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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.

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.

Tam, Sing Man (Oct 28, 2020)

Pursuant to Section 36(1) of the Health Professions Act, the Inquiry Committee has reached a Consent Agreement with Sing Man Tam (the “Registrant”), effective October 8, 2020, where the Registrant consented to:

  1. To not act as pharmacy manager until he successfully completes the College’s Jurisprudence Exam.

The Inquiry Committee considered the terms of the Consent Agreement necessary to protect the public.


May 27, 2019
(October 8, 2020 - Limits and Conditions Updated)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (the “College”) conducted an investigation into the practice of Sing Man Tam (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: May 27, 2019

  3. Name of registrant: Sing Man Tam​

  4. Admissions and Acknowledgements:

    On October 13, 2015, the College received correspondence from the BC Ministry of Health regarding potential pharmacy practice concerns at the Pharmacy, arising from a PharmaCare Audit of the Pharmacy that covered the time period between September 1, 2012 and August 31, 2014 (the “Audit Period”).  Further to the College’s investigation of those practice concerns, the Registrant acknowledged

    1. prescriptions were missing date or quantity to dispense,

    2. prescriptions were filled under the incorrect prescriber,
       
    3. a prescription was dispensed for the wrong dose,

    4. prescriptions were written by the prescriber as daily witness ingestion but were processed under the Drug Identification Number (“DIN”) for methadone given without direct interaction
       
    5. a prescription was written by the physician for daily witness ingestion but was processed under the DIN for delivery of methadone, without authorization,

    6. medication reviews were submitted to PharmaNet that did not have any supporting documentation,

    7. prescriptions for Hepatitis C medications were not submitted to PharmaNet on the day of claimed dispense,
       
    8. prescriptions were written by the physician as daily dispense, but were filled and submitted to PharmaNet as a 7 days’ supply, with no documentation of a prescriber’s authorization to do so,

    9. a prescription was filled as a verbal authorization with incomplete documentation,

    10. a methadone prescription was billed on a day marked as “missed” on the ingestion logs,

    11. a prescription adaptation was conducted without adequate documentation,

    12. a methadone prescription did not have a part fill accountability log, and

    13. a methadone prescription was provided as delivery without prescriber authorization.

  5. Disposition:

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

    1. having a Letter of Reprimand placed permanently on his registration record;

    2. payment of a fine in the amount of $10,000;
       
    3. an undertaking to:

       

      1. not repeat the conduct to which this matter relates,
         
      2. thoroughly review and read legislation, standards and policies relevant to the conduct to which this matter relates, and thereafter submit a Declaration of Understanding regarding the legislation, standards and policies reviewed and read,
         
      3. complete the BC Pharmacy Manager Training Course as well as coursework relating to opioid agonist therapy,
         
      4. successfully complete the College’s Jurisprudence Exam,
         
      5. at all times prior to completing the BC Pharmacy Manager Training Course and successfully completing the College’s Jurisprudence Exam only provide the services of a pharmacist when a least one other full pharmacist registrant is present with him in the pharmacy, and
         
      6. at all times after delivering the Declaration of Understanding, completing the BC Pharmacy Manager Training Course and coursework relating to methadone maintenance treatment, and successfully completing the College’s Jurisprudence Exam, be knowledgeable of and abide by all legislation and policy governing the practice of pharmacy.
  6. Rationale:

    The Inquiry Committee considered that in this case, the cumulative weight of the practice deficiencies demonstrated inadequate diligence and oversight in the Registrant’s practice, noting that many of the substantiated practice deficiencies were substantive, and not simply administrative. Accurate record keeping and documentation are fundamental to providing safe pharmaceutical care. Therefore, the Committee considered the Registrant’s conduct to be serious, and that the Registrant required both remediation and deterrence in order to come into compliance. 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.

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. 

Thiara, Kuljeet Singh (Oct 19, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“College”) conducted an investigation into the practice of Kuljeet Singh Thiara (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 19, 2020

  3. Name of registrant: Kuljeet Singh Thiara

  4. Location of Practice: Abbotsford, BC

  5. Admissions and Acknowledgements: 

    The Registrant has admitted and/or acknowledged the following:

    1. As a pharmacy manager, the Registrant was responsible, pursuant to section 18(2)(b) of Pharmacy Operations and Drug Scheduling Act Bylaws, for ensuring compliance with all legislation, bylaws, policies and procedures applicable to the operation of a pharmacy.

    2. On January 30, 2020, at the pharmacy where the Registrant had been manager, pharmacy staff incorrectly identified a patient and dispensed incorrect prescriptions.

      The incident was the fourth time in a period of fourteen months, and the sixth time that the Registrant’s practice as a pharmacy manager was the subject of an Inquiry Committee matter. The Registrant had previously signed Consent Agreements to remediate similar practice concerns. For these Consent Agreements, he had consented to undertakings to take steps to prevent recurrences of similar incidents.

  6. The Registrant's involvement and acknowledgments:

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

    1. To not act as a pharmacy manager for a period of one (1) year from October 19, 2020 to October 19, 2021. Prior to applying to act in the role of a pharmacy manager, he must successfully complete the BC Community Pharmacy Manager Training Program provided by the British Columbia Pharmacy Association.

    2. To pay a $7,500.00 fine.

  7. Rationale:

    The Inquiry Committee determined that on multiple instances, the Registrant failed to comply with terms of his previous Consent Agreements and there had been recurring incidents of similar nature. On multiple instances, the Registrant failed to meet his legislative responsibilities as a pharmacy manager pursuant to the Pharmacy Operations and Drug Scheduling Act Bylaws.

    The Inquiry Committee determined that the Registrant required serious remediation and deterrence in order to come into compliance with his responsibilities as a pharmacy manager. The Inquiry Committee considered the terms of the Consent Agreement appropriate to protect the public and resolve the matter.

Jiwan, Shirin (Oct 9, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“CPBC”) conducted an investigation into the practice of Shirin Jiwan (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 9, 2020

  3. Name of registrant: Shirin Jiwan

  4. Location of Practice: Burnaby, BC

  5. Admissions and acknowledgements:

    The Registrant has admitted and/or acknowledged the following:

    1. On or about September 19, 2016, while she was the director and owner of the Pharmacy:
      1. She directed a pharmacy staff member to remove patient personal health information from the Pharmacy for delivery to her residence;

      2. She directed a non-registrant, to assist her to forge patient signatures on Medication Review Forms;

      3. She knowingly submitted forged Medication Review Forms to PharmaCare inspectors for the purposes of a PharmaCare Audit.

  6. Disposition:

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

    1. To suspend her registration as a pharmacist for 90 days commencing October 9, 2020.

    2. To not be a pharmacy manager, director of a pharmacy, and preceptor for a period of one year from the date that her suspension ends;
       
    3. To pay a $5, 000.00 fine;
       
    4. To successfully complete and pass an ethics course for healthcare professionals within one year

    5. To appear before the Inquiry Committee for a verbal reprimand

    6. To have a Letter of Reprimand placed permanently on her registration record; and

    7. To make every reasonable effort to notify patients affected by the privacy breach.

  7. Rationale:

    The Registrant’s conduct was considered to be a serious matter by the Inquiry Committee. The Registrant contravened standards of the Code of Ethics involving benefiting society, committing to personal and professional integrity, and participating in ethical business practices.

    The Registrant’s actions were serious, intentional and demonstrated an egregious breach of trust. 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. 

Liang, Henry Yu Qu (Sep 24, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (the “College”) conducted an investigation into the practice of Henry Yu Qi Liang (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: September 24, 2020

  3. Name of registrant: Henry Yu Qu Liang

  4. Location of Practice: Vancouver, BC

  5. The College’s Investigation:

    Multiple registrants were involved in this matter.

    The College’s investigation found that between January 2012 and June 2018, over 20,000 false transactions were processed on patient PharmaNet records at two pharmacies where the Registrant had worked as a staff pharmacist. These transactions were considered false because:

    • Schedule I (prescription) medications associated with these transactions had not been authorized or prescribed by the prescriber associated with each transaction;
    • Medications associated with these transactions, which included Schedule I, Over-The-Counter (“OTC") medications and vitamins, were not actually dispensed to the “patient” in each case;
    • Transactions were processed as one-day supplies or seven-day supplies, for the sole purpose of artificially inflating prescription counts; and
    • Transactions were processed not for the purpose of providing health care and were not processed with each patient’s voluntary consent;
       

    The College’s investigation also found that during the same time period, over 10,000 transactions were processed on patient PharmaNet records for medications that were actually authorized but processed as one-day supplies or seven-day supplies when there was no clinical indication to do so. The medications for these transactions were not actually dispensed to the patient on a daily or weekly basis, making each patient’s PharmaNet records inaccurate and not current. These transactions were processed in this manner for the sole purpose of artificially inflating prescription counts.

    The “patients” whose PharmaNet records were affected were all either current or former employees of the two pharmacies, or family members of former employees of the two pharmacies. Reportedly, the owner of the two pharmacies had directed for transactions to be processed in the above manner in order to artificially inflate prescription counts at both pharmacies.

  6. The Registrant's involvement and acknowledgments:
    Regarding the Registrant’s involvement in this matter, the Inquiry Committee considered it substantiated, and the Registrant has acknowledged, that:

    1. He processed false transactions for Schedule I and OTC/vitamin medications on the PharmaNet records of his colleagues;

    2. He processed one-day supply transactions for Schedule I and OTC/vitamin medications on the PharmaNet records of his colleague’s family members, where these medications were not actually dispensed to the patient on a daily basis, making the patient’s PharmaNet records inaccurate and not current; were all processed as one-day supplies for the sole purpose of artificially inflating prescription counts; and were not clinically indicated to be dispensed on a daily basis;

    3. He backdated PharmaNet transactions, meaning that the transaction records were created on a date later than the date that appears on PharmaNet;

    4. He billed the false and inaccurate transactions described above to PharmaCare and/or third-party insurance plans, when he knew these to be false or misleading claims;

    5. He inappropriately used personal health information and created inaccurate PharmaNet records, placing his colleagues and his colleagues’ family members at risk of harm, in case their PharmaNet records ever needed to be accessed for legitimate medical reasons; and

    6. He failed to report to the College or to another person of authority regarding the improper practices occurring at the pharmacies, even though he knew that these practices were improper.

  7. Disposition:

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

    1. To successfully complete and pass an ethics course for healthcare professionals within two years. If he fails to complete this within the specified time period, his registration will be suspended for a period of 60 days;

    2. To appear before the Inquiry Committee for a verbal reprimand;
       
    3. To have a letter of reprimand placed permanently on the College register;
       
    4. To not be a pharmacy manager and/or a preceptor for pharmacy students for a period of 180 days (September 24, 2020 to March 23, 2021);

    5. To pay a $1000.00 fine;

    6. To successfully pass the College’s Jurisprudence Exam; and

    7. To successfully complete and pass the “BC Community Pharmacy Manager Training Program” offered by the British Columbia Pharmacy Association.

  8. Rationale:

    The Registrant’s actions were considered serious contraventions of legislation involving pharmacy practice standards and the appropriate access, use and protection of personal health information and PharmaNet records. His misconduct placed others at risk of harm. The Registrant also contravened standards of the Code of Ethics involving protecting and promoting the well-being of patients, benefitting society, committing to personal and professional integrity, and participating in ethical business practices.

    In determining an appropriate disposition for the Registrant, the Inquiry Committee considered the Registrant’s report of feeling pressured by his employer (the pharmacy owner) to commit these actions, and that he personally did not stand to gain financially from what occurred.

    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. Inappropriate access and use of personal health information compromises the public’s trust in the pharmacy profession as a whole. At all times, registrants must uphold legislative requirements and ethical obligations to appropriately access, use and protect personal health information.

Ali, Mir Rashid (Sep 21, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“CPBC”) conducted investigations into the practice of Mir Rashid Ali (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 February 24, 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: September 21, 2020

  3. Name of registrant: Mir Rashid Ali

  4. Location of Practice: Vancouver and Surrey, BC

  5. Admissions and Acknowledgements:

    The College organized and conducted undercover investigations into three pharmacies where the Registrant was involved as an owner, manager, and working pharmacist.

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

    1. In the course of the undercover investigations organized by the CPBC, the Registrant
       
      1. upon request, agreed to provide undercover investigators with cash as an incentive to continue delivering his prescriptions to one of the pharmacies the Registrant owned and where he was the manager and working as a pharmacist, and advised the investigator how to daily dispense from a prescriber so that the investigator could be paid more cash as an incentive to continue delivering his prescriptions to the pharmacy, contrary to Standards 1, 2, 6, 7, and 9 of the Code of Ethics, section 15 of the Standards of Practice, and what was then section 3(2)(aa) and is now section 18(2)(z) of the PODSA Bylaws,

      2. on multiple occasions, provided cash to two undercover investigators acting as patients as an incentive for them to continue delivering their prescriptions for dispensing at pharmacies the Registrant owned and where he was the manager and working as a pharmacist, contrary to Standards 1 (a) and (d), 2, 6, 7, and 9 of the HPA, Bylaws Schedule A – Code of Ethics (the “Code of Ethics”), section 15 of the HPA, Bylaws Schedule F, Part I – Community Pharmacy Standards of Practice (the “Standards of Practice”), what was then section 3(2)(z) and is now section 18(2)(aa) of the Pharmacy Operations and Drug Scheduling Act – Bylaws (the “PODSA Bylaws”),

      3. met with one of the undercover investigators in a car outside one of the pharmacies the Registrant owned and where he was the manager and working as a pharmacist, and provided the investigator with a four-day supply of medication all together, despite those medications having been processed daily on PharmaNet and despite the prescription for those medications directing that they be dispensed daily, and without reviewing PharmaNet or conducting an adequate consultation prior to dispensing, contrary to Standards 1(a) and (d), 2, 6, 7, and 9 of the Code of Ethics, section 11 and 12 of the Standards of Practice, section 25.92 of the HPA, and what was then section 21(1) and is now section 35(1) of the PODSA Bylaws,

      4. on two separate occasions, advised one of undercover investigators on how to have medications dispensed contrary to legislative standards, specifically how to get three identical prescriptions, all with the same date, dispensed and how to get dispensed medications that previously been processed on PharmaNet but not picked up, contrary to Standards 1, 6, 7, and 9 of the Code of Ethics,

      5. on multiple occasions, provided one of the undercover investigators with a seven-day supply of medications all together, despite the medications being processed daily on PharmaNet and despite the prescription directing that the medication be dispensed daily, and in doing so, failed to accurately record the dispensing of the medication on PharmaNet and conduct the required patient consultations, contrary to Standards 1(a) and (d), 2, 6, 7, and 9 of the Code of Ethics, sections 11 and 12 of the Standards of Practice, section 25.92 of the HPA, and what was then section 21(1) and is now 35(1) of the PODSA Bylaws,

      6. on multiple occasions, dispensed unauthorized quantities of methadone to one of the undercover investigators contrary to Standards 1(a) and (d), 2, 6, 7, and 9 of the Code of Ethics, sections 6(4), 9 and 9.1(1) of the Standards of Practice, section 25, 92 of the HPA, section 9 of PODSA, what was then section 4(5) and (6) and is now section 19(5) and (6) of the PODSA Bylaws, and Principle 4.1.6 of Professional Practice Policy #66, Policy Guide, Methadone Maintenance Treatment (2013), and contrary to previous consent agreements and undertakings to the CPBC.

    2. The Registrant operated or permitted the operation of a pharmacy for one day when not authorized under bylaw or by a pharmacy licence contrary to Standards 1(a) and (d), 2 and 6 of the Code of Ethics and sections 7(1), (2), and (3) of PODSA.
       
  6. Disposition:
    In the Consent Order under section 37.1 of the HPA, the Inquiry Committee ordered that Mr. Ali

    1. receive a written reprimand,

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

    3. is suspended for 18 months (September 21, 2020 to March 21, 2022),

    4. must pay the CPBC a fine in the amount of $20,000,

    5. must not act as owner, manager or shareholder of a pharmacy for a period of 5 years commencing the date the suspension is complete,

    6. after the suspension is complete, upon return to active practice, must practice for a period of 3 months under the supervision of a pharmacist in good standing with the College, and

    7. must successfully complete the following course work at his own cost:
       
      1. Opioid Agonist Treatment Compliance and Management Program for Pharmacy – offered by BC Pharmacy Association;
         
      2. BC Community Pharmacy Manager Training Program – offered by the BC Pharmacy Association;
         
      3. the Therapeutics and Patient Dialogue Skills modules from the University of British Columbia’s Canadian Pharmacy Practice Program;
         
  7. Rationale:

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

    After receiving notification of the undercover investigations, the Registrant took responsibility for his mistakes and did not seek to minimize the seriousness of his conduct. The Registrant did advise the CPBC that he provided cash incentives in order to compete with other pharmacies and also out of fear, as he was assaulted by a patient for refusing to pay incentives.  The Registrant agreed, however, that there was no excuse for his conduct.

    The Registrant’s contrition and cooperation with the CPBC in this proceeding were mitigating factors in this case but did not change the serious nature of his conduct.

    At the time of the undercover investigation, the Registrant had been a pharmacist in BC for 6 years. He knew, or ought to have known, that a pharmacist must perform the minimum standard of care with every patient, regardless of any systemic issues, competition from other pharmacies, or pressure from patients. The Registrant had agreed to be reprimanded and sanctioned for two previous complaints. That prior history and his pattern of repeated misconduct were the main aggravating factors in this case.

    The Registrant’s conduct in this instance, coupled with the breach of his 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 College cannot and will not tolerate this type of conduct under any circumstances.

Phu, Jenny (Sep 8, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (the “College”) conducted an investigation into the practice of Jenny Phu (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: September 8, 2020

  3. Name of registrant: Jenny Phu

  4. Location of Practice: Richmond, BC

  5. The College’s Investigation:

    Multiple registrants were involved in this matter.

    The College’s investigation found that between January 2012 and June 2018, over 20,000 false transactions were processed on patient PharmaNet records at two pharmacies, where the Registrant had worked at both pharmacies as a pharmacist and as pharmacy manager at one of the pharmacies.

    These transactions were considered false because:

    • Schedule I (prescription) medications associated with these transactions had not been authorized or prescribed by the prescriber associated with each transaction;
    • Medications associated with these transactions, which included Schedule I, Over-The-Counter (“OTC) medications and vitamins, were not actually dispensed to the “patient” in each case;
    • Transactions were processed as one-day supplies or seven-day supplies, for the sole purpose of artificially inflating prescription counts; and
    • Transactions were processed not for the purpose of providing health care and were not processed with each patient’s voluntary consent.
       

    The College’s investigation also found that during the same time period, over 10,000 transactions were processed on patient PharmaNet records for medications that were actually authorized but processed as one-day supplies or seven-day supplies when there was no clinical indication to do so. The medications for these transactions were not actually dispensed to the patient on a daily or weekly basis, making each patient’s PharmaNet records inaccurate and not current. These transactions were processed in this manner for the sole purpose of artificially inflating prescription counts.

    The “patients” whose PharmaNet records were affected were all either current or former employees of the two pharmacies, or family members of former employees of the two pharmacies. Reportedly, the owner of the two pharmacies had directed for transactions to be processed in the above manner in order to artificially inflate prescription counts at both pharmacies.

  6. The Registrant's involvement and acknowledgments:

    Regarding the Registrant’s involvement in this matter, the Inquiry Committee considered it substantiated, and the Registrant has acknowledged, that:

    1. She processed false transactions for Schedule I and OTC/vitamin medications on her own PharmaNet record and on the PharmaNet records of her colleagues;

    2. She backdated PharmaNet transactions, meaning that the transaction records were created on a date later than the date that appears on PharmaNet;

    3. She billed the false and inaccurate transactions described above to PharmaCare and/or third-party insurance plans, when she knew these to be false or misleading claims;

    4. She processed medications on PharmaNet for herself;

    5. She inappropriately used personal health information and created inaccurate PharmaNet records, placing herself and her colleagues at risk of harm, in case their PharmaNet records ever needed to be accessed for legitimate medical reasons;

    6. She failed to report to the College or to another person of authority regarding the improper practices occurring at the two pharmacies, even though she knew that these practices were improper; and

    7. As a pharmacy manager, she enabled the false transactions on patient PharmaNet records, prioritized meeting quotas and targets over patient safety and compliance with legislation and did not set or enforce policies and procedures in the pharmacy to ensure compliance with practice standards.

  7. Disposition:

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

    1. To successfully complete and pass an ethics course for healthcare professionals within two years. If she fails to complete this within the specified time period, her registration will be suspended for a period of 60 days;

    2. To appear before the Inquiry Committee for a verbal reprimand;
       
    3. To have a letter of reprimand placed permanently on the College register;
       
    4. To not be a pharmacy manager and/or a preceptor for pharmacy students for a period of one year from September 8, 2020 to September 8, 2021;

    5. To pay a $3000.00 fine;

    6. To successfully pass the College’s Jurisprudence Exam; and

    7. To successfully complete and pass the “BC Community Pharmacy Manager Training Program” offered by the British Columbia Pharmacy Association.

  8. Rationale:

    The Registrant’s actions were considered serious contraventions of legislation involving pharmacy practice standards, the appropriate access, use and protection of personal health information and PharmaNet records, and her role as a pharmacy manager. Her misconduct placed herself and others at risk of harm. The Registrant also contravened standards of the Code of Ethics involving protecting and promoting the well-being of patients, benefitting society, committing to personal and professional integrity, participating in ethical business practices, and conflicts of interest.

    In determining an appropriate disposition for the Registrant, the Inquiry Committee considered the Registrant’s report of feeling pressured by her employer (the pharmacy owner) to commit these actions, and that she personally did not stand to gain financially from what occurred.

    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. Inappropriate access and use of personal health information compromises the public’s trust in the pharmacy profession as a whole. At all times, registrants must uphold legislative requirements and ethical obligations to appropriately access, use and protect personal health information.

Sobool, Dayton Cliff (Aug 31, 2020)
  1. Nature of Action: The Inquiry Committee of the College of Pharmacists of British Columbia (“CPBC”) conducted an investigation into a complaint (the “Complaint”) about the practice of Dayton Sobool (the “Registrant”), pursuant to section 33(1) of the Health Professions Act, R.S.B.C. 1996, c. 183 (“HPA”). The CPBC issued a Citation on February 24, 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: August 31, 2020

  3. Name of registrant: Dayton Cliff Sobool 

  4. Location of Practice: Ashcroft, BC

  5. Admissions and acknowledgements:

    The Registrant admitted and/or acknowledged the following:

    1. on 7 separate occasions between September 2, 2016 and February 14, 2017 the Registrant provided, dispensed or sold narcotics included in the controlled prescription program without first obtaining a valid written prescription contrary to Standards 1(d) and 7(d) of the HPA Bylaws Schedule A – Code of Ethics (the “Code of Ethics”), section 6(4) of the HPA Bylaws Schedule F, Part I – Community Pharmacy Standards of Practice (the “Standards of Practice”), what was then section 4(5)(a) and is now section 19(5)(a) and what was then section 4(6) and is now section 19(6) of the Pharmacy Operations and Drug Scheduling Act – Bylaws (the “PODSA Bylaws”), and sections 31 Narcotic Control Regulations, C.R.C., c. 1041; and
       
    2. on 3 separate occasions between September 14, 2016 and January 3, 2017 the Registrant dispensed medications that are included in Schedule I of the Drug Schedules Regulation, B.C. Reg. 9/98, without first obtaining a valid prescription or making a written record of a verbal authorization contrary to Standards 1(d) and 7(d) of the Code of Ethics, sections 6(4) and 6(7) of the Standards of Practice, and what was then section 4(5)(a) and is now section 19(5)(a) of the PODSA Bylaws.
       
  6. Disposition:

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

    1. receive a written reprimand,

    2. sign and deliver to the College a letter of undertaking,
       
    3. be suspended for 4 weeks (August 31, 2020 to September 28, 2020),
       
    4. must pay to the CPBC:

      1. a fine of $1,000, and
      2. costs of $2,000,
         
    5. review the following legislation:

      1. Pharmacy Operations and Drug Scheduling Act;
      2. Pharmacy Operations and Drug Scheduling Act – Bylaws;
      3. Health Professions Act – Bylaws, Schedule F, Part I – Community Pharmacy Standards of Practice;
      4. Health Professions Act – Bylaws, Schedule A – Code of Ethics.
         
  7. Rationale:

    This was the second instance where the Registrant was found to have dispensed medication, including narcotics, without a written prescription. The Registrant previously provided an undertaking to the CPBC not to repeat the conduct and so these further violations were also in breach of that undertaking.

    The Inquiry Committee considered this prior history to be a significant aggravating factor in this case.

    The Registrant’s conduct in this instance, coupled with the breach of a previous undertaking that pertained to that conduct, is consider significant professional misconduct as defined in s.26 of the HPA and justifies a serious penalty. The Inquiry Committee therefore considered it appropriate that the disposition be one that serves as a strong deterrent and sends a clear message to both the profession and the public that the College does not tolerate this type of conduct.

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