The Background
The Pharmacist’s dispensing came to the notice of the Department of Health in October 2018 when it was identified, through the SafeScript database, that from March 2015 to October 2018 she had supplied 52,368 tablets of codeine-containing analgesics by way of 167 prescriptions (an average of 39 tablets per day). During interview with the Department, she acknowledged that once the evidence was placed before her it was apparent that the scripts had been altered. In a number of cases, where a script had been written by the doctor for an antibiotic, it had then been tampered with by the addition, in another person’s handwriting (attempting to mimic the doctor’s handwriting) the words ‘Panadeine Forte’ and/or ‘Valium’. On multiple occasions the Pharmacist also dispensed repeats of the scripts which had not been authorised by the prescribing doctor.
In 2019, 457 charges were issued by the Department against the Pharmacist under the Drugs Poisons and Controlled Substances Act 1981 (the Drugs Act) and the Drugs Poisons and Control Substances Regulations 2006 and 2017. The Pharmacist pleaded guilty and was fined $100,000 and ordered to pay $10,708 costs.
The Outcome
Disciplinary proceedings were subsequently pursued by the Pharmacy Board of Australia. In considering the matter the Tribunal commented on the role of a pharmacist, identifying that:
“Pharmacists play a vital role in the provision of healthcare to the community, and in protecting public health. Concerning prescribing, their role is much more than just dispensing drugs according to each script presented to them.
They do not just take scripts at face value. Pharmacists exercise independent critical judgment as to whether there might be anything about a particular script which could lead to harm to the patient, or the community. They also provide a further layer of protection in case a doctor has mistakenly or incorrectly prescribed medication.
Pharmacists have a gatekeeper role. They keep a vigilant eye out for drug seeking behaviour. They scrutinise scripts to check they have not been forged or altered. They consider whether the types and quantities of drugs sought raise suspicion. They alert the Department of Health… where they have concerns.”
It was found that her conduct was substantially below the standard reasonably expected of a pharmacist of any level of training or experience, let alone one who had been first registered 17 years earlier. In addition, it was inconsistent with her being a fit and proper person to hold registration.
The Implications
The Tribunal’s comments in this matter confirm that a pharmacist is required to critically review each script presented to them to ensure the script is clinically appropriate for the patient, and that the dispensing is consistent with the safety of the patient. A failure to do so will be considered to be a serious breach of the Code of Conduct and Code of Ethics which regulate their practice and also unlawful, giving rise to criminal charges.
To read the full decision in Pharmacy Board of Australia v Tran [2021] VCAT 1249, click here.
