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Drenic-Stojanovic, Drena (Dec 30, 2020)

Nature of Action: Pursuant to section 35(1)(a) of the Health Professions Act, R.S.B.C. 1996, c. 183 (“HPA”), effective December 30, 2020, the Inquiry Committee of the College of Pharmacists of British Columbia (the “College”) has made an order to impose limits and conditions on the pharmacy practice of the registrant Drena Drenic-Stojanovic (the “Registrant”) during the investigation into the Registrant’s practice, as follows:

  1. The Registrant shall not be involved in any way in the preparation, compounding, manipulation and/or dispensing of injectable and/or sterile products to patients/clients or health care providers/prescribers for office use;
  2. The Registrant shall not act as a pharmacy manager or owner;
  3. The Registrant shall not act as a preceptor to students or be responsible for the supervision of other staff and/or registrants;
  4. The Registrant must work under the direct supervision of another registrant acceptable to College staff; and
  5. The Registrant must inform any employer of these limits and conditions of her practice and provide it with a copy of this decision.

The Inquiry Committee considered this action necessary to protect the public.

Reasons: While practising as a pharmacist, it is alleged that the Registrant did not comply with the applicable legislation and standards of practice required to compound sterile preparations. While practising as a pharmacist, it is alleged that the Registrant distributed compounded sterile preparations from an unlicensed pharmacy.

Note: Limits and conditions ordered by the Inquiry Committee under section 35(1)(a) of the HPA are made to protect the public during an investigation or pending a hearing of the Discipline Committee. Orders made under this section relate to matters which are and remain unproven unless admitted by a registrant or determined by the Discipline Committee.

Pharmacist Registrant 45 (Dec 23, 2020)

The Inquiry Committee has reinstated pharmacist registrant’s registration, which had previously been suspended for an indefinite period on October 20, 2020. The pharmacist registrant’s name has been withheld pursuant to section 39.3(4) of the Health Professions Act


October 20, 2020
(December 23, 2020 - Registration Reinstated)

The Inquiry Committee, pursuant to section 32.2(4)(b)(ii) of the Health Professions Act, has reached an Agreement with the pharmacist registrant to voluntarily suspend their registration as a pharmacist effective October 20, 2020. The Agreement remains in effect until further notice. The Inquiry Committee considers the Agreement necessary to protect the public. The pharmacist registrant’s name has been withheld pursuant to section 39.3(4)(a) of the Health Professions Act.

Pharmacist Registrant 48 (Dec 18, 2020)

The Inquiry Committee, pursuant to section 32.2(4)(b)(ii) of the Health Professions Act, has reached an Agreement with the pharmacist registrant to voluntarily suspend their registration as a pharmacist effective December 18, 2020. The Agreement remains in effect until further notice. The Inquiry Committee considers the Agreement necessary to protect the public. The pharmacist registrant’s name has been withheld pursuant to section 39.3(4)(a) of the Health Professions Act.

Amara, Alaa Mohssen (Dec 18, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“CPBC”) conducted an investigation into the practice of Alaa Mohssen Amara (the “Registrant”), pursuant to section 33(4) of the Health Professions Act, R.S.B.C. 1996, c. 183 (“HPA”). The CPBC issued a Citation on July 6, 2020, which was subsequently amended on November 23, 2020.

    Further to a proposal for resolution from the Registrant, the Inquiry Committee made a Consent Order under section 37.1 of the HPA.

  2. Effective date: December 18, 2020

  3. Name of registrant: Alaa Mohssen Amara

  4. Location of Practice: Powell River, BC

  5. Admissions and Acknowledgements: The Registrant has admitted and/or acknowledged the following (in part):

    1. In or about February 2018, the Registrant allowed a pharmacy opioid agonist treatment (“OAT”) patient to deliver methadone to a medical clinic for administration to another pharmacy OAT patient.

    2. The Registrant failed to ensure the security of methadone by allowing it to be delivered to a medical clinic without taking sufficient precautions to ensure a secure chain of custody.

    3. The Registrant misled a College investigator and the Inquiry Committee during the investigation by not providing accurate and truthful information regarding non-pharmacist methadone delivery.

    4. Between December 2017 and February 2018, on multiple occasions, the Registrant dispensed a patient’s methadone contrary to the prescription in terms of quantity dispensed.

    5. The Registrant caused or allowed multiple methadone maintenance treatment (“MMT”) prescriptions for an OAT patient to be dispensed contrary to the legislation and practice standards.

    6. The Registrant failed to ensure that the required documentation was completed and/or retained for an OAT patient, including documentation for deliveries completed, physician notifications for missed doses, and part-fill accountability logs.

    7. From about July 1, 2017 until March 27, 2018, on multiple occasions, the Registrant backdated methadone prescriptions and failed to review the patient’s personal health information on PharmaNet prior to dispensing MMT.

    8. During a college pharmacy inspection:

      1. The Registrant was only able to produce one narcotic reconciliation. The Registrant failed to ensure that adequate narcotic counts and reconciliations were completed for the pharmacy.

      2. Schedule I, II, and III drugs and controlled drug substances were unsecured. The Registrant failed to ensure appropriate security and storage of all Schedule I, II, and III drugs and controlled substances.

    9. The Registrant failed to reverse information in the PharmaNet database for several drugs not released to a patient or the patient’s representative, and the Registrant failed to record the reason for the reversal no later than 30 days from the date of the original entry of the prescription information in PharmaNet.

    10. The Registrant was engaged in a conflict of interest and unethical behaviour by allowing OAT patients to work in the pharmacy.

    11. The Registrant breached his undertakings made to the Inquiry Committee on July 17, 2012 and February 11, 2015.

  6. Disposition:

    In the Consent Order under section 37.1 of the HPA, the Inquiry Committee ordered that the Registrant (in part):

    1. Pursuant to section 39(2) of the HPA, the Registrant’s registration with the CPBC is suspended for a period of 90 days commencing April 1, 2021 to June 29, 2021;

    2. Will not be a manager for a period of 90 days commencing on the date his suspension ends (June 30, 2021 to September 27, 2021);

    3. Successfully complete and pass the CPEP PROBE “Ethics and Boundaries Program”. After the successful completion of the program, to meet with the Inquiry Committee to reflect on his conduct and what he has learned from the program;

    4. Consent to a letter of reprimand; 

    5. Will not be a preceptor of pharmacy students and/or international pharmacy graduates for a period of five (5) years commencing on December 16, 2020 to December 15, 2025; and

    6. Pay a fine of $5000 to the CPBC.

  7. Rationale:

    The Registrant contravened sections of the HPA, Pharmacy Operations and Drug Scheduling Act (“PODSA”) Bylaws, HPA Bylaws, and the Code of Ethics in his practice as a pharmacist, pharmacy manager, owner and director, and thereby, neglected his basic duties as a pharmacist, and committed or allowed actions that were unethical and could potentially endanger patient health. The totality of his conduct demonstrated a breach of trust and undermines the integrity of the profession.

    The Registrant’s conduct in this instance, coupled with the breach of his previous undertakings, is considered professional misconduct and justifies serious consequences. The Inquiry Committee considered it appropriate that the disposition for such conduct be one that serves as a strong deterrent and sends a clear message to both the profession and the public that the CPBC does not tolerate this type of conduct under any circumstances.

McPherson, Joshua Bruce (Dec 14, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“CPBC”) conducted an investigation into the practice of Joshua Bruce McPherson (the “Registrant”), pursuant to section 33(4) of the Health Professions Act, R.S.B.C. 1996, c. 183.

    The Inquiry Committee and the Registrant have agreed to resolve all matters arising from the investigation by way of a Consent Agreement under section 36(1) of the Health Professions Act.

  2. Effective date: December 11, 2020

  3. Name of registrant: Joshua Bruce McPherson

  4. Location of Practice: Castlegar, BC

  5. Admissions and Acknowledgements: The Registrant has admitted and/or acknowledged the following:

    1. Between April 2016 and October 2019, the Registrant dispensed numerous opioid agonist treatment (“OAT”) emergency refill prescriptions contrary to Professional Practice Policy 31 – Emergency Supply for Continuity of Care (“PPP-31”) and Professional Practice Policy 66 – Opioid Agonist Treatment (“PPP-66”);

    2. On numerous occasions, the Registrant dispensed OAT contrary to the applicable legislation and policies by:

      1. Allowing non-pharmacist staff to release and witness OAT doses to patients;

      2. Not communicating with prescribers about patients’ missed OAT doses;

      3. Not ensuring that the pharmacist and patient acknowledged receipt of an OAT dose by signing a patient/prescription-specific log;

      4. Not ensuring that all OAT prescription records were filed systematically, or easily retrievable;

      5. Releasing OAT prescriptions to patients earlier than required;

      6. Dispensing OAT prescriptions to patients who had missed their doses, without referring them to their prescribers for an assessment and without decreasing their dose as recommended;

      7. Backdating several prescriptions, meaning that the dispensing records for those prescriptions were created on dates later than the dates on which the drugs were actually dispensed; and

      8. Not completing a final check on multiple OAT prescriptions dispensed.

    3. As pharmacy manager, the Registrant did not ensure: 

      1. The pharmacy had documented policies and procedures;

      2. All records required to be kept under the bylaws were readable, complete, filed systematically and maintained in a manner that was secure, auditable and allowed for easy retrieval; and

      3. Did not reconcile the pharmacy’s narcotics.

  6. Disposition:

    The Registrant entered into a Consent Agreement with the Inquiry Committee of CPBC, wherein the Registrant consented to the following terms (in part):

    1. To not be a pharmacy manager for a period of one year from December 15, 2020 to December 14, 2021;

    2. To not provide emergency prescription refills for narcotic, controlled, and targeted drug substances including zopiclone pursuant to PPP-31 for one year from November 12, 2020 to November 11, 2021;

    3. To be suspended from opioid agonist treatment dispensing privileges until the Registrant successfully completes:

      1. A thorough review of the legislative standards and policies;

      2. A decision-making and documentation course specific to healthcare professionals;

      3. A course specific to opioid agonist treatment for healthcare professionals; and

      4. A course on managing workflow in a pharmacy.

    4. To successfully pass the College’s Jurisprudence Exam. 

  7. Rationale:

    The Inquiry Committee considered that the Registrant’s opioid agonist treatment (“OAT”) practice was severely deficient. The Registrant’s OAT practice demonstrated a lack of knowledge and awareness of legislative requirements. This raised concern regarding the Registrant’s commitment to the pharmacy practice and his ethical responsibilities in ensuring that he maintained appropriate knowledge before providing a pharmaceutical service in order to ensure patient safety.

    The Inquiry Committee determined that the volume of practice deficiencies required a serious response to bring the Registrant’s practice into compliance with the standards of pharmacy practice and that the dispositions were warranted as it addressed the seriousness of the Registrant’s failure to adhere to principles and standards expected of registrants, especially when taking on roles such as pharmacy manager.

    The Inquiry Committee considered the terms of the Consent Agreement necessary to protect the public, as well as send a clear message of deterrence to the profession.


October 27, 2020
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“College”) conducted an investigation into the practice of Joshua Bruce McPherson (the “Registrant”), pursuant to section 33(4) of the Health Professions Act, R.S.B.C. 1996, c. 183.

    The Inquiry Committee and the Registrant have agreed to resolve all matters arising from the investigation by way of a Consent Agreement under section 36(1) of the Health Professions Act.

  2. Effective date: October 27, 2020

  3. Name of registrant: Joshua Bruce McPherson

  4. Location of Practice: Castlegar, BC

  5. Admissions and Acknowledgements: 

    The Registrant has admitted and/or acknowledged the following:

    1. As director of the pharmacy’s direct owner, the Registrant did not complete the “Pharmacy Closure Process” within the prescribed time frame, as instructed by the College’s Licensure Department. Specifically, the Registrant, as director, did not:

      1. Ensure patient continuity of care, by not transferring out the Pharmacy’s active prescriptions;

      2. Transfer the prescription records; and

      3. Return the pharmacy’s active inventory.
         
    2. The Registrant unlawfully operated the pharmacy (as described in section 7 of the Pharmacy Operations and Drug Scheduling Act). The Registrant operated the pharmacy premise where drugs and devices were stored without being authorized by the College to do so.

  6. The Registrant's involvement and acknowledgments:

    The Registrant entered into a Consent Agreement with the Inquiry Committee, wherein the Registrant consented to the following terms: 

    1. To not act as director for a period of two years, commencing on October 27, 2020; and

    2. To have a Letter of Reprimand placed on his registration record for two years.

  7. Rationale:

    The Inquiry Committee considered that the Registrant’s malpractice caused a significant delay in patient continuity of care by not transferring out the pharmacy’s prescriptions in a timely and efficient manner. Furthermore, the Inquiry Committee considered that the Registrant stored Schedule I, II, and III drugs in an unlicensed pharmacy premise which ultimately is a public-safety risk.

    The Inquiry Committee considered that a limit restricting the Registrant’s ability to be a director was warranted in this case, as the Registrant did not comply with the College’s requirements in closing a pharmacy.

    The Inquiry Committee considered the terms of the Consent Agreement necessary to protect the public, as well as send a clear message of deterrence to the profession. 


January 31, 2020

(Dec 14, 2020 – section 35 limits/conditions removed with new section 36 (1) limits/conditions)

Nature of Action: Pursuant to section 35(1)(a) of the Health Professions Act, R.S.B.C. 1996, c. 183 (“HPA”), effective January 31, 2020, the Inquiry Committee of the College of Pharmacists of British Columbia has made an order to impose limits and conditions on the pharmacy practice of the registrant Joshua Bruce McPherson (the “Registrant”) during the investigation into the Registrant’s practice.

In addition to restrictions placed on the Registrant’s practice on January 27, 2020 by the Inquiry Committee, the Registrant is restricted from acting as a pharmacy manager as of February 8, 2020.

The Inquiry Committee considered this action necessary to protect the public.

Note: Limits and conditions ordered by the Inquiry Committee under section 35(1)(a) of the HPA are made to protect the public during an investigation or pending a hearing of the Discipline Committee. Orders made under this section relate to matters which are and remain unproven unless admitted by a registrant or determined by the Discipline Committee.


January 27, 2020
(January 31, 2020 - Limits and conditions updated)

Nature of Action: Pursuant to section 35(1)(a) of the Health Professions Act, R.S.B.C. 1996, c. 183 (“HPA”), effective January 27, 2020, the Inquiry Committee of the College of Pharmacists of British Columbia has made an order to impose limits and conditions on the pharmacy practice of the registrant Joshua Bruce McPherson (the “Registrant”) during the investigation into the Registrant’s practice.

The Registrant will be restricted from providing any Opioid Agonist Treatment services as of February 1, 2020.

The Registrant is restricted from providing emergency prescription refills on narcotic, controlled or targeted drugs as well as zopiclone and zolpidem.

The Inquiry Committee considered this action necessary to protect the public.

Reasons: While practicing as a pharmacist, it is alleged that the Registrant did not comply with the applicable legislation and standards of practice required in order to dispense Opioid Agonist Treatment. While practicing as a pharmacist, it is alleged that the Registrant provided emergency prescription refills without exercising appropriate clinical judgement and supporting documentation.

Note: Limits and conditions ordered by the Inquiry Committee under section 35(1)(a) of the HPA are made to protect the public during an investigation or pending a hearing of the Discipline Committee. Orders made under this section relate to matters which are and remain unproven unless admitted by a registrant or determined by the Discipline Committee.

Pharmacist Registrant 47 (Dec 8, 2020)

The Inquiry Committee, pursuant to section 32.3(3)(b)(ii) of the Health Professions Act, has reached an Agreement with the pharmacist registrant to voluntarily suspend their registration as a pharmacist effective December 8, 2020. The Agreement remains in effect until further notice. The Inquiry Committee considers the Agreement necessary to protect the public. The pharmacist registrant’s name has been withheld pursuant to section 39.3(4)(a) of the Health Professions Act.

Pharmacist Registrant 46 (Nov 20, 2020)

The Inquiry Committee, pursuant to section 32.2(4)(b)(ii) of the Health Professions Act, has reached an Agreement with the pharmacist registrant to voluntarily suspend their registration as a pharmacist effective November 20, 2020. The Agreement remains in effect until further notice. The Inquiry Committee considers the Agreement necessary to protect the public. The pharmacist registrant’s name has been withheld pursuant to section 39.3(4)(a) of the Health Professions Act.

Pharmacist Registrant 22 (Nov 5, 2020)

The Inquiry Committee pursuant to section 36(1) of the Health Professions Act and after consultation with the pharmacist registrant’s physician, has reached an Agreement with the pharmacist registrant to amend some of the terms in the Agreement of June 5, 2019. The pharmacist registrant is now being medically monitored by a different medical provider.


October 22, 2019

The Inquiry Committee has approved an amendment to the June 5, 2019 Consent Agreement. The pharmacist registrant is no longer restricted from being a manager of a pharmacy.


JunE 5, 2019
(October 22, 2018 - LIMITS AND CONDITIONS UPDATED)

The Inquiry Committee, pursuant to section 36(1) of the Health Professions Act and after consultation with the pharmacist registrant’s physician, has reached an Agreement with the pharmacist registrant to amend some of the terms in the Agreement of October 12, 2018. The Registrant can now:

  • work alone in a pharmacy;
  • handle, physically prepare, and dispense prescriptions for opioid medications;
  • have access to the narcotic safe;
  • be involved with ordering narcotic medications.

October 12, 2018
(June 5, 2019 - Limits and Conditions Updated)

The Inquiry Committee has reinstated the pharmacist registrant’s registration which had previously been suspended for an indefinite period on August 13, 2015. Pursuant to Section 36(1) of the Health Professions Act, the Inquiry Committee has reached an Agreement with the pharmacist registrant whereby the pharmacist registrant consented to terms including, but not limited to, the following:

  1. To strictly adhere to the Registrant's routine medical monitoring program with the institution currently involved in the Registrant's care and remaining on the monitoring program for a period of at least 3 years;

  2. To comply with any and all recommendations and treatment prescribed or directed by medical professionals involved in the Registrant's care;

  3. To not work alone in a pharmacy, and to have another pharmacist in good standing supervising the Registrant at all times;

  4. To not handle, physically prepare, or dispense prescriptions for opioid medications at any time;

  5. To not have any access whatsoever, on or off duty, to the narcotic safe in any pharmacy;

  6. To not be involved in any way with ordering narcotic medications, except for signing off on the necessary paperwork in the presence of a witnessing pharmacy staff member for the purposes of receiving and stocking such narcotics;

  7. To inform all managers and employers with whom the Registrant gains employment of his medical condition and the limits and conditions on registration pursuant to the Agreement;

  8. To ensure that all managers and employers with whom the Registrant gains employment submits a written statement to the College declaring their awareness of the Registrant's medical condition and the Agreement, and how they will accommodate and supervise the Registrant working in the pharmacy;
     
  9. To inform the College in via e-mail of his places of employment as a pharmacist and report any changes to the location of his employment within 48 hours of such change; and

  10. To be restricted from acting in the following roles in the Registrant's practice:

    1. Be a manager of a pharmacy;
    2. Be an owner (direct or indirect) of a pharmacy; and
    3. Act as a preceptor.

     


August 13, 2015
(October 12, 2018 – Registration Reinstated)

The Inquiry Committee, pursuant to section 36 of the Health Professions Act, has reached an Agreement with the pharmacist registrant to suspend registration as a pharmacist effective August 13, 2015. The Agreement remains in effect until further notice. The Inquiry Committee considers the Agreement necessary to protect the public. The pharmacist registrant's name has been withheld pursuant to 39.3(4) of the Health Professions Act.


February 13, 2015
(AUGUST 13, 2015 - Registration Suspended)

The Inquiry Committee has reinstated pharmacist registrant’s registration which had previously been suspended for an indefinite period on August 5, 2014. Pursuant to section 36 of the Health Professions Act, the Inquiry Committee has reached an Agreement with the pharmacist registrant whereby the Registrant consented to undertakings involving regular monitoring for fitness to practice pharmacy. The undertakings include, but are not limited to:

  1. Routine and random medical monitoring;

  2. Informing all managers and employers with whom Registrant gains employment of Registrant’s medical condition and the limits and conditions on Registrant’s registration pursuant to the agreement;

  3. Ensuring that all managers and employers with whom Registrant gains employment submits a written statement to the College declaring their awareness of Registrant’s medical condition and the agreement, and how they will accommodate and supervise Registrant working in pharmacy;

  4. Registrant will not work alone in a pharmacy setting, meaning that Registrant must never be the sole pharmacist in attendance at any time and that there must be another pharmacist or pharmacy assistant or pharmacy staff working with Registrant at all times;

  5. Registrant will not have access to narcotic-safe or physically process and/or otherwise prepare any prescriptions that require access to the narcotic safe;

  6. Registrant will not be involved in any way with ordering supplies of narcotic medications;

  7. Registrant will not be involved in the dispensing, ordering, contact, destruction, counting or otherwise handling of opiate medications and other medications with abusive potential;

  8. Being restricted from the following roles in Registrant’s practice:

    1. an owner or manager of a pharmacy;
    2. a director of a corporation that owns a pharmacy; and
    3. a preceptor.

     

  9. Notifying the College of:

    1. all changes in places of employment as a pharmacist
    2. all changes in residential address and phone number; and
    3. all changes in medical provider.

     

The Agreement will remain in place for a minimum of three years of continuous pharmacy practice. The name of the Registrant has been withheld in accordance with section 39.3(4)(a) of the Health Professions Act for the purposes of not identifying the personal health information of the Registrant respecting the condition. The Inquiry Committee is satisfied that the undertakings will protect the public. 


August 5, 2014
(February 13, 2015 – Registration reinstated)

The Inquiry Committee, pursuant to section 36 of the Health Professions Act, has reached an Agreement with the pharmacist registrant to suspend registration as a pharmacist effective August 5, 2014. The Agreement remains in effect until further notice. The Inquiry Committee considers the agreement necessary to protect the public. The pharmacist registrant's name has been withheld pursuant to 39.3(4) of the Health Professions Act.

Liu, Hongwei (Liuna) (Oct 26, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“College”) conducted an investigation into the practice of Hongwei Liu (the “Registrant”), pursuant to section 33(4) of the Health Professions Act, R.S.B.C. 1996, c. 183.

    The Inquiry Committee and the Registrant have agreed to resolve all matters arising from the investigation by way of a Consent Agreement under section 36(1) of the Health Professions Act.

  2. Effective date: October 26, 2020

  3. Name of registrant: Hongwei (Liuna) Liu

  4. Location of Practice: Surrey, BC

  5. Admissions and Acknowledgements: 

    The Registrant has admitted and/or acknowledged the following:

    1. Between January 2019 and September 2019, as pharmacy manager:

      1. The Registrant and other pharmacy staff dispensed prescriptions to two patients for a quantity of seven days but processed those prescriptions once daily onto PharmaNet. This practice resulted in inadequate prescription preparation, inaccurate clinical assessments, incomplete PharmaNet checks, and false final checks, thereby breaching sections 2, 6, and 9.1 of the Health Professions Act, Bylaws, Schedule F, Part 1 – Community Pharmacy Standards of Practice (“Standards of Practice”).

      2. The Registrant and other pharmacy staff did not provide pharmacist/patient consultations for the patients involved in this matter, contrary to section 12 of the Standards of Practice.

      3. The Registrant did not maintain current PharmaNet records for the patients involved in this matter, contrary to section 35(1) of the Pharmacy Operations and Drug Scheduling Act, Bylaws.

    2. The Registrant was responsible for the overall management of the pharmacy’s practices.

    3. The Registrant provided misleading information during the investigation into the matter, including not providing truthful or accurate information.

  6. Disposition:

    The Registrant entered into a Consent Agreement with the Inquiry Committee, wherein the Registrant consented to the following terms (in part):

    1. To not be a pharmacy manager for a period of six months;

    2. To pay a $7,500.00 fine;

    3. To successfully pass the College’s Jurisprudence Exam;

    4. To successfully complete and pass an ethics course for healthcare professionals; and

    5. To have a Letter of Reprimand placed on her registration record for a period of five years.

  7. Rationale:

    The Inquiry Committee considered, that as the pharmacy’s manager, the Registrant was responsible to ensure that the pharmacy practiced pursuant to the applicable legislation and standards of pharmacy practice. As pharmacy manager, the Registrant played a significant role in allowing for false transactions to be processed onto PharmaNet, thereby creating inaccurate PharmaNet records. Additionally, the Inquiry Committee considered that during the investigation into the matter, the Registrant provided false and misleading information.

    The Inquiry Committee determined that the volume of practice deficiencies required a serious response to bring Registrant’s practice into compliance with the standards of pharmacy practice and that the dispositions were warranted as it addressed the seriousness of the Registrant’s failure to adhere to principles and standards expected of registrants, especially when taking on roles such as pharmacy manager.

    The Inquiry Committee considered the terms of the Consent Agreement necessary to protect the public, as well as send a clear message of deterrence to the profession. 

Mbamy, Joelle (Oct 26, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“CPBC”) conducted investigations into the practice of Joelle Mbamy (the “Registrant”), pursuant to section 33(4) of the Health Professions Act, R.S.B.C. 1996, c. 183 (“HPA”).  The CPBC issued a Citation on October 21, 2019, which was subsequently amended on January 29, 2020.

    Further to a proposal for resolution from the Registrant, the Inquiry Committee made a Consent Order under section 37.1 of the HPA.

  2. Effective date: October 26, 2020

  3. Name of registrant: Joelle Mbamy

  4. Location of Practice: Penticton, BC

  5. Admissions and acknowledgements:

    The Registrant has admitted and/or acknowledged the following (in part):

    The Inspection

    On November 6, 2018, the CPBC conducted an inspection of Sunrise Pharmacy (the “Inspection”) where the Registrant was acting as an owner, manager, and working pharmacist. The Inspection was conducted pursuant to a Consent Agreement the Registrant entered into with the CPBC on May 1, 2018, regarding a previous complaint and investigation.

    Contrary to Standards 1, 2, 3, 6, 7, and 9 of the Health Professions Act – Bylaws, Schedule “A” – the Code of Ethics (“Code of Ethics”), the Registrant was observed to have failed to comply with the terms of the Consent Agreement as during the Inspection, the following conduct was observed that constitutes a breach of the terms of the Consent Agreement:

    1. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics, sections 6, 9, and 9.1 of Part 1 of Schedule “F” – the Standards of Practice (the “Part 1 of the Standards of Practice”), Professional Practice Policy 66: Opioid Agonist Treatment, and Principles 2.1.1, 2.1.2, 3.1.3, 3.2.4 Professional Practice Policy 66: Policy Guide – Methadone Maintenance Treatment (2013), Ms. Mbamy was dispensing methadone or Opioid Agonist Treatment (“OAT”) without the appropriate directions or without appropriate completion of the required documentation or both
       
    2. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics, section 19(5)(a) of the CPBC’s Bylaws under PODSA (the “PODSA Bylaws”), and Professional Practice Policy 31: Emergency Prescription Refills, the Registrant was dispensing medication without a prescription, using her name as a prescriber, and in a manner that did not comply with the requirements for an emergency prescription refill;

    3. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics, section 11 of Part 1 of the Standards of Practice, and section 35 of the PODSA Bylaws, prescriptions, including prescriptions for methadone and other Schedule 1 drugs, were “backdated” such that the dispensing date entered on PharmaNet or recorded on the prescription label did not accurately reflect the date those prescriptions were dispensed; and

    4. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics, sections 18(2)(j) and 26 of the PODSA Bylaws, Professional Practice Policy-74: Community Pharmacy and Telepharmacy Security, and section 43 of the Narcotic Control Regulations, the Registrant failed to store methadone in a time-lock safe, or she stored methadone in a time-lock safe that was left open.

    In addition, during the Inspection, the following conduct was observed which constituted additional or new offences, not previously addressed in the Consent Agreement:
     
    1. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics and sections 8 and 11 of the Food and Drugs Act, R.S.C., 1985, c. F-27, the Registrant prepared an intravenous solution in an unsanitary and non-sterile environment without taking precautions to avoid contamination of the drug product and dispensed that solution to the patient’s agent;
       
    2. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics, and sections 19(2) and 20(4) of the PODSA Bylaws, expired drugs were not stored in a separate area or secured storage area within Sunrise Pharmacy;

    3. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics,  Professional Practice Policy 68: Cold Chain Management of Biologicals, and the BCCDC Communicable Disease Control Immunization Program: Section VI – Management of Biologicals, vaccines and insulin were stored in the door of a refrigerator;

    4. contrary to Standards 1(a) and (d) and 7 of the Code of Ethics, sections 9, 9.1, and 11(1) and (2) of Part 1 of the Standards of Practice, Professional Practice Policy 66: Opioid Agonist Treatment, and Principles 3.1.3, 3.2.4, and 3.2.5 of Professional Practice Policy 66: Policy Guide – Methadone Maintenance Treatment (2013), information regarding prescriptions recorded on PharmaNet was incorrect or incomplete. 

    5. contrary to Standards 1(a) and (d), and 7 of the Code of Ethics, section 19(6)(b) of the PODSA Bylaws, Principle 2.1.2, of Professional Practice Policy 66: Policy Guide – Methadone Maintenance Treatment (2013), the Registrant was selling or dispensing drugs included in the controlled prescription program (“CPP”) when the required CPP form did not contain either the signature of the dispensing pharmacist or the signature of the patient;

    6. contrary to Standards 1(a) and (d), and 7 of the Code of Ethics and Professional Practice Policy 31: Emergency Prescription Refills, emergency prescription refills were improperly provided or documented;

    7. contrary to Standards 1(a) and (d), and 7 of the Code of Ethics, sections 6(4)(g)(iv) of Part 1 of the Standards of Practice the Sunrise Pharmacy patient counselling log did not include written confirmation of who performed consultations or document when consultation was offered and declined;

    8. contrary to Standards 1 (a) and (d) and 7 of the Code of Ethics and sections 35(1), (4), (5), and (6) of the PODSA Bylaws and with respect to a specific prescription dated August 9, 2018, the PharmaNet patient record was not kept current; and

    9. contrary to Standards 1 (a) and (d), and 7 of the Code of Ethics, and section 18(2)(m) of the PODSA Bylaws, staff at Sunrise Pharmacy did not wear name badges.

    Pharmacy Security

    On March 22, 2018, the CPBC received information from the Province’s Child Death Coroner regarding the death of a minor who, at the time of his death, was an employee at Sunrise Pharmacy. The cause of death was methadone overdose.

    Upon reviewing security camera recordings from Sunrise Pharmacy, it was determined that, on September 18, 2017 and contrary to Standards 1 (a) and (d) and 7 of the Code of Ethics, sections 18(2)(j), 19(4) and 26 of the PODSA Bylaws, and Professional Practice Policy 74: Community Pharmacy and Telepharmacy Security, the minor was permitted to be in the dispensary and the compounding rooms in Sunrise Pharmacy without supervision on thirteen separate occasions for varying lengths of time.

    During these times, the minor had access to prescription medications. However, there was no evidence on the security footage to confirm that the minor obtained the methadone from the pharmacy.

    Temporary Closure of Sunrise Pharmacy

    In July 2019, the CPBC received a complaint about and conducted an investigation into the temporary closure of Sunrise Pharmacy on three consecutive Saturdays in June 2019 and found that

    1. contrary to section 25.92 of the HPA, and sections 10(1) and (2) of Part 1 of the Standards of Practice, the Registrant, without prior authorization, changed the dispensing regime of four different methadone prescriptions in order to accommodate the closure of Sunrise Pharmacy,

    2. contrary to Principle 2.2.1 of Professional Practice Policy 66: Policy Guide – Methadone Maintenance Treatment (2013), the Registrant altered a prescription and began dispensing methadone pursuant to that altered prescription and failed to obtain a corrected prescription from the physician, and

    3. contrary to section 9.1(1)(b) of Part 1 of the Standards of Practice, the Registrant dispensed Suboxone® with incorrect instructions on the label.

  6. Disposition:

    In the Consent Order under section 37.1 of the HPA, the Inquiry Committee ordered that the Registrant

    1. sign and deliver to the CPBC a letter of undertaking,

    2. be suspended for 3 months,
       
    3. subject to paragraph d below, for a period of 18 months, cannot
       
      1. dispense any narcotic or controlled drug substance intended for Opioid Agonist Treatment,
         
      2. compound any medication, or

      3. prepare or dispense any medication intended for intravenous administration.

    4. before the conditions specified in paragraph c are removed from her practice, must, at her own expense,

      1. retake and successfully complete
         
        • the BC Pharmacy Association OAT Compliance and Management Program, and

        • the BC Community Manger Training Program,

      2. successfully complete;

        • the CPEP PROBE: Ethics & Boundaries Program,

        • the UBC CPD Provincial Opioid Addiction Treatment Support Program,

        • the Critical Point, Best Practices for Nonhazardous Sterile-to-Sterile Compounding, and

      3. confirm in writing that she has

        • read “A Guideline for Clinical Management of Opioid Use Disorder” from the BC Centre on Substance Use, and

        • reviewed the YouTube videos, Ontario College of Pharmacists, “Optimizing Patient Care Series: Decision Making & Documentation – Keeping it Simple”, Parts 1 and 2,

    5. must pay a fine of $20,000 to the CPBC

    The Registrant repeatedly contravened sections of the HPA, PODSA Bylaws, Community Pharmacy Standards of Practice, and the Code of Ethics in her practice as a pharmacist, pharmacy manager, owner and director, and thereby, neglected her basic duties as a pharmacist, and committed or allowed actions that were unethical and could potentially endanger patient health. The totality of her conduct demonstrated an egregious breach of trust and undermines the integrity of the profession.

    Importantly, the Inspection was conducted only a few month after the Consent Agreement was finalized. Despite this, Ms. Mbamy was found to be in breach of several of the terms of that Consent Agreement and was noted to have engaged in further breaches of the standards applying to the practice of pharmacy. This demonstrated a disregard for the fundamentals of pharmacy practice and the CPBC’s regulatory process. More importantly, it presented a significant risk to the public.

    The Registrant’s conduct in this instance, coupled with the breach of her previous undertakings, is considered significant professional misconduct as defined in s. 26 of the HPA, and justifies serious consequences. The Inquiry Committee therefore considered it appropriate, and the Registrant agreed, that the disposition for such conduct be one that serves as a strong deterrent and sends a clear message to both the profession and the public that the CPBC cannot and will not tolerate this type of conduct under any circumstances.


May 23, 2019
(October 26, 2020 - Citation cancelled)

 

Pursuant to section 35(1)(a) of the Health Professions Act, R.S.B.C. 1996, c. 183 (“HPA”), effective May 23, 2019, the Inquiry Committee of the College of Pharmacists of British Columbia has made an order to impose limits and conditions on the pharmacy practice of the registrant Joelle Mbamy (the “Registrant”) pending a hearing of the Discipline Committee.

The Registrant will be restricted from dispensing any narcotic or controlled drug substance intended for Opioid Agonist Treatment. This limit and condition will become effective on June 7, 2019 to allow sufficient time to transition patients to another pharmacy.

The Registrant will be restricted from compounding any medication and preparing or dispensing any medication intended for intravenous administration.

The Inquiry Committee considered this action necessary to protect the public.

While practicing as a pharmacist, the Registrant is alleged to have shown a continuing pattern of providing Opioid Agonist Treatment without abiding by the legislative requirements. While practicing as a pharmacist, the Registrant is alleged to have prepared and dispensed intravenous drug product under unsanitary conditions.

Note: Limits and conditions ordered by the Inquiry Committee under section 35(1)(a) of the HPA are made to protect the public during an investigation or pending a hearing of the Discipline Committee. Orders made under this section relate to matters which are and remain unproven unless admitted by a registrant or determined by the Discipline Committee.

Citation

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