulation for a purpose,” it noted.
“Unregulated or inappropriate supply has the potential to compromise safety of members of the public. The system of supply relies to no small extent on those who are given the authority to release pharmaceutical products into the community.
“Quite apart from the duties of the prescribers, it is the pharmacist who must ensure that the supply is appropriate.”
The Tribunal decided to reprimand the pharmacist and suspend his registration for six months from March 2019.
It also imposed conditions, including that he complete the PSA’s ethics and dispensing course, and after the period of suspension, that he be mentored by a registered pharmacist for no less than four hours a week, for six months.
After the suspension he is also barred from practising as a pharmacist without another pharmacist – not his wife, another pharmacist – on the same premises, for 12 months.