Statutory Committee

Striking-off ordered for theft of tubes of moisturiser more

Three reprimands for poor practices in the manufacture of “specials” more

Reprimand for pharmacist who made dispensing error and denied it more

Restoration refused after second attempt to deceive the Society more

£52,000 PPA overpayment leads to striking-off order more

Pharmacist reprimanded for his deliberate decision not to honour a locum booking more

Striking-off ordered for theft of tubes of moisturiser

A Manchester pharmacist who stole three tubes of moisturiser has been ordered to be removed from the Register of Pharmaceutical Chemists by the Statutory Committee.

On 19 October 2004 and 25 January 2005, the Statutory Committee opened an inquiry into the case of Sohail Virdi (registration number 3000387), who on 9 March 2004, at Bolton Crown Court, had been convicted of theft, for which he had been fined £300 and ordered to pay prosecution costs of £900.

The committee heard that Mr Virdi had been caught by a store detective as he stole the cosmetics from the pharmacy where he was working.

Geoff Hudson, for the Society, said that Mr Virdi was working as a locum in charge of a Co-op pharmacy in Astley, Manchester. On 30 September 2003, a loss prevention officer working for the Co-op saw Mr Virdi enter the shop with a carrier bag. He returned shortly afterwards with the same bag, which he put in the boot of his car.

The loss prevention officer followed him into the shop and asked to carry out a routine check. When she looked in the car she found a new tube of cream in the glove box, Mr Hudson said. “She asked to see inside the boot and saw the carrier bag she had seen earlier. She asked to see inside it and found … three tubes of emollient cream.”

When questioned, Mr Virdi claimed he had brought the cream with him.

But when asked where he had bought it, he admitted, “I didn’t. Can I pay for them now?”

Mr Virdi told the hearing he was under pressure because his grandmother had died the day before. He did not regard his actions as theft. Despite his conviction, he told the committee: “I don’t accept that I acted dishonestly.”

Giving the committee’s determination, the chairman, Lord Fraser of Carmyllie, QC, said that an essential element of the offence of theft was dishonesty. The committee was not entirely confident from his evidence that Mr Virdi accepted that he had been dishonest.

He continued: “We consider his conviction such as to render him unfit to be on the register. Unlike other cases where we have seen significant factors in mitigation, regrettably we do not see them here.”

Mr Virdi had three months in which to appeal.

Three reprimands for poor practices in the manufacture of “specials”

The Statutory Committee has reprimanded two pharmacist brothers and their pharmacy company after it found proved a catalogue of complaints about the company’s practices as a manufacturer of pharmaceutical “specials”.

On 23 and 24 November and 13 December 2004, the committee inquired into a complaint by the Council of the Royal Pharmaceutical Society against Hitesh Govind Vaghjiani (registration number 83253) and Kamlesh Govind Vaghjiani (registration number 85388), both of London NW9, and Orbis Consumer Products Ltd, a company registered as a retail pharmacy and engaged in pharmaceutical manufacturing and wholesale dealing on an industrial estate in Wembley, Middlesex.

The Council alleged that the brothers might be unfit to remain on the register and the company might be liable to disqualification because of a wide range of unsatisfactory practices, among which were:

· Failing to complete batch manufacturing records adequately
· Retrospective dating of the quality control section of a batch manufacturing record
· Receipt of telephoned orders by staff with no pharmacy training
· Leaving the raw material store unlocked
· Incorrectly storing raw materials on which assessments under the Control of Substances Hazardous to Health (COSHH) Regulations 2002 had not been carried out
· Failing to separate out products that had passed their retest dates
· Using chemicals not intended for medicinal use in the preparation of medicines
· Failing to list in the log books any products purported to have been made under the Section 10 exemption of the Medicines Act 1968
· Falsely claiming that a product was made in accordance with a specials licence
· Falsely representing that unlicensed products purportedly made under the Section 10 exemption were manufactured in accordance with the specials licence
· Preparing an unlicensed penicillin product in the same room as licensed specials
· Failing to use separate spatulas or ointment slabs in the preparation of coal tar products
· Failing to write COSHH assessments in relation to coal tar
· An inadequate knowledge of what constituted a sensitising product or a product with a narrow therapeutic index
· Inadequate product preparation facilities
· An inadequate labelling procedure
· Inadequate procedures for supervising product preparation
· Leaving methadone mixture on an open bench in the quality control laboratory
· Failing to maintain adequate safe custody storage facilities for methadone
· Inadequate recording and custody of Controlled Drugs
· Storing about 900 litres of methadone mixture 1mg/ml in unlabelled plastic drums in an accessible storage area
· Falsely representing in the methadone register that the methadone had been returned to its supplier

The Vaghjiani brothers, who had admitted the allegations, were not present or represented at the inquiry.

The committee heard that the allegations related to the period between January and June 2003, during which Orbis held a manufacturer’s licence and a wholesale dealer’s licence and its premises were licensed for the manufacture of medicinal products (specials) and also registered as a retail pharmacy. The Section 10 exemption provided by registration as a pharmacy allowed the company to make small batches of extemporaneous products under less stringent conditions than under the specials licence.

The committee was told that the supplier of the methadone, which was recorded as having been returned to the supplier on the day of supply, had confirmed that it should have been removed on that day. But neither brother could give any good reason for its continued presence, with their knowledge, over a period of years. Furthermore, Hitesh Vaghjiani, at least initially, had sought to mislead the investigating team by asserting that the drums were empty.

Giving the committee’s determination, the chairman, Lord Fraser of Carmyllie, QC, said: “With the exception of the receiving of orders by telephone by untrained staff, which we question as being required in any part of the standards set by the Society, we find the case … established, in so far as is not already admitted. We also conclude that individually and cumulatively their acts amount to such misconduct as to render them unfit to be on the Register, and in the case of company liable to disqualification. We then have to consider whether we will direct the removal of their names from the Register.”

As the committee saw it, there was no intent to mislead, and the brothers had ceased any involvement Controlled Drugs. A Society inspector had visited the premises on several occasions and had reported many improvements, although she still had some concerns. There were plans to relocate the business to larger premises in June 2005, with separate rooms for Section 10 production and for the production of coal tar preparations.

The chairman concluded that, in the circumstances, the committee, with some hesitation, would restrict itself to reprimanding both brothers and the company. However, if any Society inspector were to report adversely on the new premises the committee might then be compelled to take a different view.

Reprimand for pharmacist who made dispensing error and denied it

A pharmacist who dispensed carvedilol against a prescription for bisoprolol and then tried to blame the error on the patient’s GP has been reprimanded by the Statutory Committee.

On Monday 24 January 2005, the committee inquired into a complaint by the Council of the Royal Pharmaceutical Society against Sureshchandra Lalaji Patel (registration number 65289), of Cockfosters, Hertfordshire, who at the material time was proprietor and pharmacist in charge of a pharmacy in Church Street, Edmonton, London N9.

The Council alleged that on 4 August 2003, in response to a prescription for 56 1.25mg tablets of the selective beta-blocker bisoprolol, Mr Patel had dispensed 56 12.5mg tablets of the non-selective beta-blocker Eucardic (carvedilol), which he had labelled as bisoprolol 1.25mg tablets.

Adverse symptoms

The patient, who had been taking bisoprolol for more than 18 months for her hypertension, took the tablets regularly during a three-week holiday in Jamaica. She experienced a number of adverse symptoms throughout the period and on 22 September 2003 made an appointment with her GP, who noted the error and wrote a new prescription for bisoprolol.

When the patient spoke to Mr Patel on the same day, he denied making an error and said that he had dispensed as the doctor had prescribed. He informed her that he would contact her within a few days, but failed to do so. Only when she visited the pharmacy some days later did he accept that he had made an error.

Investigating a complaint from the patient, one of the Society’s inspectors visited the pharmacy on 30 October 2003. She observed that when dispensing Mr Patel did not check the label or product against the prescription and did not carry out a final check. She also noted that he was not taking simple practical procedures to minimise the risk of dispensing errors.

Mr Patel was not present at the hearing.

Geoff Hudson, for the Society, told the committee: “The error appears to have been caused simply as a result of not checking. The deficiencies in his checking routines make him vulnerable to making just the type of serious dispensing error that led to the patient taking the wrong drug.”

The patient told the hearing that she had developed skin irritation, blurred vision, fatigue and sleeping problems and suffered from hand spasms. “I was feeling unwell but put it down to the change of climate,” she said. “During the three weeks we spent in Jamaica I felt unwell. When I came back, for about two weeks I was still feeling unwell and I went to my doctor.”

Her symptoms disappeared only after five days of the correct medication.

Denis Keegan, for Mr Patel, said that the pharmacist’s confidence has been thoroughly shaken. “He is a man effectively at the end of his career. He has no intention of acquiring another pharmacy, but obviously intentions can change in the future,” Mr Keegan said.

He added that Mr Patel admitted dispensing the wrong drug, failing to deal with a complaint in a timely manner, failing to admit the error and deficiencies in his dispensing procedures.

Allegations proved

Giving the committee’s determination, the chairman, Lord Fraser of Carmyllie, QC, said that all the allegations against Mr Patel had been proved.

The chairman added that Mr Patel had been on the Register for some 30 years but had sold his pharmacy. He had not worked as a pharmacist since 30 November 2003 and did not intend to resume employment in that capacity.

“ In those circumstances we are prepared to restrict our censure to that of a reprimand, but Mr Patel should appreciate that it is so restricted on the basis of instructions he gave to Mr Keegan that he does not intend to practise again. We are taking that at its face value and we do not expect him to practise in the future. On that basis we are able to leave him on the non-practising Register and draw back from directing the removal of his name from the Register altogether.”

Restoration refused after second attempt to deceive the Society

A former pharmacist who tried to mislead the Royal Pharmaceutical Society with a forged certificate of professional indemnity has lost a second bid for restoration after a further attempt to deceive the Society.

On 26 January, the Statutory Committee heard an application for restoration from Chhaganbhai Dahyabhai Nathubhai Mistry, of London N6, who had been removed from the Register of Pharmaceutical Chemists on 2 March 2000 after an unsuccessful appeal against a striking-off order made by the committee on 20 May 1999. A first application for restoration had been dismissed on 20 November 2002 (PJ, 5 April 2003, p494)

Dishonest for second time

The committee heard that Mr Mistry had been dishonest for a second time when his son tried to take the blame for a bin liner full of syringes and waste drugs being dumped in Mr Mistry’s back garden in Highgate, London N6.

Geoff Hudson, for the Society, said the “adverse information” was another example of Mr Mistry’s “continued lack of respect for the Society’s supervisory role”.

The pharmaceutical waste was found in his garden in August 2002 when a neighbour was replacing her fence. The woman said in a statement that her builder “found the trench of drugs and hypodermic needles and felt unable to continue work”.

She took 12 photographs and reported the find to Camden’s environmental health department. She was advised to report the matter to the police, who then informed the Society. “My husband and I were concerned they be could be picked up by a child,” she said in a statement to the Society.

Mr Mistry later had the bag incinerated in line with regulations.

His son Rajesh, who had succeeded his father as superintendent pharmacist of the family business, claimed responsibility for the bag to protect his father. His father had falsely told him that the bag contained medicines cleared from their domestic medicine cabinet whereas they were in fact from the pharmacy and included prescription only medicines whose disposal was subject to the requirements of the Special Waste Regulations 1996.

The son was given a formal warning by the Society after admitting he had lied.

Mr Mistry told the hearing that he had locked the bag of waste in his garden shed in the late 1990s. He claimed he put the bag out of his mind until builders demolished the shed, leaving the bag in his garden. “I just forgot about it,” he said.

He said he allowed his son to lie to the Society “to minimise the mistake”. He added: “I am sorry for my arrogance. It really hurts me not to be able to advise people with my knowledge. I wish to continue pharmacy in my later years.”

Ambivalent

Giving the committee’s determination, the chairman, Lord Fraser of Carmyllie, QC, said that when struck off Mr Mistry had “ambivalently” admitted that what he had done was dishonest and done with intent to deceive the Society. Nothing in his demeanour had indicated a real change of heart or any shift in his attitude towards the statutory role of the Society.

“Mr Mistry appears yet again to have sought, through his son, to deceive the Society and it confirms … that there has been no shift in his attitude towards the Society,” he said. “In these circumstances, we will again refuse the application for restoration.”

£52,000 PPA overpayment leads to striking-off order

The name of a pharmacist who made erroneous claims to the Prescription Pricing Authority about the supply of an expensive growth hormone product is to be removed from the Register of Pharmaceutical Chemists on the order of the Statutory Committee. The false claims totalled about £52,000.

The committee took no action against a company that was a party to the inquiry.

At its meeting on 26 January, the committee considered a complaint from the Council of the Royal Pharmaceutical Society concerning Allan Stuart Black (registration number 70782), of Cheadle, Cheshire, and Formans (Chemists) Ltd, of which Mr Black was superintendent pharmacist and a director. The company owned a pharmacy in Prestwich, Manchester. The Council alleged that the submission of the erroneous claims might have demonstrated misconduct such as to render Mr Black unfit to have his name on the register and the company liable to disqualification.

The committee heard that between October 1999 and March 2003 the PPA received 33 claims in respect of a total of 416 Genotropin (36 unit) cartridges allegedly dispensed for a patient between October 1999 and November 2002. Enquiries revealed that the company only purchased 222 cartridges (from various suppliers) between 8 December 1999 and 1 February 2003.

Mr Black requested repeat prescriptions from the patient’s GP and, whatever the quantity on the prescription, never supplied more than eight cartridges against any prescription. When interviewed by the police on 29 October 2003 he admitted that he had submitted the prescriptions for payment without endorsing them to reflect the fact that a lesser number of cartridges had been dispensed.

Fenella Morris, for the Society, said that on one occasion Mr Black supplied just five cartridges against a prescription for 30 but claimed for the full amount.

Mr Black told the committee that the false claims had been made because of a “chaotic” filing system. He said that the patient’s mother, who was Jewish, had refused to take the right amount of the drug home because she believed it was not kosher and could not be kept in her refrigerator. He said her difficult nature made it hard for him to keep tabs on how much of the prescription was still outstanding.

He added: “I was very stressed. It was a poor administration error.” He said he was “absolutely distraught and ashamed” and had been prescribed antidepressants.

Giving the committee’s determination on 24 February, the chairman, Lord Fraser of Carmyllie, QC, said that Mr Black had acknowledged sole responsibility for the erroneous submission of the claims. Although the company had been enriched by £52,000, most of that had already been repaid and it would soon have been wholly repaid.

There had been no allegation of dishonesty or fraud by Mr Black, but an overclaim of such a size amounted to such misconduct as to render him unfit to be on the register, the chairman said.

He continued: “We have concluded that such is the extent of the overclaim that there is no option to us but to instruct the removal of his name from the register. It may be true that he received only a salary for his work in the pharmacy, but still he has acknowledged his sole responsibility for the amounts claimed and that is a significant amount that might have been lost to the public purse. Accordingly, we make the direction for the removal of his name. However, on the assumption that the total amount of £52,000 will have been repaid by the end of next month, we will make no direction against the company.”

Mr Black was told that he had three months in which to exercise his right of appeal.

Pharmacist reprimanded for his deliberate decision not to honour a locum booking

The Statutory Committee has reprimanded a pharmacist who forced a supermarket pharmacy to close for several hours when he deliberately failed to honour a locum booking and worked elsewhere instead.

On 17 June 2003, 19 October 2004, 13 December 2004 and 24 January, the committee inquired into a complaint by the Council of the Royal Pharmaceutical Society against Fahim Samri (registration number 1067909), of Enfield, Middlesex. The Council alleged that Mr Samri was booked by a locum agency to work on 20 July 2002 at a supermarket pharmacy in Huntingdon but that at about 6.30pm on the previous evening hetelephoned the pharmacy manager to say he would not be working the next day because he was sick. Because of the short notice, the company could not find replacement cover for the whole of the day and the pharmacy had to close between noon and 5pm. Meanwhile, Mr Samri was working on that day as a locum at a pharmacy in Kent, having made a booking at his own request early in July.

During the inquiry, which opened on 17 June 2003 and was then adjourned to 19 October 2004, Mr Samri said that he had acted out of revenge in cancelling the booking at short notice, knowing that the supermarket would be highly unlikely to be able to obtain alternative cover for the day. He said that his grudge against the supermarket company had started earlier in 2002 when he had twice arrived at bookings to find another locum in his place. On one occasion he had set off at 4.30am from his then home in Hackney, East London, for an 8.30am start in Norwich. He took weeks to get over his anger and frustration at his treatment by the company, he claimed.

On 19 October 2004, the committee found the misconduct proved and adjourned the inquiry for mitigation until 13 December 2004, when it was further adjourned for Mr Samri to conclude his mitigation, principally by providing a reference from his current employer.

When the inquiry resumed on 24 January, the committee heard that Mr Samri was now superintendent of an Essex-based company and was pharmacist in charge of one of its eight pharmacies.

Giving the committee’s decision on 24 January, the chairman, Lord Fraser of Carmyllie, QC, said: “In the circumstances we will draw this complaint to a conclusion by restricting our sanction to that of a reprimand. However, we do urge Mr Samri to make absolutely sure that he understands all that is entailed not only in being a pharmacist in charge, but also in being a superintendent pharmacist as well.”