Discipline Decisions (February 2023)

• False or unsubstantiated claims submitted to the Ontario Drug Benefit Program (ODB) from the Pharmacy from approximately February 1, 2016 to approximately August 22, 2017 for seven identified drugs, or any of them; and/or
• Improper claims for prescriptions and/or other products submitted to the ODB from the Pharmacy in relation to one or more of certain identified claims.

In particular, the Panel found that he:

• Failed to maintain a standard of practice of the profession;
• 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 5, 15, 17 and/or 23 of the Ontario Drug Benefit Act and/or;
  • sections 18, 25 and 29(1) of Ontario Regulation 201/96, and/or;
  • section 166 of the Drug and Pharmacies Regulation Act;
• Failed to keep records as required respecting his patients;
• 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 dishonourable and unprofessional.

The Panel imposed an Order as follows:

1. A reprimand;

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

a. The Registrant shall successfully complete within twelve (12) months of the date of the Order, a course with Gail E. Siskind Consulting Services, or another professional ethics consultant approved by the College, to address the professional misconduct arising from this matter, to be designed by the consultant. The following terms shall apply to the course:

i. The number of sessions shall be at the discretion of the consultant, but shall be no fewer than three;

ii. The manner of attendance at the sessions (e.g., in person, via videoconference, etc.) is a matter to be discussed in advance between the Registrant and the consultant, but shall ultimately be at the discretion of the consultant;

iii. The Registrant shall be responsible for the cost of the course;

iv. The Registrant shall provide to the consultant the following documents, in advance of the course, to facilitate the design of the course:

1. A copy of the Notice of Hearing, the Agreed Statement of Facts, and the Joint Submission on Order, or

2. A copy of the Panel’s Decision and Reasons

v. Successful completion of the course includes completion of an essay acceptable to the Registrar, which essay shall address the professional misconduct issues arising in this case;

vi. The essay shall be at least 1,000 words in length and the Registrant shall be responsible for the cost of the essay’s review by the consultant to assist the Registrar to determine whether the essay is acceptable, up to a maximum of $500; and

vii. The Registrant shall direct the consultant to report the results of the ethics course to the College, which report shall be made no later than twelve (12) months from the date this Order becomes final, to confirm that the Registrant completed the course to the consultant’s satisfaction.

b. that for a period of three years from the date this Order becomes final, the Registrant shall be prohibited from

i. having any proprietary interest in a pharmacy as a sole proprietor or partner, or director or shareholder in a corporation that owns a pharmacy (excepting only that he may be permitted to own shares in a publicly traded corporation that has an interest in a pharmacy), or in any other capacity;

ii. receiving any remuneration for his work as a pharmacist, or related in any way to the operation of a pharmacy, other than remuneration based on hourly or weekly rates or salary and in particular, not on the basis of any incentive or bonus for prescription sales; and

iii. acting as a Designated Manager in any pharmacy.

3. That the Registrar suspend the Registrant’s Certificate of Registration for a period of eleven (11) months, with one (1) month of the suspension to be remitted on condition that the Registrant complete the remedial training as specified in subparagraph 2(a) above. The suspension shall commence on November 2, 2022, and shall continue until September 1, 2023, inclusive. If the remitted portion of the suspension is required to be served by the Registrant because he fails to complete the remedial requirements specified in subparagraph 2(a), above, that portion of the suspension shall commence on November 2, 2023, and shall continue until December 1, 2023, 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 $10,000.00.

In its reprimand, the Panel noted that, as a member of the profession of pharmacy, the Registrant should understand that integrity, trust, and professional conduct are at the core of the practice of pharmacy and the delivery of care to the public.

The Panel expressed its disappointment with the Registrant’s failure to maintain the standards of practice of the profession. The Panel recognized the Registrant’s admissions and cooperation throughout the discipline process, as well as the steps he took once discovering the errors in the pharmacy software.

The Panel observed that the role of Designated Manager is one of serious responsibilities that include the obligation to ensure the entire operation of the pharmacy, including inventory management, is overseen in accordance with the College’s standards of practice.

The Panel relayed its expectation that the Registrant has learned from this experience and will not appear before a panel of the Discipline Committee again.

In particular, the Panel found that the Registrant:

• Failed to maintain a standard of practice of the profession;
• Failed to keep records as required respecting his patients or practice;
• Contravened the Pharmacy Act, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991 or the regulations under those Acts, in particular but not limited to the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H.4, and Ontario Regulation 264/16 under that Act;
• Contravened any federal, provincial or territorial law or municipal by-law with respect to the distribution, purchase, sale, or dispensing or prescribing of any drug or product, in particular but not limited to the Natural Health Products Regulations, SOR/2003-196;
• 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 unprofessional.

The Panel imposed an Order, as follows:

1. A reprimand;

2. An Order directing the Registrar to suspend the Registrant’s certificate of registration for a period of three (3) months, with one (1) month of the suspension to be remitted on the condition that the Registrant successfully completes the terms, conditions and limitations specified in paragraph 3 below. This suspension shall commence on November 18, 2022, and shall continue without interruption until January 17, 2023, inclusive. If the remitted portion of the suspension is required to be served by the Registrant because he fails to complete the terms, conditions and limitations as specified in paragraph 3 below, that portion of the suspension shall commence on November 6, 2023, and shall continue without interruption until December 5, 2023, inclusive. If the time for completing the terms, conditions and limitations in paragraph 3 below is extended by the Registrar, the date on which the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly;

3. An Order directing the Registrar to impose specified terms, conditions and limitations on the Registrant’s certificate of registration, as follows:

a. the Registrant must successfully complete, within twelve (12) months of the date of this Order, a mentorship program regarding the standards of practice and record keeping, including the following:

i. the Registrant shall retain, at his own expense, a mentor selected by the College;

ii. the Registrant shall meet, virtually or in person, at least five (5) times with the mentor, for the purpose of reviewing the Registrant’s practice with respect to the standards of practice and record keeping;

iii. to this end, the Registrant shall provide the mentor with the following documents related to this proceeding:

1. a copy of the Notice of Hearing;

2. a copy of the Agreed Statement of Facts;

3. a copy of this Joint Submission As To Order and Costs; and

4. a copy of the Decision and Reasons of the Discipline Committee following from this hearing, when released;

iv. the Registrant shall develop a learning plan with the mentor to comprehensively address the role and responsibilities of a pharmacist and Designated Manager with respect to the standards of practice and record keeping;

v. the Registrant shall demonstrate to the mentor that he has successfully achieved all of the goals of the learning plan; and

vi. the Registrant shall require the mentor to report the results of the mentorship program to the College no later than November 3, 2023. Such report shall include, but is not limited to, the learning plan and the mentor’s assessment of the Registrant’s success in meeting the goals of the learning plan; and

b. The Registrant must successfully complete, at his own expense, the College’s Jurisprudence e-Learning Modules and Jurisprudence Examination within twelve (12) months of the date of this Order.

4. Costs to the College in the amount of $10,000.00.

In its reprimand, the Panel noted that the Registrant’s misconduct was entirely inappropriate and unprofessional. Practicing pharmacy is a privilege, not a right, and carries with it significant obligations to patients, the profession, and oneself.

The Panel observed that the Registrant’s misconduct involved a serious and persistent disregard of his professional obligations. He was the Pharmacy’s Designated Manager, and a Director and shareholder of the corporation which owns the Pharmacy. As an experienced, long-standing College registrant, he should have known better. The Panel indicated that it was dismayed that this was not the Registrant’s first appearance before the Discipline Committee.

The Panel pointed out that by admitting to the allegations against him and undertaking some remedial training prior to this hearing, the Registrant has taken an initial step towards his rehabilitation. The Panel expressed its trust that the Registrant will learn from this shameful experience and will not appear before a panel of the Discipline Committee again.

• Between about January 1, 2019 and August 26, 2020, he dispensed and/or sold (or permitted, consented to or approved, expressly or impliedly, the dispensing and/or selling of) certain identified prescription drugs without a prescription;
• Between about January and April 2020, he permitted, consented to or approved, expressly or impliedly, a staff member who was not a member of the College dispensing and/or selling a drug and/or supervising the part of the Pharmacy where drugs are kept, when no pharmacist was physically present in the Pharmacy;
• Between about January 1, 2019 and August 26, 2020, he submitted (or permitted, consented to or approved, expressly or impliedly, the submission of) charges for certain identified drugs and/or products that were not dispensed;
• Between about January 1, 2019 and August 26, 2020, he permitted the creation of false and/or misleading pharmacy records documenting the dispensing of certain identified drugs and/or products that were not dispensed;
• He misappropriated certain identified sample medication from the physician’s office adjacent to the Pharmacy;
• Between about January 1, 2019 and August 26, 2020, he submitted (or permitted, consented to or approved, expressly or impliedly, the submission of) charges for sample medication that the Pharmacy was not charged for, and in particular, with respect to charges for Synjardy, Xarelto and Invokana;
• He permitted, consented to or approved, expressly or impliedly, a staff member documenting that he had performed clinical verification of certain identified prescriptions, when he had not.

In particular, the Panel found that he:

• Failed to maintain a standard of practice of the profession;
• Permitted the creation of false and/or misleading pharmacy records relating to his practice or a person’s health record;
• Submitted an account or charge for services or products that he knew or ought to have known contained a false or misleading statement;
• Charged a fee or amount that was excessive in relation to the service or product provided;
• Contravened the Act, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, the Narcotics Safety and Awareness Act, 2010, the Drug Interchangeability and Dispensing Fee Act or the Ontario Drug Benefit Act or the regulations under those Acts, and in particular:
  • s. 155 of the Drug and Pharmacies Regulation Act;
  • s. 149 of the Drug and Pharmacies Regulation Act and s. 27 of the Regulated Health Professions Act, 1991;
• Contravened a federal, provincial or territorial law or municipal by-law with respect to the distribution, purchase, sale, or dispensing or prescribing of any drug or product, the administering of any substance, or the piercing of the dermis, and in particular:
  • s. C.01.041 of the Food and Drug Regulations, CRC, c 870, made under the Food and Drugs Act;
• 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, as follows:

1. A reprimand;

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

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

b. The Registrant shall be prohibited from acting as Designated Manager in any pharmacy for three (3) years from the date of this Order, or until the successful completion of the remediation described in paragraphs 2(a) above, whichever is longer; and

c. The Registrant shall be prohibited from having any proprietary interest in a pharmacy as a sole proprietor or partner, or director or shareholder in a corporation that owns a pharmacy (excepting only that he may be permitted to own shares in a publicly traded corporation that has an interest in a pharmacy), or in any other capacity for three (3) years from the date of this Order;

d. The Registrant shall be prohibited from receiving any remuneration for his work as a pharmacist, or related in any way to the operation of a pharmacy, other than remuneration based on hourly or weekly rates or salary and in particular, not on the basis of any incentive or bonus for prescription sales acting as Director or voting as a shareholder in any corporation operating a pharmacy for three (3) years from the date of this Order;

3. That the Registrar suspend the Registrant’s Certificate of Registration for a period of twelve (12) months, with one (1) month of the suspension to be remitted on condition that the Registrant complete the remedial training as specified in subparagraph 2(a) above. The suspension shall commence on November 24, 2022, and shall continue until October 23, 2023, inclusive. If the remitted portion of the suspension is required to be served by the Registrant because he fails to complete the remedial requirements specified in subparagraph 2(a) above, that portion of the suspension shall commence on October 24, 2023, and shall continue until November 23, 2024, 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 $10,000.00.

In its reprimand the Panel noted that the Registrant was the Designated Manager, director, and shareholder of the corporation that operated the Pharmacy where his misconduct occurred.

As an experienced, long-standing registrant of this College, he should have known better.

The Panel pointed out that practicing pharmacy is a privilege granted to those who possess the knowledge, skill, and judgment to practice safely, ethically, and professionally, which the Registrant failed to do. His conduct is unacceptable and casts serious doubt on his fitness to practice the profession. He has brought shame to those who have worked so hard to maintain the high standards required and demanded by the public and the profession.

The Panel observed that the Registrant has taken a positive step to begin to remediate his practice, but that he must change his ways and learn from this experience.

• Failed to exercise appropriate professional diligence with respect to the dispensing of narcotics, which resulted in her filling forged prescriptions purportedly written by [Physician A]. and/or [Physician B] without making appropriate inquiries

In particular, the Panel found that she

• Failed to maintain a standard of practice of the profession;
• 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, and/or section 40 of O.Reg. 58/11, R.S.O. 1990, c.H.4;
• 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, section 31 of the Narcotic Control Regulations, C.R.C., c.1041, as amended, under the Controlled Drugs and Substances Act, S.C. 1996, c. 19, 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 of the profession as dishonourable and unprofessional.

Following submissions with respect to Order heard on March 24, 2021, the Panel issued an Order in a decision dated June 7, 2021, which came into effect on November 18, 2022, as follows:

1. A reprimand

2. Directing the Registrar to impose specified terms, conditions, or limitations on the Member’s Certificate of Registration, and in particular:

a. The Member shall be prohibited, for a period of five (5) years from the date this Order becomes final, from:

i. Acting as a Designated Manager in any pharmacy;

ii. Acting as a narcotic signer at any pharmacy; and

iii. Acting as preceptor for pharmacy students in training.

b. That for a period of five (5) years from the date this Order becomes final, the Member shall provide the College with the count and reconciliation of all narcotics, controlled drugs and targeted substances at her pharmacy every six (6) months, beginning three (3) months after the date this Order becomes final. The Member shall ensure that the information is sent to the College by the Pharmacy’s Designated Manager.

c. That the Member, at her own expense, successfully complete, within twelve (12) months of the date this Order becomes final, an individualized ethics course with Gail E. Siskind Consulting Services, or another professional ethics consultant chosen by the College, to be designed by the consultant to provide significant education and remediation concerning the basic ethical responsibilities inherent in the pharmacist’s professional role as being part of the “Patient’s Circle of Care”, specifically addressing that pharmacists should be asking questions about the patient’s diagnosis for the purpose of assessing the safety and appropriateness of the prescription. The following terms shall apply to the course:

i. The number of sessions shall be at the discretion of the consultant, but shall be at least 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 Panel’s Decision and Reasons (Both Findings and Penalty phases).

d. That the Member complete successfully with an unconditional pass, at her own expense, within twelve (12) months of the date this Order becomes final, the ProBE course on professional/problem based ethics for health care professionals;

e. That the Member successfully complete the CAMH Opioid Dependence Treatment Core Course within twelve (12) months of the date this Order becomes final;

f. That the Member successfully complete Module 5: Practice and Pharmacy Management II (including JP #7-Controlled Drugs and Substances Act) from the Canadian Pharmacy Skills Program II; or an equivalent course approved by the Ontario College of Pharmacists within twelve (12) months of the date this Order becomes final;

g. That the Member shall successfully complete, at her own expense, the Jurisprudence exam offered by the College within twelve (12) months of the date this Order becomes final;

h. That the Member:

i. retain, at the Member’s expense, a practice mentor acceptable to the College, which shall be no later than three (3) months after the Member is permitted to resume her practice subsequent to the suspension as outlined in the Order;

ii. meet at least three (3) times with the practice mentor, at the Member’s place of practice, for the purpose of observing her interacting with patients during the dispensing process and to assess her clinical knowledge and judgment, and to identify areas in the Member’s practice with respect to these  issues that require remediation, with the timing of each meeting at the discretion of the mentor;

iii. shall provide the practice mentor the following documents in advance of the meetings, to facilitate the design of a learning plan:

1. The Notice of Hearing; and

2. The Panel’s Decision and Reasons (Both Findings and Penalty phases);

iv. develop a learning plan, together with the mentor, to address the areas requiring remediation;

v. demonstrate to the practice mentor that the Member has achieved success in meeting the goals established in the learning plan; and

vi. request a report from the practice mentor to report the results of the mentorship meetings to the Manager, Investigations and Resolutions, at the College after their completion, which shall be no later than twelve (12) months after the date the College approves the mentor selected by the Member.

i. That the Member’s practice shall be monitored by the College by means of inspection(s) by a representative or representatives of the College in such number and at such time or times as the College may determine, for a period of thirty-six (36) months from the date this Order becomes final. The thirty-six (36) month period shall be suspended during any period of time during which the Member is not actively practising pharmacy and shall resume when the Member resumes the practice of pharmacy. The Member shall cooperate with the College during the inspections and, further, shall pay to the College in respect of the cost of monitoring, the amount of $1,000.00 per inspection to a maximum of three (3) inspections, such amount to be paid immediately after completion of each of the inspections.

j. That the order previously issued where the Member is not permitted to dispense narcotics and targeted substances be extended for five (5) years from the date this Order becomes final. The Member must apply to the Discipline Committee to have this restriction removed from her Certificate of Registration and in so doing, must demonstrate to the Discipline Committee the successful completion of all aspects of this Order.

3. That the Member’s Certificate of Registration be suspended for a period of fourteen (14) months, with two (2) months remitted upon completion of the courses outlined in this Order above. The suspension shall commence on the date that this Order becomes final.

4. That the Registrar is empowered, in her discretion, to grant a request for an extension of time to complete the remedial steps set out in subparagraphs 2(c), 2(d), 2(e), 2(f), 2(g) and 2(h) if the Registrar is of the view that it would be in the interests of fairness to do so and that it would not be contrary to the College’s mandate to serve and protect the public interest.

5. That the Member pay costs to the College in the amount of sixty-one thousand seven hundred and fifty dollars ($61,750.00) with ten thousand dollars ($10,000) payable immediately and the balance of fifty-one thousand seven hundred and fifty dollars ($51,750.00) payable within twelve (12) months of the date this Order becomes final.

The reprimand in this matter was administered on February 8, 2023.

In its reprimand, the Panel noted that the Member is part of the highly respected profession of pharmacy. Integrity, trust and professional conduct are at the core of the practice of pharmacy and the delivery of care to the public.

The Panel observed that pharmacy is a self regulated profession and as such it bears the responsibility to ensure that it maintains the trust of its members and the public it serves. The practice of pharmacy is a privilege that carries with it significant obligations to the public, the profession and to oneself. Practice standards require safe and secure management of narcotics and controlled substances.  These practice standards are designed to prevent misuse, abuse, and diversion of the substances that are legislatively regulated due to their high potential for addiction and toxicity.

The Panel indicated that the Member’s lack of adherence to the standards of practice and procedures for appropriate dispensing of narcotics cannot be ignored.  Her failure to follow the OCP guidelines on identifying forgeries and fraudulent prescriptions over a significant period of time is very troubling, particularly in light of the opioid addiction crisis in our society today. The fact that her inaction in the proper handling and dispensing of highly addictive substances led to tens of thousands of doses of potent narcotics potentially entering into the black-market is reprehensible, casts a dark shadow over her practice as a pharmacist, and brings dishonour to the profession of pharmacy.

The Panel expressed its trust that the period of suspension and the required remediation and rehabilitation will provide the Member the opportunity to improve her practice standards to mitigate the risk of these types of events from ever occurring again. The Panel relayed its hope that this has been a learning experience for the Member and that she will not return before a panel of the Discipline Committee again.

• Submitted (or permitted, consented to, or approved, expressly or by implication, the submission of) an account or charge for services or products that he knew and/or ought to have known was false or misleading with respect to one or more of certain identified drugs and/or products;
• Falsified (or permitted, consented to or approved, expressly or by implication, the falsification of) a record regarding his patients and/or his practice with respect to one or more of certain identified drugs and/or products;
• Signed or issued, in his professional capacity, (or permitted, consented to, or approved, expressly or by implication, the signing or issuance of) a document he knew and/or ought to have known contained a false and/or misleading statement with respect to one or more of certain identified drugs and/or products; and/or
• Failed to keep records as required regarding his patients and/or his practice with respect to one or more of certain identified drugs and/or products.

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 and/or his practice;
• Falsified a record relating to his patients and/or his practice;
• Signed or issued, in his professional capacity, a document that he knew and/or ought to have known contained a false or misleading statement;
• Submitted (or permitted, consented to or approved, expressly or by implication, the submissions of) an account or charge for services or products that he knew and/or ought to have known was false and/or misleading;
• 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, as follows:

1. A reprimand;

2. Directing the Registrar to suspend the Registrant’s certificate of registration for a period of 17 months with one month to be remitted on the condition that the Registrant completes the remedial training specified in subparagraph 3(a) within 12 months of the date of the Order;

3. Directing the Registrar to impose specified terms, conditions or limitations on the Registrant’s certificate of registration, including:

a. The Registrant must successfully complete, with an unconditional pass, at his own expense and within 12 months of the date of this Order, the ProBE Program on professional/problem-based ethics for health care professionals offered by the Centre for Personalized Education for Professionals;

b. For a period of three (3) years from the date of this Order, the Registrant:

i. shall be prohibited from having any proprietary interest in a pharmacy of any kind and/or receiving remuneration for his work as a pharmacist other than remuneration on an hourly or weekly basis;

ii. shall be prohibited from acting as a Designated Manager in any pharmacy;

iii. shall be required to notify the College in writing of the names(s), address(s) and telephone numbers(s) of all employer(s) within fourteen (14) days of commencing employment in a pharmacy;

iv. shall provide his pharmacy employer with a copy of the Discipline Committee Panel’s decision in this matter and its Order; and

v. shall only engage in the practice of pharmacy for an employer who agrees to write to the College within fourteen (14) days of the Registrant commencing employment, confirming that it has received a copy of the required documents identified in subparagraph 3(b)(iv), and confirming the nature of the Registrant’s remuneration.

4. Costs to the College in the amount of $15,000.00.

In its reprimand, the Panel noted that it was extremely disappointed in the Registrant’s conduct and was appalled by the facts presented in this case. The Registrant’s admissions of fraudulent billings were shocking as they started shortly after his takeover of the Pharmacy.

The Panel observed that pharmacists are members of a highly respected profession. The public expects pharmacists to act with integrity and trust. The Registrant’s conduct as Owner, Director, Pharmacist, and Designated Manager of the Pharmacy demonstrated an egregious failure to understand and fulfill his ethical, professional, and legal obligations.

The Panel indicated that the Registrant has brought shame to those who have worked so hard to maintain the high standards required and demanded by the public and the profession.

The onerous Order imposed upon him is warranted.

The Panel expressed its expectation that the Registrant will take this opportunity to reflect on his actions. He must change the way he practices to meet his moral, ethical, and legal obligations. The Panel relayed its hope that the Registrant will never appear before a panel of the Discipline Committee again.

Referral 1

The Panel found that Mr. Ma, while engaged in the practice of pharmacy as director, shareholder, owner, Designated Manager, and/or dispensing pharmacist at Pharm Can Drug Mart (the “Pharmacy”) in Ottawa, committed professional misconduct in that he:

• Dispensed monitored drugs without acting on Narcotic Monitoring System alerts for one or more of certain identified prescriptions;
• Dispensed monitored drugs without documenting the actions taken, and/or the reason(s) for not taking any action, in response to Narcotic Monitoring System alerts for one or more of certain identified prescriptions; and/or,
• Dispensed one or more of certain identified prescriptions without labelling the container in which the drug(s) was dispensed.

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 and/or practice;
• Contravened the Act, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, or the regulations under those Acts, and in particular:
  • Sections 156 and 166 of the Drug and Pharmacies Regulation Act, section 20(1) of Ontario Regulation 264/16, and/or
  • Section 54 of Ontario Regulation 58/11;
• 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

Referral 2

The Panel found that Mr. Ma, from in or about March 2015 to in or about November 2017, while engaged in the practice of pharmacy as director, shareholder, owner, designated manager, and/or dispensing pharmacist at Pharm Can Drug Mart (the “Pharmacy”) in Ottawa, Ontario, committed professional misconduct in that he:

• Dispensed and/or billed for drugs and/or products without a prescription authorized by a prescriber for one or more of certain identified drugs and/or products;
• Submitted an account or charge for services that he knew was false or misleading with respect to:

i. one or more of certain identified drugs and/or products; and/or,

ii. one or more of certain identified claims to the Ontario Drug Benefit Program; and/or,

• Falsified a record relating to his practice with respect to:

i. one or more of certain identified drugs and/or products; and/or,

ii. one or more of certain identified claims to the Ontario Drug Benefit Program; and/or,

• Signed or issued, in his professional capacity, a document he knew contained a false and misleading statement with respect to:

i. one or more of certain identified drugs and/or products; and/or,

ii. one or more of certain identified claims to the Ontario Drug Benefit Program; and/or,

• Failed to keep records as required respecting his patients with respect to:

i. one or more of certain identified drugs and/or products; and/or,

ii .one or more of certain identified claims to the Ontario Drug Benefit Program.

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;
• Falsified a record relating to his practice;
• Signed or issued, in his professional capacity, a document that he knew contained a false or misleading statement;
• Submitted an account or charge for services or products that he knew and/or ought to have known was false or misleading;
• Contravened the Pharmacy Act, 1991, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, the Narcotics Safety and Awareness Act, 2010, the Drug Interchangeability and Dispensing Fee Act or the Ontario Drug Benefit Act or the regulations under those Acts, and in particular:
  • sections 155, 156, 163, and 166 of the Drug and Pharmacies Regulation Act, as amended;
  • section 20(1) of Ontario Regulation 264/16, as amended;
  • sections 40 and 54(1) of Ontario Regulation 58/11;
  • sections 5, 6, 15(1), 17(2), and/or 23(1) of the Ontario Drug Benefit Act, as amended; and/or
  • sections 18, 19, 25, 27, and/or 29(1) of Ontario Regulation 201/96, as amended;
• Contravened a federal, provincial or territorial law with respect to the distribution, sale or dispensing of any drug or mixture of drugs, with respect to the distribution, purchase, sale, dispensing or prescribing of any drug or product, the administering of any substance, or the piercing of the dermis, whose purpose is to protect or promote the public health, and/or that is otherwise relevant to his suitability to practise, and in particular:
  • sections 155, 156, 163, and 166 of the Drug and Pharmacies Regulation Act, as amended;
  • section 20(1) of Ontario Regulation 264/16, as amended;
  • sections 40 and 54(1) of Ontario Regulation 58/11, as amended;
  • sections 5, 6, 15(1), 17(2), and/or 23(1) of the Ontario Drug Benefit Act, as amended; and/or
  • sections 18, 19, 25, 27, and/or 29(1) of Ontario Regulation 201/96, 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.

Following submissions heard on February 11, 2021, and May 9, 2022, regarding the order to be made, the Panel imposed an Order in a decision dated October 5, 2022, as follows:

1. A reprimand;
2. Directing the Registrar to revoke Mr. Ma’s Certificate of Registration;
3. A fine in the amount of $20,000 payable to the Minister of Finance;
4. Costs to the College in the amount of $85,000.00.

The reprimand in this matter remains outstanding.

a. Submitted (or permitted, consented to or approved, expressly or by implication, the submission of) false, misleading, inaccurate, and/or unsubstantiated claims to the Ontario Drug Benefit Program (“ODBP”) for one or more of certain identified drugs and/or products listed and/or one or more of certain identified claims; and/or

b. Failed to keep records as required with respect to one or more of certain identified drugs and/or products and/or one or more of certain identified claims submitted to the Ontario Drug Benefit Program and/or one or more of certain other identified claims.

In particular, the Panel found that the Registrant:

• Failed to maintain a standard of practice of the profession;
• Failed to keep records as required respecting his patients or practice;
• Falsified records relating to his practice;
• Signed or issued, in his professional capacity, a document he knew or ought to have known contained a false or misleading statement;
• Submitted an account(s) or charge(s) for services that he knew and/or ought to have known was false or misleading;
• 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:
  • section 15 of the Ontario Drug Benefit Act, 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 of the profession as disgraceful, dishonourable and unprofessional.

The Panel imposed an Order, as follows:

1. A reprimand;

2. Directing the Registrar to suspend the Registrant’s Certificate of Registration for a period of thirteen (13) months with one (1) month of the suspension to be remitted on condition that the Registrant successfully complete the remedial training as specified in paragraph 3(a), below. The suspension shall commence January 18, 2023, and shall continue without interruption until January 17, 2024, inclusive. If the remitted portion of the suspension is required to be served by the Registrant because he fails to complete the remedial requirement specified in paragraph three, that portion of the suspension shall commence on January 18, 2024, and continue without interruption until February 17, 2024, inclusive. If the time for completing the remedial steps in paragraph 3(a) is extended by the Registrar, the date on which the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly.

3. Directing the Registrar to impose specified terms, conditions or limitations on the Registrant’s Certificate of Registration as follows:

a. The Registrant shall successfully complete, at his own expense and within twelve (12) months of the date of this Order: a course with Gail E. Siskind Consulting Services or another ethics consultant approved by the College, to address the professional misconduct arising from this matter, to be designed by the consultant. The following terms shall apply to the course:

i. The number of sessions shall be at the discretion of the consultant, but shall be no fewer than three;

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

iii. Successful completion of the course will include completion of an essay, acceptable to the Registrar, addressing the professional misconduct arising from this matter;

iv. The essay shall be at least 1000 words in length. The Registrant shall be responsible for the cost of review by the consultant to assist the Registrar to determine whether the essay is acceptable, up to a maximum of $500; and

v. The Registrant shall require the consultant to report the results of the course to the College no later than twelve (12) months from the date of this Order.

b. For a period of three (3) years from the date of this Order:

i. the Registrant shall be prohibited from having any proprietary interest in a pharmacy of any kind and/or receiving remuneration for his work as a pharmacist other than remuneration on an hourly or weekly basis; and

ii. the Registrant shall be prohibited from acting as a Designated Manger in any pharmacy.

c. For a period of two (2) years from the date of this Order:

i. the Registrant shall be required to notify the College in writing the name(s), address(es), and telephone number(s) of all employer(s) within 14 days of commencing employment in a pharmacy;

ii. the Registrant shall only work for an employer who confirms to the College in writing within fourteen (14) days of the Registrant commencing employment that they have been provided with a copy of:

1. the Notice of Hearing in this matter;

2. this Order; and

3. the panel’s reasons for decision in this matter, when available.

4. Costs to the College in the amount of $10,000.00.

In its reprimand, the Panel noted that the Registrant has been a member of the profession of pharmacy and of this College for over 40 years. Pharmacy is a self-regulated health profession. As such, the members of this College bear the responsibility to ensure that they maintain the trust of the public and of members. Integrity and trust are paramount to the profession.

The Panel expressed its disappointed with the Registrant’s actions. He should have known better, especially after four decades of pharmacy practice. As the Designated Manager and a Director of his pharmacy business, he was entrusted by this College and the public to operate in a manner that is honest and ethical. He did not.

The Panel observed that the Registrant’s actions have violated the standards of practice and the code of ethics expected by the public and by the profession of pharmacy. The suspension of his Certificate of Registration is essential to protect the public and to deter him from engaging in this type of conduct in the future. The remediation ordered today is intended to provide him with an opportunity for rehabilitation of his conduct in his pharmacy practice.

The Panel indicated that it did not expect to see him again before a panel of the Discipline Committee of the Ontario College of Pharmacists.