The Society

Statutory Committee

Striking-off for unlawful supply and falsely claiming urgent dispensing fees The name of a Newport, Gwent, pharmacist who had supplied amoxicillin from premises other than a pharmacy, had endorsed emergency prescriptions with false times of dispensing and had claimed fees to which she was not entitled has been removed from the register on the order of the Statutory Committee [more]

Pharmacist's "cavalier disregard" for prescription endorsement requirements The Statutory Committee found that a Newcastle upon Tyne pharmacist had shown a "cavalier disregard" of what was required of a pharmacist in endorsing prescriptions for medicines he had not supplied [more]

Reprimand for dispensing before obtaining prescription A pharmacist who had dispensed Soneryl and temazepam tablets to a patient without the authority of a prescription, and who had failed to make entries in a Controlled Drugs register, has been reprimanded by the Statutory Committee [more]

Striking-off for unlawful supply and falsely claiming urgent dispensing fees

The name of a Newport, Gwent, pharmacist who had supplied amoxicillin from premises other than a pharmacy, had endorsed emergency prescriptions with false times of dispensing and had claimed fees to which she was not entitled has been removed from the register on the order of the Statutory Committee.

At its meeting on 23 April, the committee inquired into the case of Farhat Shoukat, of 2 Priory Drive, Newport, Gwent. Ms Shoukat was proprietor of a pharmacy trading as Health+Pharmacy at 2 St Lukes Road, Pontnewynydd, Pontypool. On 13 July 2000, she had pleaded guilty at Pentonville magistrates' court, Newport, to supplying amoxicillin unlawfully at 146 Malpas Road, Newport, other than on registered pharmacy premises. She had been fined £200 and ordered to pay £500 costs.

Further, complaints had been received from the Council of the Royal Pharmaceutical Society alleging that on several occasions medicines had been supplied outside the pharmacy's opening hours and that false claims had been made for dispensing "urgent" prescriptions. This had been done by endorsing the prescription with a time of dispensing later than was the case, or by claiming it had been dispensed after 11pm from the pharmacy.

Geoff Hudson, of Penningtons (solicitors), appeared in order to present the facts of the case to the committee.

Neither Ms Shoukat nor her legal advisers, Crosse & Crosse (solicitors), were present at the inquiry. The committee was informed that the allegations made against her were accepted in their entirety. A letter from Ms Shoukat's lawyers stated that she was unable to attend for medical reasons and was prepared for the case to be heard in her absence. It was decided to proceed with the hearing, which had previously been adjourned.

Regarding the amoxicillin prosecution, the committee heard that one of the Society's inspectors and an investigator from the local health authority were looking into reports that patients could have their prescriptions dispensed out of hours at a residential address and that such medicines were handed out there by Ms Shoukat's husband, Zia Hassan, in the absence of a pharmacist.

24-hour service

The investigator had telephoned her pharmacy's "24 hour prescription service" when the pharmacy was closed and inquired about having a prescription dispensed. Part of the prescription, including the fact that the medicine should be sugar-free, was read over to the person who answered the telephone. The investigator was asked to wait while the person checked that the medicine was in stock and was then told to go to 146 Malpas Road, which was later established as the couple's home. The door was opened by Mr Hassan who was asked, "Are you the pharmacist". He replied "Yes, I am". After discussion about payment, Mr Hassan returned indoors and was seen by the Society's inspector measuring liquid into a bottle. He gave the bottle, which was found to contain amoxicillin mixture 250mg in 5ml, to the investigator; the label did not indicate that it was a sugar-free preparation. When challenged by the inspector, Mr Hassan admitted that he was not a pharmacist, but that his wife was one.

Evidence was produced establishing that in two other instances emergency prescriptions had been supplied in the evening, after telephoning the pharmacy's emergency number. In one case the supply had been made from the house, and in the other from a garage opposite the pharmacy, where it was handed to the patient by a man who arrived in a car. The forms had been endorsed with the Health+Pharmacy stamp, as if dispensed by the pharmacy.

A further seven false claims were admitted. The sum involved in those cases was about £200 but more false claims had been admitted and in all about £2,000 was said to be involved. Ms Shoukat had said she was willing to pay back any monies that had been misappropriated.

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC) said the facts of the case had been established and amounted to such misconduct as to render Ms Soukat unfit to be on the register of pharmacist. The committee had taken into account that she had had to deal with personal difficulties; but where false claims for payment were made, the trust between the profession and the pricing bureau was destroyed, with very serious consequences for the profession as a whole.

Ms Shoukat's name was ordered to be removed from the register.

She had three months in which to appeal against the decision.

Pharmacist's "cavalier disregard" for prescription endorsement requirements

The Statutory Committee found that a Newcastle upon Tyne pharmacist had shown a "cavalier disregard" of what was required of a pharmacist in endorsing prescriptions for medicines he had not supplied. But, after criticising the excessive delay before the case came before it, the committee decided to take no further action.

At its hearing on 24 April, the committee inquired into the case of Mukesh Ashok Paripatyadar, of Clyde Chemist, 136 Armstrong Road, Newcastle upon Tyne. A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that on a number of occasions in 1996 and 1997 Mr Paripatyadar had dispensed prescriptions for fluconazole 50mg capsules and had claimed for supplying 42 capsules on each when 21 had been supplied and that, on a number of other occasions, Mr Paripatyadar had claimed for medicines ordered on prescription but not supplied, or for quantities greater than had been dispensed.

Geoff Hudson, of Penningtons (solicitors), appeared in order to present the facts of the case to the committee.

Mr Paripatyadar was present at the inquiry. He was represented by David Reissner, of Charles Russell (solicitors).

The committee heard that over a period between September 1996 and March 1997, a patient had been prescribed capsules of fluconazole 50mg, three to be taken daily. The prescriptions, issued weekly and intended to be for a week's supply, had each been for 42 capsules, sufficient for two weeks, rather than the 21 necessary. Mr Paripatyadar had endorsed each prescription as if 42 had been supplied but in fact the equivalent of 21 had been given out.

Investigation

The prescribing doctor had discovered the error when checking the cost of drugs prescribed by his practice and had drawn the matter to Mr Paripatyadar's attention. A number of other instances of overclaiming came to light in the ensuing investigation by the Prescription Pricing Authority. They included a claim for 60 sachets of Fybogel that had not supplied, four occasions on which 28 folic acid tablets 5mg had been supplied when 100 had been ordered and claimed for, betahistine and prochlorperazine tablets prescribed and claimed for but not supplied, and a glyceryl trinitrate spray ordered but not supplied although endorsed to the effect that it had been. An overpayment of about £1,500 had resulted.

In a statement, Mr Paripatyadar had said that he did not have time to endorse prescriptions at the pharmacy, so he took home each evening forms covering 250 to 300 items and endorsed them in front of the television. He much regretted the errors, which, he said, had been due to laxness on his part.

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC) said that, although it had been submitted that the committee could not properly find either dishonesty or fraud, Mr Paripatyadar's conduct fell well below that to be expected of any pharmacist in endorsing prescriptions. It represented a cavalier disregard of what was required of a pharmacist. Such conduct had the potential for immeasurable damage to the National Health Service.

It was disappointing that Mr Paripatyadar had not discovered any error for himself but had had it brought to his attention by the general practitioner who had prescribed the fluconazole capsules. Although that doctor had some responsibility for the original error, it was not the doctor's error that the medicine that was not supplied had been claimed for. It was obvious that the prescriptions were for a seven-day period, not 14 days.

While the other incidents of overclaiming were less significant, they demonstrated a continuing and unacceptable pattern of claiming for medicines that were not supplied to patients.

If the matter had ended there, said the chairman, the committee would have decided that Mr Paripatyadar had been guilty of misconduct such as to render him unfit to be on the register and directed his removal.

Unfortunately, however, the history in the case went back as far as 1996. The matter had been brought to the attention of the authorities in June 1997 but had come before the committee only in April 2001. It was not clear that any one body had to take the blame for what had been described as "oppressive delay".

The committee was concerned that no efforts appeared to have been made to carry out the necessary investigation in parallel, said the chairman. Instead, what had occurred was, unhappily, that in a sequential fashion different authorities, including the police, made their enquiries before the matter was brought before the disciplinary committee of County Durham Health Authority in April 2000, when the first indication of such a reference had been in July 1998.

The committee felt there were no reasons why comparable investigations should not proceed in parallel so that such extraordinary delays would not occur. It was hoped that would be the case in future.

The committee expressed its grave disquiet over Mr Paripatyadar's actions but decided it could take no further action.

Reprimand for dispensing before obtaining prescription

A pharmacist who had dispensed Soneryl and temazepam tablets to a patient without the authority of a prescription, and who had failed to make entries in a Controlled Drugs register, has been reprimanded by the Statutory Committee.

At its meeting on 24 April, the committee inquired into the case of Sirtaj Allana, of 215 Albury Drive, Pinner, Middlesex. Information had been received that, at Harrow magistrates' court on 24 May 2000, Mr Allana, the proprietor of a pharmacy, Angie's Chemist, 3 High Street, Pinner, had pleaded guilty to and been convicted of dispensing methadone on a number of occasions between 14 and 20 April 2000, without making an entry in a Controlled Drugs register on the day of the transaction or the following day, contrary to section 18(1) of the Misuse of Drugs Act 1971. He had been fined £1,000 and ordered to pay £55 costs.

It was further alleged that Mr Allana had, on 31 March 2000, supplied without prescription 56 Soneryl 100mg tablets and 28 temazepam 10mg tablets, contrary to the Misuse of Drugs Act 1971.

Geoff Hudson, of Penningtons (solicitors), appeared in order to present the facts of the case to the committee.

David Aaronberg, of counsel, instructed by Charles Russell (solicitors), represented Mr Allana, who was present at the inquiry.

The committee heard that the offences in relation to the Soneryl and temazepam arose after an elderly patient who had been having those medicines on a repeat prescription for several years decided to change her doctor. She had said she was running out of the tablets and Mr Allana had called at the surgery to collect the prescription, as was his custom. Having been told that the prescription was not ready, he nevertheless dispensed the tablets and sent a note to the new doctor advising what he had done and requesting a repeat prescription. He had wrongly assumed that the original prescriber would have liaised with the new one, whose practice was in the same premises.

Missing methadone entries

The new doctor wrote to Mr Allana expressing concern at what had been done and said he might take the matter further. As a result, a police officer visited Mr Allana's pharmacy to question him. In the course of his investigations, the missing entries for the methadone, which had been dispensed as part of a regular supply to an addict, were discovered and the prosecution resulted.

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC) said that Mr Allana's explanation for the failure to make entries in the register was that he was concerned about the supply without prescription. Hitherto, he had said, he had kept the register up to date and would have made the entries on the day in question or, at the latest the next day. The committee found that slightly curious, but took the statement at its face value. Certainly, it was admitted that on the days in question he had failed to make up the register as required by law.

The conviction and the dispensing without a prescription amounted to misconduct that would render Mr Allana unfit to be on the register of pharmacists. However, Mr Allana had done what he did for the patient, although erroneously, probably from the best of motives, and an exceptional set of references had been produced on his behalf.

The committee directed that Mr Allana should be reprimanded.