Traumatised pharmacist misappropriated morphine, codeine

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A pharmacist has been ordered not to work more than 40 hours a week, after she took medicines from a hospital in 2014

For 10 weeks in 2014, the pharmacist worked as a locum at a hospital in rural NSW.

She was stood down in October 2014 following an allegation that she had misappropriated drugs; she resigned later that month and moved interstate to live with her parents.

In July 2018, after a hearing conducted into a complaint which had been referred to the NSW Civil and Administrative Tribunal by the Health Care Complaints Commission about the pharmacist’s conduct, she was found guilty of “unsatisfactory professional conduct” and “professional misconduct”.

Only some of the conduct the Commission had alleged was found proven – including that the locum misappropriated two bottles of morphine and 40 tablets of Codapane Forte from the hospital. The Codapane Forte was taken for her own use.

The allegation that she made a false entry in the hospital’s records to conceal the misappropriation of Codapane Forte was also proven, as was the allegation that she made a false statement to the Pharmacy Council of NSW about the reason the hospital was unable to account for the missing 40 Codapane Forte tablets.

The latest hearing before the Tribunal was to determine whether disciplinary orders should be made – and if so, in what form.

While the Commission’s original complaint lodged with NCAT had alleged that the pharmacist was not a “suitable person” to hold registration, that allegation was withdrawn in October 2018.

At the latest hearing, the Commission urged the Tribunal to cancel the pharmacist’s registration and order that she be barred from applying for a review of that order for a period of 12 months.

The pharmacist said a reprimand and the imposition of conditions on her registration would be more appropriate.

Since the conduct in question, she had worked as a locum pharmacist interstate, and then as a locum and later full-time pharmacy technician in the UK.

On her return to Australian in 2016, she commenced work with an agency which provides care and support to elderly people in their home; by November of that year, she had started a job as pharmacist-in-charge at a community pharmacist in Western Australia.

Since then she has routinely worked up to 60 or 70 hours a week as a locum in that state, including in several rural and remote pharmacies, and as a solo pharmacist in one town.

A psychiatrist assessed her in 2016 not long after her return to Australia, diagnosed her with mixed anxiety/depressive disorder and said she was not psychologically suited to undertake the duties, tasks and responsibilities of a pharmacist.

However, he also noted her “firm resolve and commitment to optimise her psychological health and functioning” and said her prognosis was favourable.

In January 2019, he assessed her again and said her condition was in remission and that there was no evidence that in the foreseeable future she would be “likely to reoffend with regard to professional misconduct”, or that she should restrict her tasks or duties, reduce her hours of work or work under supervision.

In May 2017 she was assessed by another psychiatrist who noted that she had first experienced some mental health problems in 2013, and that being the victim of bullying had caused some depression and anxiety, while an assault in 2013 had caused significant trauma.

This psychiatrist said the pharmacist continued to experience chronic anxiety as a result of the Commission’s investigation of its complaint.

A third psychiatrist found that in 2014, the pharmacist had suffered from a single episode of a mental health disorder in 2014, which responded well to treatment and was now in remission.

The pharmacist was compliant with all treatment recommendations and the third psychiatrist noted that she had “excellent” insight into her disorder, the Tribunal noted.

Her GP noted that she had ceased taking treatment for her mental health and was no longer using alcohol, which she had been consuming heavily around the time of the 2014 conduct; since he began treating her in 2017 she has experienced several issues in life which could have “pulled her off course,” he said, but this has not occurred.

Colleagues including in the UK, where the pharmacist had ready access to “Class A” drugs in a hospital dispensary, gave positive references and said that there had been no stock discrepancies.

The Tribunal decided that the conduct in 2014 was not part of a pattern, and thus did not suggest a fundamental character flaw or behavioural problem.

Instead, it coincided with the anniversary of the 2013 serious assault, it noted, at which time she was socially isolated, drinking heavily and being treated for depression and anxiety, though the evidence fell short of establishing that this condition caused the conduct or that she had an addiction.

The pharmacist now has a strong support network, including colleagues, and the Tribunal felt it was unlikely she would reoffend.

The Tribunal ordered that the pharmacist pay 70% of the Health Care Complaints Commission’s costs.

It decided not to cancel her registration, but to impose conditions, including a condition – which she opposed, saying it would make her virtually unemployable in WA – that she not act as a pharmacist-in-charge.

She was ordered not to work more than 40 hours a week, to undertake a course on ethics and dispensing, submit to an audit of her practice, and be mentored by another pharmacist.

Within 14 days of the decision, the Commission must file and serve any submissions on the form of the proposed conditions, and the pharmacist will have 14 days from receipt of these to file and serve her own submissions.

In these submissions, each party was invited to comment on whether the formulation of conditions can adequately be dealt by way of written submissions without holding a hearing.

Readers who are distressed can contact the Pharmacists’ Support Service on 1300 244 910.

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