Statutory Committee

Statutory Committee takes no action over breach of CD regulations

The Statutory Committee has taken no action in the case of a pharmacist who breached Controlled Drug regulations by supplying a customer with methadone other than in accordance with an instalment prescription and failing to record the supply.

At an inquiry held on 7 January and 24 April, the committee considered a complaint by the Council of the Royal Pharmaceutical Society against Mustafa Hakimuddin Bhaiji (registration number 1050805), of Nottingham. The Council alleged that misconduct such as to render Mr Bhaiji unfit to have his name on the Register of Pharmaceutical Chemists may have been demonstrated, individually or cumulatively, by the supply of methadone to a patient otherwise than in accordance with the direction contained in the prescription and by his failure to make an entry in the pharmacy’s Controlled Drugs register in respect of the supply.

The committee heard that on 18 December 2004 Mr Bhaiji was working as a locum pharmacist at Sainsbury’s Pharmacy at Arnold, Nottingham, when a patient presented a prescription dated on the previous day and calling for 840ml of methadone 1mg/1ml mixture. It was to be supplied as 420ml on 17 December 2004 and 420ml on 24 December 2004 and to be taken as daily doses of 60ml from 17 to 30 December 2004 inclusive. The patient having missed his first day’s dose, Mr Bhaiji dispensed 360ml of the mixture, although this was contrary to Regulation 16(4) of the Misuse of Drugs Regulations 2001, which requires that when a prescription contains a direction that specifies instalments of the total amount may be supplied at stated intervals, the supply must be made only in accordance with that direction. Mr Bhaiji also made no record of the supply in the pharmacy’s CD register, contrary to Regulations 19(1) and 20(b) of the same Regulations.

On 1 February 2005, Mr Bhaiji accepted an official police caution for the offences.

Mr Bhaiji told the committee that he made the supply after the patient turned up at the pharmacy with his family, including a young child. Mr Bhaiji said he dispensed the drug after weighing up the benefits and the risks. He believed that if the patient had not received his methadone supply he may had obtained illegal drugs and endangered his family.

Common sense

Giving the committee’s determination on 27 April, the chairman (Lord Fraser of Carmyllie, QC) said that if on 17 December 2004 Mr Bhaiji had dispensed 420ml of methadone, there could have been no complaint. However, what he did was to dispense a day later only 360ml of methadone, which might appear to be common sense when the expectation was that 60ml would be consumed daily.

The chairman said: “Instalment prescriptions, as this was, fall into a rather special category and, as we understand the law at the relevant time, … he should have declined altogether to provide any dispensing against that prescription for instalments if it was presented later than 17 December 2004. … That appears to us to be a startling absurdity and the government guidance now accords precisely with what Mr Bhaiji did, namely, that if the instalment prescription was presented a day later, he should cut out that missing day and otherwise dispense the prescription. That would appear to us to be not only common sense but it must be in the public interest.

The chairman said that the committee had concluded that Mr Bhaiji’s approach was so in accord with both common sense and what is now to be the legal requirement that there should be no further action.

He added: “Mr Bhaiji is fortunate that the law has moved in the direction in which he sensibly acted; it was, however, a brave decision. He might have been wrong and he could have suffered grave consequences. Pharmacists would be far better advised to communicate to the Society their concerns and invite the Society to advance their concerns. I can only say that that would appear to us to be the correct way forward. The great common law of England is larded with sarcasm in decisions where common sense has not been followed and there are many instances where common sense has been followed and the law has then been changed. Nevertheless, we emphasise that pharmacists defy the law very much at their own peril and should observe the law as it is at the time.”