Discipline Decisions (Fall 2018)

• He failed to report to the College within a reasonable time that he had been charged with a criminal offence (having care and control of a motor vehicle while “over 80”, contrary to section 253(1)(b) of the Criminal Code) on November 5, 2011, and/or that he had been convicted of that offence on April 16, 2015;
• On his annual renewal forms submitted in 2012, 2013, 2014, 2015, and/or 2016, he falsely answered “no” to the question asking whether he had been charged with or convicted of an offence in any jurisdiction

In particular, the Panel found that he

• Contravened a term, condition or limitation imposed on his certificate of registration by O. Reg. 202/94 under the Pharmacy Act, 1991
• Signed or issued, in his professional capacity, a document that he knew contained a false or misleading statement
• Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members of the profession as unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand
2. That the Registrar is directed to impose specified terms, conditions or limitations on the Member’s Certificate of Registration, and in particular:

a. that the Member must successfully complete, within twelve (12) months of the date that this Order is imposed, a course with Gail E. Siskind Consulting Services, or another professional ethics consultant acceptable to the College, to be designed by the consultant, with the purpose of addressing the professional misconduct issues raised in this case, and the following terms shall apply to that course:

i. the number of sessions shall be at the discretion of the consultant;

ii. the manner of attendance at the session(s) (e.g. in person, via Skype, etc.) is a matter to be discussed in advance between the Member and the consultant, but shall ultimately be at the discretion of the consultant;

iii. the Member shall be responsible for the cost of the course; and

iv. the consultant shall agree to confirm to the College once the Member has completed the course to the satisfaction of the consultant.

3. That the Registrar suspend the Member’s Certificate of Registration for a period of two months, with one month of the suspension to be remitted on condition that the Member complete the remedial training as specified in paragraph 2.

4. Costs to the College in the amount of $3,500.00

In its reprimand, the Panel noted that, as a pharmacist registered with the College, there are obligations that must be followed. The fact that the Member did not truthfully report the charges pending against him on five consecutive annual renewal forms indicates that he did not uphold these obligations.

The Panel observed that, as a self-regulated profession, the mandatory self-reporting requirements of Ontario College of Pharmacists rely heavily on the honour system. Any violation of that premise is of significant concern to the College, the profession, and the public.

The Panel indicated that it is the members’ responsibility to truthfully and accurately report to the College, in a timely manner, any charge or conviction arising in any jurisdiction relating to any offence.

The Panel expressed its trust that, as a member of this college, the Member realizes the importance of this responsibility, that he will uphold the standards of the profession with honour and integrity, and that will not appear before a panel of the Discipline Committee again.

• He was found guilty of theft under five thousand dollars, which is an offence contrary to section 334(b) of the Criminal Code
• He misappropriated drugs while working as a pharmacist, including but not limited to [Drug X] on or about June 21, 2015

In particular, the Panel found that he

• Was found guilty of an offence that is relevant to his suitability to practise
• Failed to maintain a standard of practice of the profession
• Practised the profession while his ability to do so was impaired by drugs
• Dispensed or sold drugs for an improper purpose
• Contravened the Act, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, or the regulations under those Acts
• Contravened a federal or provincial law or municipal by-law with respect to the distribution, sale or dispensing of any drug or mixture of drugs, in particular but not limited to the Food and Drug Regulations, C.R.C., c. 870, as amended, section 4 of the Controlled Drugs and Substances Act, S.C. 1996, c. 19, as amended, and section 31 of the Narcotic Control Regulations, C.R.C., c. 1041, as amended
• Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable and unprofessional

At the same hearing, the Panel also made findings of professional misconduct against Mr. Ramsammy with respect to the following:

• He engaged in the practice of pharmacy and worked in a pharmacy from June through August 2016, in breach of the restrictions on his certificate of registration that he agreed to in his undertaking to the College dated June 1, 2016
• He failed to advise the pharmacy that his certificate of registration had been restricted such that he was not entitled to engage in the practice of pharmacy or to work in a pharmacy in any capacity whatsoever after June 1, 2016

In particular, the Panel found that he

• Contravened a term, condition or limitation imposed on his certificate of registration
• Engaged in conduct or performed an act or acts relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable and unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand before a Panel of the Discipline Committee;
2. An Order directing the Registrar to revoke Mr. Ramsammy’s certificate of registration; and
3. Costs to the College in the amount of $1,500.00.

In its reprimand, the Panel expressed that it was deeply troubled by the facts presented. The Panel indicated that it was clear that Mr. Ramsammy’s conduct demonstrates that he is ungovernable.

The Panel related that Mr. Ramsammy showed utter disregard for the high standards of the pharmacy profession. He deliberately breached the Discipline Committee’s Order and the Undertaking he gave, putting the public at great risk.

The Panel pointed out that Mr. Ramsammy jeopardized not only the public trust in pharmacy professionals, but also the public confidence in the profession’s ability to effectively regulate its members.

The panel expressed its satisfaction that the safety of all Ontarians will best be protected by stripping Mr. Ramsammy of his privilege to practice pharmacy and revoking his certificate of registration.

• That she misappropriated from the hospital pharmacy certain identified narcotics that had not been prescribed for her, in or about March to June, 2016
• That she did not properly document the return and destruction of Codeine Contin 100mg (9 tablets), on or about June 3, 2016, having received those narcotics back from a nursing unit but failing to enter the narcotics back into the count before destruction.

In particular, the Panel found that she

• Failed to maintain a standard of practice of the profession
• Dispensed or sold drugs for an improper purpose
• Failed to keep records as required respecting her patients
• Contravened the Act, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, or the regulations under those Acts, and in particular, section 155 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H.4, as amended
• Contravened a federal or provincial law or municipal by-law with respect to the distribution, sale or dispensing of any drug or mixture of drugs, and in particular, sections C.01.041 and/or G.03.002 of the Food and Drug Regulations, C.R.C., c. 870, as amended; section 4 of the Controlled Drugs and Substances Act, S.C. 1996, c. 19, as amended; and/or section 31 of the Narcotic Control Regulations, C.R.C., c.1041, as amended
• Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as dishonourable and unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand
2. Directing the Registrar to impose specified terms, conditions or limitations on the Member’s certificate of registration requiring that:

(a) the Member successfully complete, within six (6) months of the date of the order, a course with Gail E. Siskind Consulting Services, or another professional ethics consultant chosen by the College, to be designed by the consultant, regarding the issues raised by the facts and findings of professional misconduct in this case, including the professional and ethical obligations to account for narcotics and maintain accurate records; and the following terms shall apply to the course:

(i) the number of sessions shall be at the discretion of the consultant, but shall be a minimum of two (2) meetings;

(ii) the manner of attendance at the session(s) (e.g. in person, via Skype, etc.) is a matter to be discussed in advance between the Member and the consultant, but shall ultimately be at the discretion of the consultant;

(iii) the Member shall be responsible for the cost of the course;

(iv) the Member shall provide to the consultant the following documents, in advance of the course, to facilitate the design of the course:

• the Notice of Hearing;
• the Agreed Statement of Facts;
• this Joint Submission on Order; and
• the Panel’s Decision and Reasons, if and when available; and

(v) the Member will request a report from the consultant confirming that the Member has completed the course to the satisfaction of the consultant, and the Member will provide a copy of the report to the College within six (6) months of the date of this Order; and

(b) the Member shall provide notification to all her employers in pharmacy regarding the disposition of this discipline proceeding, for a period of two (2) years from the date of this Order, on the following terms:

(i) the Member shall notify the College in writing of the name, address, and telephone number of any current or future employer, within fourteen (14) days of resuming any current employment or commencing any future employment in pharmacy;

(ii) the Member shall provide her employer(s) in pharmacy with a copy of the Agreed Statement of Facts and this Joint Submission on Order, or the Decision and Reasons of the Discipline Committee in this matter, including this Order (when available), prior to resuming any current employment or commencing any future employment in pharmacy; and

(iii) the Member shall only engage in the practice of pharmacy for an employer who agrees to advise the College in writing, within fourteen (14) days of the Member resuming any current employment or commencing any new employment with the employer, confirming that the Designated Manager of the employer’s pharmacy has received a copy of the documents set out in paragraph 2(b)(ii) above.

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of five (5) months, with one (1) month of the suspension to be remitted on condition the Member complete the remedial training program specified in paragraph 2, above.

4. Costs to the College in the amount of $2,500.00

In its reprimand, the Panel noted that integrity, trust, and professional conduct are at the core of the practice of Pharmacy and the delivery of care to the public. In return, Pharmacy Technicians are held in high regard by the public.

The Panel observed that pharmacy is a self-regulated profession. Members bear the responsibility to ensure that they maintain the trust of our members and the public they serve. The practice of pharmacy is a privilege that carries with it significant obligations to the public, the profession, and to oneself.

The Panel acknowledged the Member’s acceptance of responsibility for her actions and her cooperation during this process. The Panel expressed its belief that the Member has learned from this process and its confidence that she will not appear before a panel of the Discipline Committee of the Ontario College of Pharmacists again.

• Dispensed certain identified controlled and prescription drugs that had not been prescribed, in or about September 2014 – June 2016

In particular, the Panel found that she

• Failed to maintain a standard of practice of the profession
• Failed to keep records as required respecting herself and her patients
• Contravened the Act, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, or the regulations under those Acts, and in particular, section 155 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H.4, as amended
• Contravened a federal or provincial law or municipal by-law with respect to the distribution, sale or dispensing of any drug or mixture of drugs, and in particular, sections C.01.041 and/or G.03.002 of the Food and Drug Regulations, C.R.C., c. 870, as amended; section 4 of the Controlled Drugs and Substances Act, S.C. 1996, c. 19, as amended; and/or section 51 of the Benzodiazepines and Other Targeted Substances Regulations, S.O.R./2000-217, as amended
• Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable and unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand
2. Directing the Registrar to impose specified terms, conditions, or limitations on the Member’s certificate of registration requiring that:

a. the Member shall complete successfully the following courses, programs, and instruction, including any evaluations, at her own expense and within twelve (12) months of the date of this Order, or provide evidence satisfactory to the College that she has completed these courses and any related evaluations within the twelve (12) months prior to the date of this Order:

i. the College’s complete jurisprudence e-learning modules and examinations; and

ii. the ProBE Program on Professional/Problem Based Ethics for Healthcare Professionals, with an unconditional pass;

b. the Member shall be prohibited, for a period of three (3) years from the date of this Order, from acting as a Designated Manager or narcotic signer at any pharmacy;

c. the Member shall provide notification to all her employers in pharmacy regarding the disposition of this discipline proceeding, for a period of three (3) years from the date of this Order, on the following terms:

i. the Member shall notify the College in writing of the name, address, and telephone number of any current or future employer, within fourteen (14) days of resuming any current employment or commencing any future employment in pharmacy;

ii. the Member shall provide her employer(s) in pharmacy with a copy of the Agreed Statement of Facts and this Joint Submission on Order, or the Decision and Reasons of the Discipline Committee in this matter, including this Order (when available), prior to resuming any current employment or commencing any future employment in pharmacy; and

iii. the Member shall only engage in the practice of pharmacy for an employer who agrees to advise the College in writing, within fourteen (14) days of the Member resuming any current employment or commencing any new employment with the employer, confirming that the Designated Manager of the employer’s pharmacy has received a copy of the documents set out in paragraph 2(b)(ii) above.

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of four (4) months, with two (2) months of the suspension to be remitted on condition the Member complete the remedial training program specified in paragraph 2(a), above. The suspension shall commence on September 4, 2018 and continue without interruption until November 3, 2018, inclusive. If the remitted portion of the suspension has to be served, the further suspension shall commence on September 5, 2019 and continue without interruption until November 4, 2019, inclusive, unless the time for completing the remedial steps in paragraph 2(a), above, is extended by the Registrar, in which case, the date the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly.

4. Costs to the College in the amount of $3,500.00

In its reprimand, the Panel noted that the Member breached the trust given to her by this College, as well as the trust of her colleagues and the public.

The Panel indicated that while it acknowledged the Member’s acceptance of responsibility for her actions and her cooperation during the process, it viewed her actions as totally unacceptable.

The Panel expressed its trust that the rehabilitation outlined in the Order gives the Member an opportunity to reflect on her practice, and its expectation that she will learn from this experience and will not appear before a panel of a discipline committee again.

• Failed to report that he had been charged on or about September 4, 2015 with a criminal offence contrary to the Criminal Code, section 252:
  • within 30 days, as required by College By-Law No. 3, Article 12.1.3, and/or
  • by providing a false statement to the College in response to the question regarding charges for an offence on the annual registration renewal questionnaire, on or about March 3, 2016
• Failed to report that he had been found guilty on or about April 22, 2016 of an offence contrary to the Highway Traffic Act, section 200(1)(a):
  • within 30 days, as required by College By-Law No. 4, Article 12.1.3, and/or
  • by providing a false statement to the College in response to the question regarding a finding of guilty for an offence on the annual registration renewal questionnaire, on or about March 10, 2017
• Dispensed prescriptions for methadone, Suboxone or buprenorphine, and/or sold methadone, Suboxone or buprenorphine by retail, to certain identified patients at Ancestral Voices Medical Centre & Pharmacy in Ohsweken, Ontario, premises for which no certificate of accreditation has been issued, in or about April 2017;
• Used the designation “pharmacy” in relation to Ancestral Voices Medical Centre & Pharmacy in Ohsweken, Ontario, premises for which no certificate of accreditation has been issued;
• Failed to comply with the Methadone Maintenance Treatment (MMT) and Dispensing Policy of the College regarding methadone dispensing at the Pharmacy with respect to notification to the College, patient agreements, labeling of methadone doses, and documentation of methadone prescriptions, in or about April 2017;
• Failed to keep records as required regarding the prescriptions for methadone, Suboxone or buprenorphine dispensed to certain identified patients;
• Falsely denied to the College inspectors on or about April 24, 2017 that methadone or buprenorphine were being dispensed from the Pharmacy;
• Failed to maintain accurate records regarding methadone, Suboxone and/or buprenorphine purchased and/or dispensed by the Pharmacy, and thereby failed to take all reasonable steps necessary to protect the narcotics at the Pharmacy against loss or theft;
• Charged dispensing fees for approximately 105,000 claims to the Ontario Drug Benefit Program, in or about April 7, 2015 to May 1, 2017, and/or approximately 175 claims to the Non-Insured Health Benefits Program, in or about November 8, 2016 to May 1, 2017, which were excessive charges for the services provided, in that Mr. Syed was not authorized to claim payment for such dispensing fees without documenting and reporting to the prescriber any exercise of professional judgment to dispense less than the full amount prescribed or the consent of the patient or the patient’s agent to that effect;
• Failed to verify delivery by receipt signed by the patient or patient’s agent for medications dispensed daily in relation to claims to the Ontario Drug Benefit Program, and/or claims to the Non-Insured Health Benefits Program, between approximately February 1, 2017 and May 1, 2017

In particular, the Panel found that the Member

• Contravened a term, condition or limitation imposed on his certificate of registration
• Failed to maintain a standard of practice of the profession
• Failed to keep records as required respecting his patients
• Signed or issued, in his professional capacity, a document that he knew contained a false or misleading statement
• Charged a fee that is excessive
• Contravened the Act, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, or the regulations under those Acts, and in particular, section 23(2) of the Health Professions Procedural Code; section 5 of O.Reg. 202/94; and/or sections 139, 147, 152 and/or 156 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H-4
• Contravened, while engaged in the practice of pharmacy, a federal or provincial law or municipal by-law with respect to the distribution, sale or dispensing of any drug or mixture of drugs, and in particular, section 10 of the Narcotic Safety and Awareness Act, 2010; sections 38 and/or 43 of the Narcotic Control Regulations, C.R.C., c.1041; sections 5, 6 and/or 15 of the Ontario Drug Benefits Act; and/or sections 18 and/or 27 of O.Reg. 201/96
• Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable and unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand
2. Directing the Registrar to impose specified terms, conditions, or limitations on the Member’s Certificate of Registration requiring that:

(a) the Member shall complete successfully, at his own expense, the ProBE Program on Professional/Problem Based Ethics for Healthcare Professionals, with an unconditional pass, within twelve (12) months of the date of this Order;

(b) the Member shall complete successfully, at his own expense, the Opioid Dependence Treatment (ODT) Core Course by the Centre for Addiction and Mental Health within twelve (12) months of the date of this Order;

(c) the Member shall be prohibited from dispensing methadone, buprenorphine, and/or similar medications at any pharmacy or other location in Ontario or engaging in any activities related to the purchase, preparation, dispensing, sale, and/or billing of methadone, buprenorphine, and/or similar medications to patients or others until he has successfully completed the Opioid Dependence Treatment course described in subparagraph 2(b), above and has provided the College with notice, using the Methadone Dispensing Notification Form, of his intention to dispense methadone;

(d) the Member shall complete successfully, after successfully completing the ProBE Program described in subparagraph 2(a), above, and within eighteen (18) months of this Order, a course with Gail E. Siskind Consulting Services, or another professional ethics consultant chosen by the College, to be designed by the consultant, for the purpose of addressing the professional and ethical obligations raised by the facts and findings of professional misconduct in this case, on the following terms:

(i) the number of sessions shall be at the discretion of the consultant, but shall be a minimum of two (2) meetings and a maximum of three (3) meetings;

(ii) the manner of attendance at the session(s) (e.g. in person, via Skype, etc.) is a matter to be discussed in advance between the Member and the consultant, but shall ultimately be at the discretion of the consultant;

(iii) the Member shall be responsible for the cost of the course;

(iv) the Member shall provide to the consultant the following documents, in advance of the course, to facilitate the design of the course:

1. the Notice of Hearing;
2. the Agreed Statement of Facts;
3. this Joint Submission on Order; and
4. the Panel’s Decision and Reasons, if and when available;
5. any essay or other assignments the Member completes for the ProBE Program; and
6. the evaluation of the Member by the ProBE Program; and

(v) the consultant will confirm in writing to the College that the Member has completed the course to the satisfaction of the consultant; and

(e) the Member’s practice will be monitored by the College for a period of twenty-four (24) months from the date that the suspension of the Member’s Certificate of Registration has been lifted, as described in paragraph 3 below. The monitoring shall be on the following terms:

(i) the monitoring will be by means of inspections conducted by a representative of the College at such times as the College may determine;

(ii) the monitoring inspections may be in addition to any routine inspections conducted by the College pursuant to the Drug and Pharmacies Regulation Act, s. 148;

(iii) the Member shall cooperate fully during such inspections;

(iv) the Member shall pay to the College in respect of such monitoring inspections the amount of $1,000.00 per inspection, after each inspection, with the total number of inspections for which the Member must pay not to exceed a total of four (4); and

(v) the College may choose to conduct additional inspections within the monitoring period at no further cost to the Member; and

(f) the Member shall be prohibited from acting as the Designated Manager at any pharmacy for a period of three (3) years from October 9, 2018.

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of twelve (12) months, with two (2) months of the suspension to be remitted on condition the Member complete the remedial training programs as specified in subparagraphs 2(a), 2(b) and 2(d) above. The suspension shall commence on October 9, 2018 and continue without interruption until August 8, 2019, inclusive. If the remitted portion of the suspension has to be served because the Member fails to complete the ProBE Program as specified in subparagraph 2(a) above, and/or the Opioid Dependence Treatment course as specified in subparagraph 2(b) above, the further suspension shall commence on September 25, 2019 and continue without interruption until November 24, 2019, inclusive. If the Member fails to complete the course with a professional ethics consultant as specified in paragraph 2(d) above, then the further suspension shall commence on March 25, 2020, and continue without interruption until May 24, 2020, inclusive. If the time for completing the remedial steps in subparagraphs 2(a), 2(b) and/or 2(d) above is extended by the Registrar, the date on which the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly.

4. Requiring the Member to pay costs to the College in the amount of $7,500.00.

In its reprimand, the Panel noted its deep disappointment by the events that brought the Member before it. The Panel indicated that the practice of Pharmacy is a privilege that carries significant obligations to the public, the profession, and oneself. The result of the Member’s professional misconduct is that he eroded the public trust in the pharmacy profession and cast a shadow over his own integrity. The Panel expressed its hope that this hearing has given the Member the opportunity to pause for reflection.

The Panel observed that the Order, including the suspension, is significant, and that it appropriately addresses the conduct for such serious offences while also allowing the potential for rehabilitation. The Panel recognized that the Member is a newly licensed pharmacist; the Panel voiced its expectation that the remedial components of the Order will allow the Member to improve his practice to the professional standards expected of a pharmacist in Ontario and ensure that the public interest is foremost.

The Panel pointed out that the Member’s actions demonstrated poor judgment and a disregard for the regulatory scheme of Ontario. He exposed the public to unnecessary risk by operating an unaccredited pharmacy serving the most vulnerable population. The panel expressed its expectation that the Member will not appear again before a Panel of the Discipline Committee.

• Failed to complete inventory reconciliations for narcotics and other controlled drugs at least every six months, and/or failed to retain records of such inventory reconciliations, for the period, February 2014-February 2017;
• Failed to identify and report losses of narcotics and other controlled drugs to Health Canada as required during the period, February 2014-February 2017;
• Submitted up to 277 improper claims for both MedsCheck Annual reviews and MedsCheck Diabetes reviews at substantially the same time in the period, January 2014-July 2016;
• Submitted certain identified improper claims for MedsCheck reviews for patients who were not eligible, claims that were submitted prior to the MedsCheck reviews being performed, MedsCheck reviews that were not documented, and/or for MedsCheck review documents that were not signed by the patient and/or pharmacist in the period, June 2015-June 2016; and/or
• Submitted improper claims for certain identified patients for dispensing fees for compliance packages at more frequent intervals than the compliance packages were being dispensed to the patients in the period, December 2016-February 2017.

In particular, the Panel found that he

• Failed to maintain a standard of practice of the profession;
• Failed to keep records as required respecting his patients;
• Charged a fee that was excessive;
• Contravened, while engaged in the practice of pharmacy, a federal or provincial law or municipal by-law with respect to the distribution, sale or dispensing of any drug or mixture of drugs, and in particular, sections 4, 5, 6 and/or 15 of the Ontario Drug Benefit Act, R.S.O., 1990, c.O. 10, as amended; sections 18 and/or 27 of O.Reg 201/96, as amended; sections 42, 43 and/or 71 of the Narcotic Control Regulations, CRC, c1041, as amended; and/or section 7 of the Benzodiazepines and Other Targeted Substances Regulations, SOR/2000-217, as amended;
• Permitted, consented to or approved, either expressly or by implication, the commission of an offence against any Act relating to the practice of pharmacy or to the sale of drugs by a corporation of which he was a director, and in particular, sections 4, 5, 6 and/or 15 of the Ontario Drug Benefit Act, R.S.O., 1990, c.O. 10, as amended; sections 18 and/or 27 of O.Reg 201/96, as amended; sections 42, 43 and/or 71 of the Narcotic Control Regulations, CRC, c1041, as amended; and/or section 7 of the Benzodiazepines and Other Targeted Substances Regulations, SOR/2000-217, as amended;
• Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as dishonourable and unprofessional.

The Panel imposed an Order which included as follows:

1. A reprimand
2. Directing the Registrar to impose specified terms, conditions, or limitations on the Member’s Certificate of Registration requiring that:

a. the Member shall complete successfully, at his own expense, the ProBE Program on Professional/Problem Based Ethics for Healthcare Professionals, with an unconditional pass, within twelve (12) months of the date of this Order;

b. the Member shall complete two comprehensive inventory reconciliations for all narcotics and other controlled substances in his current pharmacy, with the first inventory reconciliation to be completed and submitted to the College no later than by February 8, 2019, and the second inventory reconciliation to be performed and submitted to the College six (6) months after the first (i.e., by August 8, 2019), with the inventory reconciliations to cover the six-month period preceding each inventory reconciliation;

c. the Member’s practice will be monitored by the College for a period of twenty-four (24) months from the date of this Order. The monitoring shall be on the following terms:

(vi) the monitoring will be by means of inspections conducted by a representative of the College at such times as the College may determine;

(vii) the monitoring inspections may be in addition to any routine inspections conducted by the College pursuant to the Drug and Pharmacies Regulation Act, s. 148;

(viii) the Member shall cooperate fully during such inspections;

(ix) the Member shall pay to the College in respect of such monitoring inspections the amount of $1,000.00 per inspection, after each inspection, with the total number of inspections for which the Member must pay not to exceed a total of four (4); and

(x) the College may choose to conduct additional inspections within the monitoring period at no further cost to the Member; and

d. the Member shall be prohibited from acting as the Designated Manager at any pharmacy for a period of twelve (12) months from the date of this Order.

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of four (4) months, with one (1) month of the suspension to be remitted on condition the Member complete the remedial training program as specified in subparagraph 2(a), above. The suspension shall commence on October 9, 2018 and continue without interruption until January 8, 2019, inclusive. If the remitted portion of the suspension has to be served because the Member fails to complete the ProBE Program as specified in subparagraph 2(a) above the further suspension shall commence on September 26, 2019 and continue without interruption until October 25, 2019, inclusive. If the time for completing the remedial steps in subparagraph 2(a), above, is extended by the Registrar, the date on which the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly.

4. Costs to the College in the amount of $6,000.00

In its reprimand, the Panel noted that pharmacy is a highly respected profession within the healthcare system and the community at large. Integrity and trust are paramount to this profession. Pharmacists provide care to the public and in return are held in high regard for the role they play.

The Panel observed that a pharmacist’s relationship with third party payors is based on honesty and integrity, which are paramount in a real time claims adjudication system. Claims are submitted and accepted in good faith.

The Panel indicated that the frequency and volume of the Member’s billing activities related to MedsCheck services and compliance pack billing intervals were clearly a flagrant abuse of the system. These claims did not occur by accident especially for multiple claims for individual patients made on the same day.

The Panel expressed its view that the Member failed to maintain the standards of the profession in that he neglected to maintain proper inventory reconciliation of narcotic and other controlled drugs, despite several reminders from the College. The Panel also felt the Member’s actions as a Designated Manager fell short of the standards and responsibilities expected by the profession.

The Panel expressed its trust that this disciplinary process has caused the Member to reflect on his practice and will motivate him to make changes, and that the Member will not appear before a Panel of the Discipline Committee of the Ontario College of Pharmacists again.

• Between at least October 2014 and December 2014, he engaged in behaviour and/or remarks of a sexual nature towards [Patient], a patient to whom he was dispensing methadone
• Between approximately December 2013 and December 2014, he harassed and/or sexually harassed [Patient], a patient of the Pharmacy

In particular, it was alleged that the Member had

• Sexually abused a patient
• Failed to maintain the standards of the profession
• Engaged in conduct relevant to the practice of pharmacy that, having regard to all of the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable and/or unprofessional

The Member denied the allegations as set out in the Notice of Hearing.

In a decision dated January 19, 2018, a panel of the Discipline Committee (the “Panel”) found that the evidence presented by the College was not sufficient to establish, on a balance of probabilities, to the Panel’s satisfaction, that the alleged misconduct occurred. The Panel dismissed all allegations against the Member and indicated that it did not have clear, cogent and convincing evidence that the Member engaged in the misconduct alleged in the Notice of Hearing.