The Pharmaceutical Journal
Vol 269 No 7222 p658-660
2 November 2002

Striking-off follows dispensing errors A pharmacist whose dispensing errors included supplying dexamphetamine when dexamethasone was ordered and labelling oral tablets to be inserted into the rectum has been ordered to be removed from the register by the Statutory Committee [more]

Practising as a pharmacist while not on the register leads to striking off The name of a pharmacist who had continued to practise after being removed from the register for non-payment of fees, and who had not provided an address at which he could be contacted after his restoration, has been struck off [more]

Unauthorised Viagra supply results in reprimand A Suffolk pharmacist who supplied himself and others with Viagra tablets in the absence of any prescription has been reprimanded by the Statutory Committee [more]

Striking-off for pharmacist who was jailed A pharmacist who had been sent to prison after repeatedly breaking the terms of a community service order has had his name removed from the register [more]

Superintendent pharmacist failed to fulfil responsibilities A London pharmacist has been reprimanded for failing to carry out his duties properly as a superintendent, including ensuring that a pharmacist was present when a pharmacy was open [more]

Striking-off follows dispensing errors

A pharmacist whose dispensing errors included supplying dexamphetamine when dexamethasone was ordered and labelling oral tablets to be inserted into the rectum has been ordered to be removed from the register by the Statutory Committee.

At its hearing on 16 January, the committee inquired into the case of Errol G. D. Ganpatsingh, of 23 Harrington Road, Brighton, East Sussex. Mr Ganpatsingh is the proprietor of two pharmacies in Brighton, at 209 Preston Road and 88–90 Beaconsfield Road. Information had been received from the Council of the Royal Pharmaceutical Society alleging that Mr Ganpatsingh had made a number of dispensing errors while pharmacist in charge at the premises at 88–90 Beaconsfield Road.

The alleged errors included the supply on 23 January 2001 of 28 dothiepin capsules 25mg and 28 dothiepin 75mg tablets when 100 dothiepin 25mg capsules had been prescribed, and failing to counsel the patient about the change of dose this necessitated. He had endorsed the prescription "OP Prothiaden", although generic dothiepin had been supplied.

It was also alleged that on 29 January 2001 Mr Ganpatsingh had dispensed dexamphetamine tablets on a prescription ordering dexamethasone and, when the error had come to light, had retrieved the wrongly dispensed dexamphetamine tablets and had returned them into stock.

Further, Mr Ganpatsingh was stated to have supplied, on 5 March 2001, Colofac tablets that were incorrectly labelled.

Following those errors, it was alleged that Mr Ganpatsingh had failed to review procedures for dispensing and checking medicines at his pharmacy as he had been advised to do by the Society's inspectors.

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

Oliver Britton, of Turner & Debenhams (solicitors) represented Mr Ganpatsingh, who was present at the hearing.

The committee heard that one of the Society's inspectors had visited Mr Ganpatsingh on 23 October 2000 in connection with two dispensing errors that had taken place in August of that year. The first involved the supply of candesartan 8mg tablets when the prescription had called for ondansetron 8mg; the second error was that diazepam 2mg had been supplied and labelled digoxin 62.5mcg, when the latter had been prescribed.

Following the visit, a letter had been sent to Mr Ganpatsingh on 19 January 2001, reinforcing verbal advice given on the October visit that he should review his dispensing and checking procedures, and pointing out that staffing levels in the pharmacy did not seem sufficient for the volume of work being done. The letter required that he should reply within 21 days, confirming that he had followed the advice given. When no reply was received, a further letter was sent. Mr Ganpatsingh claimed he had received neither letter.

Meanwhile, the Society received further complaints about dispensing errors. On 23 January 2001, on a prescription for 100 dothiepin 25mg capsules, 28 dothiepin 75mg tablets in one container and 28 capsules of 25mg in another container were supplied. Instead of the prescriber's directions that two capsules should be taken at night for five days, then three capsules at night, he had labelled both containers "take one at night". The patient's prescription records stated that 120 capsules of 25mg had been supplied. The patient had taken one of each strength for four nights and experienced extreme drowsiness. She consulted her doctor and the complaint resulted.

The complaint about the dexamphetamine tablets arose after a patient who happened to be a nurse visited the pharmacy to collect the balance owing on a prescription for dexamethasone. She saw the container being taken from the dispensary shelves, not from the Controlled Drugs cabinet. After returning home, she found that she had been given dexamphetamine tablets. She had telephoned Mr Ganpatsingh, who went to her house and exchanged the dexamphetamine for the correct tablets. During the course of an interview with the Society's inspector, Mr Ganpatsingh had admitted that he had returned the dexamphetamine tablets to the Controlled Drugs cupboard for redispensing.

The incident relating to the Colofac tablets took place on 5 March 2001. The medication was properly dispensed but instead of being labelled "one to be taken three time a day before food", as prescribed, the container was labelled "Place one high in the rectum (remove wrapper) before food". The patient telephoned the pharmacy to query this; Mr Ganpatsingh apologised and delivered a new label.

Serious consequences

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC), said that little was disputed about the matters complained of. Dealing first with the supply of dothiepin, he said that there had been serious consequences for the patient. Having had no opportunity to understand what she should have been taking, she took something like twice the amount her doctor had advised. This had caused her to become exceptionally drowsy and had also meant that the course of medication prescribed could not be followed in the appropriate manner. Coupled with that was Mr Ganpatsingh's failure to counsel the patient about the changes to the dosage necessitated by his having dispensed 75mg tablets and the endorsing of the prescription "OP Prothiaden" despite the fact that he had dispensed at least some of the generic equivalent.

The supply of dexamphetamine against a prescription calling for dexamethasone was also a serious matter. They were very different medications. It was particularly careless to give a patient a Controlled Drug against a prescription that did not call for it. Furthermore, he should not have returned to stock the dexamphetamine tablets that had been wrongly dispensed.

The committee felt the incorrect labelling of the Colofac tablets was extraordinary. While no harm had been caused to the patient, because he had noticed that the instructions on the label were incorrect, it was a serious dispensing error.

Turning to Mr Ganpatsingh's failure to review his dispensing procedures in accordance with the advice given by the Society, The chairman said that this did not loom as large in the committee's consideration as might have been thought. That was because in any pharmacy not only should there be procedures for dispensing and checking but they should be rigorously observed. That was an integral part of the profession of being a pharmacist. Any experienced pharmacist, such as Mr Ganpatsingh, should have been aware of that, whether or not he had received advice or letters from the Pharmaceutical Society.

Mr Ganpatsingh should have laid down proper procedures for dispensing and checking and, as the pharmacist owner, should have been the first person to ensure that those procedures were wholly carried through. However, it appeared that he had not even followed the procedures he did have in place.

Mr Ganpatsingh had been personally responsible for the serious errors that had been established; they amounted to misconduct such as to make him unfit to be on the register.

The committee was informed that Mr Ganpatsingh had been reprimanded in 1994 (over a different matter). It had been directed on that occasion that that decision should be brought before the committee if he were to appear before them again.

Mr Ganpatsingh's name was ordered to be struck from the register. He had three months in which to appeal against the decision

The chairman added that members of the committee, who had been told that Mr Ganpatsingh was awaiting an operation for cataracts, had expressed their concern about his eyesight. If Mr Ganpatsingh wished at some time in the future to apply for restoration the committee would, among other things, have to be satisfied that his eyesight had improved sufficiently to allow him to resume his profession.

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Practising as a pharmacist while not on the register leads to striking off

The name of a pharmacist who had continued to practise after being removed from the register for non-payment of fees, and who had not provided an address at which he could be contacted after his restoration, has been struck off.

At its meeting on 14 January, the committee inquired into the case of Philip F. Sloane, whose registered address is 1 Catton Grove, Norwich. A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that after his removal from the register for non-payment of fees on 2 June 1999, Mr Sloane had worked as a pharmacist for 74 days between that date and 29 October 1999. Mr Sloane had also failed to make adequate arrangements to ensure that correspondence sent to his registered address by the Society was properly dealt with.

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

Mr Sloane was not present and was not represented.

The committee heard that on 8 January 2000, after his removal from the register, Mr Sloane had contacted the Society. He was advised that before his name could be restored he had to provide an address at which he could be contacted. On 1 March 2000, Mr Sloane had sent in the necessary fees, listing his address as 1 Catton Grove, Norwich, and his name had been restored to the register. The address was that of a guest house. Subsequently, the fact came to light that Mr Sloane had worked as a pharmacist while not on the register. Attempts to communicate with him, including recorded delivery letters sent to that address on matters relating to his alleged misconduct in practising after the removal of his name, and advising him of the forthcoming hearing by the committee, had failed.

The chairman (Lord Fraser of Carmyllie, QC), giving the committee's decision, said that Mr Sloane had not appeared at the hearing and there had been no indication that he would want to seek an adjournment. All steps required to give notice of the proceedings had been properly taken and it would not be in the public interest to allow the case to drag on.

It had been established that Mr Sloane had worked for 74 days after his removal from the register. That amounted to misconduct such as to render him unfit to have his name on the register. His failure to make arrangements to ensure that correspondence sent to him by the Society would be received was also misconduct that would make him unfit to be on the register.

It was essential, said the chairman, that the Royal Pharmaceutical Society should have an address at which it can communicate with the pharmacist in question.

The committee ordered that Mr Sloane's name should be struck off. Notice of his removal from the register was published in The Pharmaceutical Journal of 26 January (p120).

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Unauthorised Viagra supply results in reprimand

A Suffolk pharmacist who supplied himself and others with Viagra tablets in the absence of any prescription has been reprimanded by the Statutory Committee.

At its meeting on 14 January, the committee inquired into the case of Michael O. G. Allen, of Grange Farmhouse, Hasketon, Woodbridge, Suffolk, and Tranby Investments Ltd. Mr Allen is superintendent and a director of the company, which owns two pharmacies: one at the White Hart, High Street, Wickham Market, the other at 32 Market Hill, Framlingham, Suffolk. A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that Mr Allen had supplied Viagra (sildenafil) tablets other than on the authority of a prescription and had failed to ensure that accurate records of Viagra were kept between January and October 2000.

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

Kevin McCartney, of counsel, instructed by Charles Russell (solicitors) represented the company and Mr Allen, who was present at the hearing.

The committee heard that one of the Society's inspectors had received information that Mr Allen was supplying Viagra to friends at a golf course. In consequence, he obtained from the company's main wholesaler details of Viagra supplied to the two pharmacies and from the Prescription Pricing Authority details of the quantity dispensed on NHS prescriptions. A comparison indicated that between 1 January 2000 and 3 October 2000, a total of 384 Viagra 50mg tablets had been supplied and 156 dispensed. The company's pharmacies were accordingly visited to investigate the matter.

Examination of the dispensary stock at the Wickham Market pharmacy on 3 October revealed no stock of Viagra. At the Market Hill premises, four Viagra 100mg tablets and two 25mg tablets were found, with three private prescriptions. Mr Allen was not present at the time of those visits but when the inspector telephoned him the following day he said there were some tablets in a cupboard under the sink at the Wickham Market pharmacy. Three packs of eight Viagra 50mg were found there, concealed behind the waste pipe. Altogether, there was a discrepancy of 204 tablets between the numbers supplied to and dispensed by the two pharmacies. In an interview, Mr Allen said he had supplied tablets to four or five individuals and had taken some himself. He said he had not taken any money for the tablets he had supplied but had been concerned to help friends who were having difficulties. He admitted that he had been wrong to do so and regretted his action.

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC), said that Mr Allen had failed in his duty to have adequate systems in place to ensure that accurate records of Viagra were kept for the period in question. Mr Allen had also admitted not only that he had used Viagra personally, knowing that it was a prescription-only medicine, but that he had also supplied Viagra to a number of other individuals who were his friends in the absence of any prescription.

Of the shortfall of 204 tablets, his estimate was that he had retained somewhere in the region of 150 for his own use and the remainder had been supplied to his friends. He had been open in indicating that he recognised that what he had done was wrong and that supplying Viagra without a prescription was something that a pharmacist should not have allowed himself to be led into. Making those unauthorised supplies to himself and others amounted to illegal and unprofessional conduct and was such as to render him unfit to be on the register.

However, the committee had decided to draw back from removing his name. Mr Allen had been open and frank in his admissions and in his evidence. He had been a pharmacist for 36 years and had an unblemished record. He would be 64 on his next birthday and if his name were to be removed it would be in effect an end to his career as it would be unlikely that any application for restoration would be considered in less than two years. The committee would regard that as an unnecessarily stern attack on him for this particular professional misconduct; it was accepted there had been no financial gain on his part.

Mr Allen was ordered to be reprimanded; no further action was ordered against the company.

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Striking-off for pharmacist who was jailed

A pharmacist who had been sent to prison after repeatedly breaking the terms of a community service order has had his name removed from the register.

At its meeting on 14 January, the committee inquired into the case of Howard L. Rodkoff, of 26 Turpin Avenue, Romford, Essex. Information had been received that Mr Rodkoff had been sentenced to 12 months' imprisonment at Snaresbrook crown court on 31 January 2001 for having breached the requirements of a community service order. He had also completed a declaration on the retention fee form for 2001 declaring that he was unfit to practise through ill health. In fact, he had been employed as a pharmacist on 15 days between 1 October and 12 December 2001.

Geoff Hudson, of Penningtons (solicitors) was present to place the facts of the case before the committee.

Mr Rodkoff attended the hearing without legal representation.

The committee heard that in 1997, Mr Rodkoff had become bankrupt. Subsequently, he had been found guilty of failing to disclose to the official receiver details of a lump sum and an annuity received from a pension fund. For that offence, he had received an order for 200 hours community service from Snaresbrook crown court on 8 October 1999. He had completed 70.5 hours of that service at a hospice when he had been told not to return there. At Redbridge magistrates' court on 9 June 2000 he was fined £500 and ordered to complete the remainder of the community service. However, he had failed to do so and had received the prison sentence instead, imposed by the court on 31 January 2001. Mr Rodkoff had contended that he had not received letters sent by the probation service informing him of alternative placements for completion of his community service.

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC) said that the case against Mr Rodkoff fell into two parts: one relating to the three convictions following his bankruptcy and one relating to his practising as a pharmacist when he had previously indicated that he was unfit through ill health. In making the declaration that he was unable to practise through ill health, which allowed him to pay the reduced fee of £19 for the year 2001, he had confirmed that he would "not during the year 2001 be gainfully employed in any occupation". If he was, he undertook to remit "without demand the balance of the fee as required ...". In the lead-up to the present inquiry, however, it was discovered that he had worked for some 15 days as a pharmacist. Subsequently, he had paid the balance due.

That misconduct, the chairman continued, was less important than the convictions and the 12-month prison sentence. He noted that the judge sentencing Mr Rodkoff had said he was "astonished, given the persistent deception this man has practised, that he should be allowed to continue to practise". The committee had given due weight to those remarks. However, it was their own, separate, opinion that Mr Rodkoff should be removed from the register.

The committee therefore ordered that Mr Rodkoff's name should be struck from the register. He had three months in which to appeal.

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Superintendent pharmacist failed to fulfil responsibilities

A London pharmacist has been reprimanded for failing to carry out his duties properly as a superintendent, including ensuring that a pharmacist was present when a pharmacy was open.

At its meeting on 15 January, the Statutory Committee inquired into the case of Rohitkumar D. Kotecha, of "Weathertrees", South Hill Avenue, Harrow, Middlesex, and Niemans Chemists Ltd. Mr Kotecha is superintendent pharmacist and a director of the company, which owns five retail pharmacies. A complaint had been received from the Royal Pharmaceutical Society alleging that Mr Kotecha may have been guilty of professional misconduct. It was alleged that, as superintendent pharmacist, he had failed to ensure that, at the company's pharmacy at 8 Farringdon Road, London EC1, all sales of pharmacy medicines were made by or under the supervision of a pharmacist on 28 December 2000, and he had also failed to ensure that a pharmacist was in personal control of the pharmacy on 27 and/or 28 December 2000. It was further alleged that he had failed to fulfil his duties and responsibilities in relation to monitoring procedures and practices in the pharmacy.

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

Mr Kotecha was present at the inquiry, and he and the company were represented by Oliver Britton, of Turner & Debenhams (solicitors).

The committee heard that one of the Society's inspectors had visited the Farringdon Road pharmacy on 28 December 2000 at 10.17am. The pharmacy was open for business and two assistants were in the shop. The inspector asked for, and was sold without question, a pack of 12 Solpadeine tablets. When the inspector asked if there was a pharmacist present, the assistant replied that there was not, adding that the pharmacy was open only for a few hours that day.

The inspector made herself known and asked the assistant to contact the superintendent pharmacist, Mr Kotecha. In a telephone conversation, she asked why the premises were open in the absence of a pharmacist. Mr Kotecha indicated that the premises were open only for the sale of such things as perfumes and photographic goods, and so that films for processing could be collected and delivered and the premises cleaned.

Interviewed by the inspector, Mr Kotecha admitted that he had instructed the staff to open on 28 December, and had allowed it to open on 27 December, knowing that there would be no pharmacist in personal control. He acknowledged that he should have instructed the staff to lock the door to exclude the public. He also admitted not having given specific instructions that pharmacy medicines should not be sold. He accepted that that there should have been a medicines sale protocol at the pharmacy but that he had not checked it. He also confirmed that he did not visit the pharmacy for the purposes of reviewing procedures and practices.

Giving the committee's decision, the chairman (Lord Fraser of Carmyllie, QC) said that none of the facts of the case had been challenged. The Society properly contended that Solpadeine should not have been sold in the absence of a pharmacist and that there had been a failure on Mr Kotecha's part as superintendent pharmacist to ensure that a pharmacist was in control that day.

What did not appear appropriate to allege against Mr Kotecha, however, was that there was a stand-alone failure on his part as superintendent pharmacist to have a pharmacist in personal control on 27 December. Accordingly, said the chairman, the committee was not prepared to make a finding in respect of that part of the complaint.

However, there was a further complaint that Mr Kotecha had failed in his duties and responsibilities as a superintendent pharmacist in relation to monitoring practices and procedures in the pharmacy. When the inspector had asked if there was a written medicine sales protocol in the branch, he had admitted that there should have been one there, but he had not gone to the branch and looked for it. From that admission, it seemed that Mr Kotecha had recognised that he had an array of responsibilities as superintendent pharmacist that he had not discharged. Since then, however, there had been a marked improvement in the way he had set about his responsibilities in superintending all five of his pharmacies, and he was in the process of preparing a pharmacy manual.

Mr Kotecha was ordered to be reprimanded. No further action was taken against the company.

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