Statutory Committee

Failure to improve procedures leads to reprimand more

Pharmacist became addicted to dihydrocodeine tablets more

Man restored to register after striking-off for theft from his employer more

Reprimand for “erroneous” script endorsements more

Failure to improve procedures leads to reprimand

A pharmacist in Wales who failed to improve procedures for stock control of medicines and for recording prescriptions, after repeated advice to do so, has been reprimanded by the Statutory Committee.

At its meeting on 14 August 2003 the committee resumed its inquiry into the case of Peter Samuel Rees, of Tongwynlais Pharmacy, 17 Merthyr Road, Tongwynlais, Cardiff. The inquiry had been adjourned from 19 September 2002, when the committee had considered a complaint from the Council of the Royal Pharmaceutical Society making a number of allegations against Mr Rees. These included: failure to ensure that a pharmacist was present at the pharmacy from the opening time of 9am on 6 December 1999, 10 July 2001 and 29 October 2001; failure to ensure compliance with the requirements for recording supplies of Controlled Drugs, private prescriptions and emergency supplies; and the presence on the dispensary shelves of date expired stock and/or medicines without batch numbers and/or expiry dates, a container of phenytoin tablets from which the batch number and expiry date had been removed and a container of capsicum tincture bearing a false expiry date.

It was also alleged that Mr Rees had exhibited an inappropriate attitude towards the Society during a visit by an inspector on 29 October 2001.

Geoff Hudson, of Penningtons (solicitors), presented the facts of the case to the committee.

Mr Rees attended both hearings and was represented by Oliver Britton, of Turner & Debenhams (solicitors).

The committee heard that matters of concern to the Society had first been identified in September 1999. Following another visit by an inspector, in September 2000, an inspection advice note was issued, a copy of which was left at the pharmacy. Following the inspector’s next visit, in July 2001, a letter was sent from the Society’s Professional Standards Directorate drawing attention to the shortcomings found in procedures. However, when the inspector revisited the pharmacy on 29 October 2001 the hoped for improvements had not been put in place. Among other matters, loose blister strips of tablets and date-expired stock were found in the dispensary.

At the resumed inquiry, it was reported that three visits had been made to Mr Rees’s pharmacy since the date of adjournment; improvements had been noted and a satisfactory state of affairs established. References on Mr Rees’s behalf were presented.

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie, QC) said on the inspector’s visits, most recently on 8 August 2003, the Society had been satisfied with the way Mr Rees was running his pharmacy. The references indicated that Mr Rees was well regarded in his local community and that he had undertaken valuable responsibilities for the Society in its Mid Glamorgan East branch. That had been recognised by the committee.

It was important for the Statutory Committee, continued the chairman, that Mr Rees recognised the role of the Society in maintaining the highest of professional standards for pharmacists throughout Britain.

Mr Rees was reprimanded.

Pharmacist became addicted to dihydrocodeine tablets

An inquiry into the case of a pharmacist who took dihydrocodeine tablets from the stock of his pharmacies for his own use has been adjourned by the Statutory Committee.

At its meeting on 13 August 2003 the committee inquired into the case of James Clark, of 73 Corporation Road, Darlington, County Durham. A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that Mr Clark had taken a quantity of dihydrocodeine 30mg tablets for his own use without the authority of a prescription or prescriptions.

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

Sara Morgan, of Brooke North (solicitors), represented Mr Clark, who was present.

The committee heard that Mr Clark, in partnership with his former wife, owned two pharmacies, Clarks Chemist at Geneva Road, Darlington, and J. & L. C. Clark at 10 Cheveley Park, Durham. Mr Clark was the principal pharmacist at both premises, working at each on various days of the week with locums at other times.

As well as running both businesses and dealing with family problems, in the autumn of 2001 Mr Clark began to experience health problems including severe leg pains. He had not consulted a doctor, but to relieve the pain he had begun taking dihydrocodeine tablets from the stock of the pharmacies. At first, he took two or three tablets four times a day; as their effect lessened he increased the dose until, by July 2002, it had reached 30 to 50 tablets a day.

Mr Clark realised he had become addicted to dihydrocodeine and decided to treat his addiction by taking an opiate blocker, naltrexone. The severe reaction that followed necessitated emergency treatment in hospital. This led to comprehensive therapy for both his addiction to dihydrocodeine and his health problems.

Through a stock check, it had been estimated that Mr Clark had taken some 8,560 dihydrocodeine 30mg tablets in all.

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie, QC) said it had been conceded on Mr Clark’s behalf that such an excessive consumption of dihydrocodeine without the authority of a prescription amounted to misconduct such as to render him unfit to be on the register.

He had, however, been frank and forthright with the committee, he had a set of supportive references and the medical reports on him were optimistic in their assessment. There had been no complaints from, or any indication of risk to, the public. In those circumstances, the committee did not consider the public interest required the removal of Mr Clark’s name from the register.

The committee would adjourn the case for 12 months, over which period Mr Clark would be requested to provide results of four urine tests to the Society. If nothing adverse was reported during that time Mr Clark could expect no more than a reprimand, the chairman said.

Man restored to register after striking-off for theft from his employer

The Statutory Committee has ordered the restoration to the register of a pharmacist who had been struck off for theft from his employer.

An application for restoration by Anthony Clive Jones, of 13 Wood Street, Burnopfield, Newcastle upon Tyne, was heard by the committee on 14 August 2003. Mr Jones’s name had been ordered to be removed in January 2001 after the committee heard that he had been put on probation and sentenced to 80 hours of community service for stealing cash from his then employer (PJ, 7 July 2001, p267).

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie, QC) said the committee was confident that Mr Jones now understood the responsibility a pharmacist owed not only to his employers but also to society as a whole. It was clear that he had more than learnt his lesson.

The committee directed that Mr Jones’s name should be restored to the register.

Reprimand for “erroneous” script endorsements

The Statutory Committee has reprimanded a pharmacist who endorsed prescriptions for growth hormone that had not been supplied, which resulted in an overpayment of £5,505.15.

When it met on 13 August 2003, the committee inquired into the case of Amarjit Singh Sidhu, pharmacist owner of Sidhu’s Dispensing Chemist, 369 High Street, West Bromwich, West Midlands. A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that Mr Sidhu had endorsed 20 prescriptions in such a way as to imply that the quantity called for on each prescription had been dispensed when this was not the case, and that he had submitted such erroneously endorsed prescriptions to the Prescription Pricing Authority, resulting in a claim for payment in respect of 21 cartridges of Genotropin that had not been supplied.

Geoff Hudson, of Penningtons (solicitors), presented the facts of the case.

John Holl-Allen, of counsel, instructed by Glaisyers (solicitors), appeared for Mr Sidhu, who attended the inquiry.

The committee heard that in July 2000 a teenage patient began treatment with the growth hormone Genotropin. The prescriptions, each for a 36-unit cartridge sufficient for seven days’ doses, were initially issued on a weekly basis and always taken to Mr Sidhu’s pharmacy for dispensing. After seven weeks, when the prescribing doctor was satisfied that the patient was self-injecting the medicine satisfactorily, he started to issue prescriptions on a repeat basis, each one ordering two cartridges.

The patient was not told of the change and continued to collect the prescriptions on a weekly basis. Mr Sidhu continued to supply one cartridge on each prescription, including one occasion when the doctor had ordered three cartridges. However, Mr Sidhu continued to endorse the prescriptions as if the full quantity had been supplied.

The prescribing doctor noticed something was amiss when he had a new computer system installed. He learnt that the patient had only been receiving one cartridge on each prescription and brought the matter to the attention of the authorities.

An investigation followed. Mr Sidhu was found to have been overpaid £5,505.15. He had subsequently repaid that sum.

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie. QC) said that the committee found the Society’s allegations proved. In all, Mr Sidhu had endorsed 20 prescriptions, in respect of 21 items, so as to imply that the quantities called for had been dispensed when this was not the case. His submission of those prescriptions to the PPA resulted in a claim for payment for 21 Genotropin cartridges that had not been supplied.

The matter had been examined by the PPA’s counter-fraud specialist and put to the Crown Prosecution Service but no criminal proceedings had been brought, the chairman noted.

He continued: “Any professional pharmacist might from time to time make some error in the submission of endorsed prescriptions to the PPA but such is the scale of Mr Sidhu’s repetitive error that it is wholly unacceptable.” He had repeated the same mistake on no fewer than 20 occasions over a six-month period, resulting in significant loss to the public purse.

It was troubling, said Lord Fraser, that the mistakes he had made did not come to light as a consequence of Mr Sidhu’s checking his own systems but had only done so when the general practitioner checked the prescriptions on his new computer.

Mr Sidhu’s repeated misconduct was such as to render him unfit to have his name on the register, the chairman said. However, the committee, after careful consideration and with some hesitation, had decided not to remove his name. There were significant mitigation factors: Mr Sidhu had been on the Register for some 26 years without a blemish to his name; impressive references and testimonials had been produced on his behalf; the money had been repaid; the Society’s inspector for the area had no other criticism to make of Mr Sidhu; and he had a well-laid out pharmacy. Finally, he had revised the endorsing procedures that had led to this “catalogue of disasters”.

Mr Sidhu was reprimanded.