Statutory Committee

Pharmacist struck off after making repeat supplies of POM medicines without obtaining prescriptions more

Reprimand for supplying POMs against non-existent prescription more

Company disqualified from owning pharmacy premises after running its business without a superintendent or a pharmacist in charge more

Reprimand for pharmacist who claimed sick pay while working more

Pharmacist struck off after making repeat supplies of POM medicines without obtaining prescriptions

A London pharmacist who, over a period of nine months, supplied prescription-only medicines (POMs) to the residents of a care home without obtaining repeat prescriptions authorising their supply has been struck off the register by the Statutory Committee.

When it met on 18 March the committee inquired into the case of Rajnikant Jashbhai Patel, of Rains Chemist, 2 Staplehurst Road, Hither Green, London SE13. A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that between September 2000 and May 2001 Mr Patel had failed to request repeat prescriptions under a repeat medication service offered to a care home by his pharmacy. Mr Patel had admitted dispensing POMs during that period to 20 named patients at a care home and that such supplies had been unlawful.

Fenella Morris, of counsel, instructed by Penningtons (solicitors), appeared on behalf of the Council to present the facts of the case.

Denis Keegan, of Turner & Debenhams (solicitors), represented Mr Patel, who attended the inquiry.

The committee heard that Mr Patel had, since 1994, supplied residents of a care home near his pharmacy with their prescription medicines. New and repeat prescriptions obtained from the doctor’s surgery were delivered to the pharmacy by the managers of the home and the medicines required supplied in Nomad trays.

In 1996, most or all of the residents were transferred to the list of a new doctor. Mr Patel had proposed to the managers that the pharmacy would be responsible for collecting repeat prescriptions for the residents. It was arranged that each week the home would provide repeat prescription request slips for patients; details of repeat medication noted as required, following the doctor’s routine visit to the home the preceding week, would be recorded in the home’s drug order book; any new prescriptions would be brought to the pharmacy. The expectation on the home’s part was that Mr Patel would obtain the repeat prescriptions from the surgery before the medicines were supplied. In fact, Mr Patel started to supply repeat medicines without the authority of the doctor.

In October 1999 the home became aware that Mr Patel was not always requesting repeat prescriptions from the surgery and it was agreed to revert to the original arrangement, by which the home’s managers delivered the prescriptions to the pharmacy. That lawful arrangement continued until August 2000, when Mr Patel again offered to obtain the repeat prescriptions from the doctor. The reversion to the former system took place in September 2000 and until May 2001, when contacted by the doctor concerned, Mr Patel had failed to obtain repeat prescriptions for the medicines he continued to supply to the residents at the home.

Not inexperienced

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie, QC) said that Mr Patel was not an inexperienced pharmacist, having registered in 1980. He had claimed that in the first period (1996–99) when he had supplied repeat medicines to the home without valid prescriptions, he had lost about £18,800, as he had no prescriptions to send to the Prescription Pricing Authority for payment. Notwithstanding that substantial loss, the chairman continued, he again offered to resume the practice by which it was left to him to obtain repeat prescriptions from the doctor’s surgery.

From September 2000 to May 2001, he had made no attempt to obtain the prescriptions nor had he told the home that he was not obtaining the repeat prescriptions. Then, in May 2001, the doctor had telephoned Mr Patel and told him in no uncertain terms that he was not to supply medicines to her patients in the home without the authority of a prescription from her.

Mr Patel had admitted that serious error.

It was, said Lord Fraser, fundamental to the practice of pharmacy that there should be no dispensing of POMs without the authority required at law of a valid prescription. The doctor had vigorously denied Mr Patel’s assertion that she had ever authorised him to supply medicines without a prescription. In a sense, that was irrelevant because a prescriber would not have had the authority to set aside what was required by law; and as a pharmacist, Mr Patel knew very well what was required of him.

The committee found that Mr Patel had been guilty of misconduct such as to render him unfit to be on the register. Before coming to a decision on the case, the chairman asked if anything was known concerning Mr Patel.

He was told that Mr Patel had appeared before the Statutory Committee on 20 November 2002 after having been convicted, and fined a total of £1,050, on six charges relating to the supply of Controlled Drugs where no dose was specified and failing to record the receipt and supply of CDs; a further 205 offences had been taken into consideration (PJ, 5 April 2003, p495). Mr Patel had been reprimanded and warned that if he came before it again the committee would not be able to deal with any set of errors as leniently as it had on that occasion.

Lord Fraser said that, even without taking into consideration that earlier conviction, the committee regarded Mr Patel’s misconduct as so serious that his name should be removed from the register Mr Patel had three months in which to appeal.

Reprimand for supplying POMs against non-existent prescription

The supply of 190 clomethiazole capsules to a patient who said she had a prescription for them when none existed has led to a Northumberland pharmacist being reprimanded by the Statutory Committee.

At its meeting on 17 March, the committee considered the case of John Edward Bradbeer, of “Mill Bank”, Ashington Road, Ellington, Morpeth, Northumberland, and R. Hindhaugh (Chemists) Ltd, which operates a pharmacy at 8 Laburnum Terrace, Ashington, Northumberland. Mr Bradbeer is superintendent pharmacist, a director and major shareholder of the company.

A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that Mr Bradbeer had failed to take reasonable steps to be satisfied that a valid prescription was in existence when, on 6 January 2003, he had supplied 30 clomethiazole (Heminevrin) capsules to a patient and, on 10 January 2003, had supplied 160 clomethiazole capsules to the same patient.

It was also alleged that Mr Bradbeer had made the supplies without the authority of a prescription and that he had failed to have in place proper procedures in respect of delivery to a patient and recovery of a valid prescription in respect of such delivery.

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

Mr Bradbeer attended the inquiry; he and the company were represented by Denis Keegan, of Turner & Debenhams (solicitors).

The committee heard that on 6 January 2003 a patient known to the pharmacy, and who regularly had her prescribed medicines delivered to her home, telephoned and asked to be supplied with 190 Heminevrin (clomethiazole) capsules, a prescription-only medicine, against a prescription she said had been issued by her consultant psychiatrist and which she had at home. The patient said she would give the prescription to the driver when he delivered the medicine. Mr Bradbeer told her that there were only 30 capsules in stock but made no inquiry as to the identity of the consultant. Thirty capsules were prepared and labelled “two to be taken at night”. They were given to a taxi driver who delivered the capsules but failed to obtain a prescription.

Four days later, on 10 January, no prescription had been received; the patient, however, telephoned and asked for the balance of 160 clomethiazole capsules she claimed were owing on the prescription. When Mr Bradbeer asked where the prescription was, he was told “in direct terms” that it had been given to the delivery driver. The patient also claimed that she was going away for the weekend and needed the capsules. In those circumstances, Mr Bradbeer had supplied the 160 capsules, labelled “4 to be taken at night”.

No prescription was ever received.

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie, QC) said that Mr Bradbeer had shown a degree of caution in advising the patient that there were only 30 capsules in stock, when that was not the case. However, the taxi driver to whom the capsules were given for delivery had been given no clear instructions as to what steps he should take in the event that the patient failed to offer him a prescription. Further, Mr Bradbeer had failed to have in place a proper or verifiable audit trail. When the patient telephoned again, on 10 January and asked for the balance of the clomethiazole that she said remained to be supplied under the prescription, Mr Bradbeer asked her about the whereabouts of the prescription.

Mr Bradbeer had candidly admitted that he was in error in supplying clomethiazole in the absence of a prescription, said Lord Fraser.

At no time did he ever receive a prescription, and in a subsequent interview with the patient he discovered from her that there had never been any such prescription from her consultant psychiatrist. Mr Bradbeer’s admitted error in making the supply of 190 clomethiazole capsules without a prescription was a serious error, said Lord Fraser. It was one that amounted to misconduct such as to render him unfit to be on the register.

However, he continued, Mr Bradbeer had had a long and distinguished career in pharmacy and had put forward some substantial references of his services to the community. He had made a single mistake, although he had supplied the clomethiazole on two occasions.

The committee reprimanded Mr Bradbeer. No direction was made in respect of the company.

Company disqualified from owning pharmacy premises after running its business without a superintendent or a pharmacist in charge

The Statutory Committee has disqualified a west London limited company from owning pharmacy premises “without limitation of time”. The company’s director, a former pharmacist who had been struck off, had run the company’s pharmacy business without appointing a superintendent pharmacist or having a pharmacist in charge while medicines were supplied and prescriptions dispensed.

At its meeting on 16 March, the committee inquired into the case of Mount Shilo Trading UK Ltd. Information had been received that on 30 June 2003 at West London magistrates’ court the company had pleaded guilty to the unlawful sale of medicines at a pharmacy it owned at 809 Harrow Road, Kensal Green, London NW10. The offences related to the sale, on 22 April 2002, of Solpadeine tablets other than by or under the supervision of a pharmacist and to six counts of supplying medicinal products not on a general sale list. The medicines were diclofenac 75mg tablets, cephalexin 250mg capsules, olanzapine 10mg tablets, temazepam 10mg tablets and diazepam 2mg tablets The company was fined a total of £7,000 and ordered to pay £3,300 costs.

The then director of the company, Felix Owolabi Olubunmi Kuforiji, had pleaded guilty to and been convicted of seven related offences for having permitted the offences and having failed to appoint a superintendent pharmacist. Mr Kuforiji was fined a total of £700 and ordered to pay £150 costs.

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

Mary Aspinall-Miles, of counsel, instructed by Powell, Spender & Partners (solicitors), appeared on behalf of Mount Shilo Trading UK Ltd.

The inquiry heard that on 22 April 2002 one of the Society’s inspectors purchased a pack of 24 Solpadeine soluble tablets from the pharmacy. She was served by Mr Kuforiji, who had responded when she had asked to speak to “the pharmacist”.

In fact, Mr Kuforiji had been removed from the register by order of the committee at its May 2001 meeting (PJ, 8 December 2001, p833). He had said there was no pharmacist on duty that day because the business was in process of being transferred to 797 Harrow Road. When asked who had been in personal control of the pharmacy during the previous week, Mr Kuforiji had given the names of two individuals who were found to be not on the register.

Later, Mr Kuforiji had been requested to supply a list of all pharmacists who had been employed at the pharmacy since 1 March 2002. That list contained two names; one of the pharmacists concerned had not worked at the pharmacy on any of the dates he was stated to have done. Mr Kuforiji had persuaded the pharmacist, against his better judgement, to sign forms purporting to show that he had worked at the pharmacy on dates in April 2002; the pharmacist had denied having worked there. Further, there had been no superintendent pharmacist appointed for the company.

Both premises had been deregistered in March 2004.

Investigations had revealed that during a period when no pharmacist was present, between 19 March 2002 and 20 April 2002, no fewer than 80 prescriptions with a total of 121 items had been dispensed.

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie, QC) said Mr Kuforiji, having failed to appoint a superintendent pharmacist, had permitted the company to be open for the sale and supply of medicinal products. The effect of this was that the company was not “a person lawfully conducting a retail pharmacy business” as defined in Section 69 of the Medicines Act.

As well as the convictions proved against him, Mr Kuforiji had not disputed charges of an extended series of lies to and deceptions of the Society’s inspectors relating to pharmacists allegedly on duty and in personal control on dates in March and April 2002. It transpired that there were no such persons on the register or he had attempted to get a pharmacist falsely to claim he had been working on days when he had not been working. “And this,” said Lord Fraser, “was against the background of a significant number of prescriptions having been submitted for payment during this period.”

The Society asserted that the matters alleged against Mr Kuforiji and the company amounted to such misconduct as to render Mount Shilo Trading UK Ltd unfit to be a “person” conducting a retail pharmacy business and liable to disqualification. None of this was disputed and the committee found the Society’s case proved.

As at the present time there were no pharmacy businesses in the name of the company registered with the Society, the committee made no direction for the removal of the name of any set of premises. The body corporate, Mount Shilo Trading UK Ltd, was ordered to be disqualified from holding retail pharmacy premises. No time limit was set on the disqualification.

Lord Fraser added that it was not open to the committee to make any order against Mr Kuforiji, as he had been removed from the register.

Reprimand for pharmacist who claimed sick pay while working

A London pharmacist who claimed sick pay from Boots The Chemists, his regular employer, while being employed as a locum at other Boots branches has been reprimanded by the Statutory Committee.

At its meeting on 17 March, the committee inquired into the case of Derek Christopher Sukhdeo, of Flat 3, Falcon Brook Mansions, 262 Balham High Road, London SW17. A complaint had been received from the Council of the Royal Pharmaceutical Society alleging that, while signed off from his regular employment on sick leave on 14, 17, 18, 19, 20 and 22 June 2002, Mr Sukhdeo had worked as a locum elsewhere, and that he had claimed sick pay to which he had not been entitled on 19, 20 and 22 June, dates for which he had been paid for locum services.

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

Kevin McCartney, of counsel, instructed by Charles Russell (solicitors) appeared for Mr Sukhdeo, who was present.

The inquiry heard that Mr Sukhdeo had been employed for some years by Boots The Chemists, working at Notting Hill and Queensway, London. In early June 2002 he had undergone laser eye surgery. On 12 June he advised his manager that he was not feeling well following the surgery and that his doctor would be advising him to take two weeks’ sick leave. He obtained a medical certificate on the same day and submitted it to his employers on 15 June, indicating that he would not return to work until 27 June.

However, he had contacted a locum agency through which he obtained placements at various Boots pharmacies in the London area. Although signed off sick, he worked on 14, 17, 18, 19, 20 and 22 June. On 27 June, when he returned to his regular work, he signed a form claiming sick pay for 19, 20 and 22 June, days on which he should have been working at his regular job. By that time, Boots had become aware of his actions and he was interviewed by a manager. Initially, he had denied having worked during the period he was off, but subsequently admitted he had done so. He had said he was short of money.

He was suspended on full pay and eventually, on 30 August, dismissed. Mr Sukhdeo’s appeal against his dismissal had been rejected in early October. He had repaid the sum of £829.96 he had wrongly claimed as sick pay.

Giving the committee’s decision, the chairman (Lord Fraser of Carmyllie, QC) said that when Mr Sukhdeo returned to work, the falsity of his claim for sick pay had been quickly discovered and, after his dismissal had been confirmed, Boots had advised the Society of what had happened.

Mr Sukhdeo’s action had been a serious breach of the trust he owed his employers, who were treating him generously, paying him beyond what was required as statutory sick pay. “This was wholly unacceptable conduct,” said the chairman. It was not surprising that Boots had investigated and pursued the case vigorously. Such a breach of trust would alone, in some cases, suffice to support a direction for a pharmacist’s removal.

On the other hand, he continued, this was a single incident in a career. Mr Sukhdeo had already been punished by the loss of a job and he had repaid the money paid to him erroneously. There was no question over his competence as a pharmacist and he had now found employment in a hospital pharmacy where he appeared to have settled down.

“With very great hesitation”, Lord Fraser concluded, the committee had decided not to direct Mr Sukhdeo’s removal from the register but would restrict its censure to a reprimand.