Decisions of the Discipline Committee between February 2023 and April 2023.
Amro Noureldin (OCP #215249)
At a hearing on February 8, 2023, a Panel of the Discipline Committee made findings of professional misconduct against Amro Noureldin, while engaged in the practice of pharmacy as a relief pharmacist and/or dispensing pharmacist at Shoppers Drug Mart Pharmacy in Kenora, Ontario (the “Pharmacy”) in that he stole, misappropriated, and/or took without authorization drugs from the Pharmacy.
In particular, the Panel found that the Registrant:
- Failed to maintain a standard of practice of the profession;
- Contravened a federal law with respect to the distribution, purchase, sale, or dispensing or prescribing of any drug or product, whose purpose is to protect or promote public health, and/or that is otherwise relevant to his suitability to practise, and in particular theft under $5,000, contrary to section 334(b) of the Criminal Code, 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;
- Engaged in conduct that is unbecoming of a member.
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 5 months with 1 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. The suspension shall commence on February 8, 2023 and shall continue without interruption until June 7, 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 3(a), that portion of the suspension shall commence on February 8, 2024 and continue until March 7, 2024, inclusive;
3. Directing the Registrar to impose specified terms, conditions, or limitations on the Registrant’s certificate of registration, including:
a. The Registrant shall 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 5 years from the date of this Order, the Registrant shall be prohibited from acting as a Designated Manager or narcotic signer at any pharmacy;
c. For a period of 2 years from the date of this Order:
i. the Registrant shall notify the College in writing of the name(s) address(es) and telephone number(s) of all employers within 14 days of commencing employment in a pharmacy;
ii. the Registrant shall provide his pharmacy employer(s) with a copy of the Discipline Committee Panel’s decision in this matter and its Order; and
iii. the Registrant shall provide written confirmation to the College that he has provided each pharmacy employer a copy of the Discipline Panel’s decision in this matter and its Order within 14 days of commencing employment.
4. Costs to the College in the amount of $10,000.00.
In its reprimand the Panel noted that the Registrant’s conduct is all of disgraceful, dishonourable, and unprofessional. He pleaded guilty in the criminal courts to one count of theft under $5,000. His actions have brought shame to himself and the profession. The Panel observed that, as an experienced, long-standing College registrant, he should have known better.
The Panel indicated that by admitting to these serious allegations, the Registrant has taken a first step towards his rehabilitation. The Panel expressed its trust that the Registrant will learn from this shameful experience and commit to never again appear before a Panel of the Discipline Committee.
Mary Azzer (OCP #617811)
At a hearing on February 13, 2023, a Panel of the Discipline Committee made findings of professional misconduct against Mary Azzer, while engaged in the practice of pharmacy as Designated Manager and/or dispensing pharmacist at Family Care Pharmacy in Iroquois Falls, Ontario (the “Pharmacy”), and/or as a shareholder and/or director of the corporation that operates the Pharmacy, with respect to the following incidents:
- On or about June 12, 2019, she permitted, consented to or approved, expressly or impliedly, the Pharmacy operating without a pharmacist being physically present;
- On or about June 12, 2019, she permitted, consented to or approved, expressly or impliedly, the sale and/or dispensing of drugs at the Pharmacy while no pharmacist was physically present, with respect to certain identified prescriptions;
- On or about June 12, 2019, she permitted, consented to or approved, expressly or impliedly, the dispensing of prescriptions to patients without the prescriptions having been checked appropriately by a pharmacist, with respect to certain identified prescriptions;
- On or about June 12, 2019, she delayed the dispensing of a methadone prescription to a patient experiencing acute opioid withdrawal, rather than directing the person presenting the prescription to a nearby pharmacy that could fill it promptly.
In particular, the Panel found that she:
- Failed to maintain a standard of practice of the profession;
- Contravened the Pharmacy 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. 146 and s. 149 of the Drug and Pharmacies Regulation Act;
- 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 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 her 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 successfully complete, at her own expense and within twelve (12) months of the date of the Order, all six of the College’s current Jurisprudence elearning Modules and the Jurisprudence Exam;
c. The Registrant shall successfully complete, at her own expense and within twelve (12) months of the date of the Order, the College’s Designated Manager (DM) Module;
d. The Registrant shall successfully complete, at her own expense and within twelve (12) months of the date of the Order, the CAMH Opioid Use Disorder Treatment Course;
e. The Registrant shall be prohibited from acting as Designated Manager in any pharmacy for one (1) year from the date of this Order, or until the successful completion of the remediation described in paragraphs 2(a), 2(b), 2(c) and 2(d) above, whichever is longer; and
3. That the Registrar 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 condition that the Registrant complete the remedial training as specified in subparagraphs 2(a), 2(b), 2(c), and 2(d) above. The suspension shall commence on February 13, 2023, and shall continue until April 12, 2023, inclusive. If the remitted portion of the suspension is required to be served by the Registrant because she fails to complete the remedial requirements specified in subparagraphs 2(a), 2(b), 2(c), or 2(d) above, that portion of the suspension shall commence on February 13, 2024, and shall continue until March 12, 2024, inclusive. If the time for completing the remedial steps in subparagraphs 2(a), 2(b), 2(c), 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. Costs to the College in the amount of $10,000.00.
In its reprimand, the Panel noted that pharmacists are expected to conduct themselves in a manner that maintains the public’s confidence in the healthcare system. The Panel expressed its disappointment that the Registrant, as a pharmacist, put the public at risk by having her pharmacy open without a licensed pharmacist present. The potential impact of her actions on public safety is particularly disturbing.
The Panel noted that the legislation that governs the practice of pharmacy is designed to protect the public. It defines who can own and operate a pharmacy as being a pharmacist. Therefore, to practice pharmacy is a privilege. The Panel indicated that fundamental to this privilege is the expectation that the rules will be followed when operating a pharmacy every day. The Registrant did so every day except one and on this one day, instead of referring her patients to other pharmacies in the area, she chose to keep her pharmacy open and, in so doing, she put the public at risk and placed undue pressure on her staff in her absence.
The panel observed that the Registrant’s handling of the dispensing of methadone for a patient who was in acute opioid withdrawal demonstrates a misunderstanding of the role of a pharmacist in the management of acute opioid withdrawal. As a result of her inaction, this patient suffered the ill effects of acute opioid withdrawal for at least seven hours before the Registrant eventually released the product. This should never have happened. The prescription for this patient should have been referred to the other pharmacy in her area that had the authority to dispense methadone. In this regard, the Registrant contravened a fundamental principle of the College’s Code of Ethics: “do no harm and prevent harm from occurring”. Such lack of understanding was very concerning to the Panel and cast doubt over the Registrant’s ability to provide professional services in the methadone program.
This Panel expressed its hope that the Registrant now understands what a privilege it is to practice the profession of pharmacy, and its expectation that she will learn from this process, improve her practice, work hard to regain the public trust, and never appear before the Discipline Committee again.
Practice Insight: Learning from Common Complaints to the College
Identify opportunities for improvement in your own practice by learning about the top 5 categories of complaints to the College.
Augustine Daniar (OCP #610605)
At a hearing on March 1, 2023, a Panel of the Discipline Committee made findings of professional misconduct against Augustine Daniar, since May 2019, while engaged in the practice of pharmacy as director, shareholder, owner, Designated Manager, and/or dispensing pharmacist at White Cedar Pharmacy in Thunder Bay, Ontario, in that he:
- Failed to keep records as required relating to his patients and/or his practice with respect to the drug product Suboxone;
- Signed or issued, in his professional capacity, a document he ought to have known contained a false and misleading statement with respect to the drug product Suboxone;
- Submitted an account or charge for services or products that he ought to have known was false or misleading with respect to the drug product Suboxone.
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;
- Signed or issued, in his professional capacity, a document that ought to have known contained a false or misleading statement;
- Submitted an account or charge for services or products that he ought to have known was false 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 23 months with 1 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. The suspension shall commence on March 2, 2023 and shall continue, without interruption, until January 1, 2025, 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 3(a), that portion of the suspension shall commence on January I, 2025 and shall continue until January 31, 2025, 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, including:
a. The Registrant must successfully complete, with an unconditional pass, at his own expense and within 12 months of the date of the Order:
i. the ProBE Program on professional/problem-based ethics for health care professional offered by the Centre for Personalized Education for Professionals;
ii. the ISMP Canada course on Medication Safety Considerations for Compliance Packaging;
iii. the College’s Jurisprudence exam; and
iv. the College’s Designated Manager e-learning module.
b. For a period of 3 years from the date of the Order, 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.
c. For a period of 3 years from the date of the Order, the Registrant shall be prohibited from acting as a Designated Manager in any pharmacy;
d. The Registrant’s practice, and the operation of any pharmacy in which he has a proprietary interest or acts as a Designated Manager, shall be subject to Compliance Audit Reviews (“CAR” or “CARs”) by the College, on the following terms:
i. the College will be entitled to conduct CARs for a period of 3 years from the date that the Registrant becomes a Designated Manager of a pharmacy or obtains a proprietary interest in a pharmacy (the “CARs Period”);
ii. if the Registrant ceases to act as Designated Manager or to have a proprietary interest in a pharmacy at any time within the 3 years specified in subparagraph 3(d)(i) above, such that the College is unable to conduct any CARs, then the CARs Period shall be paused and shall resume on the date on which the Registrant obtains a proprietary interest in a pharmacy or commences acting as Designated Manager of a pharmacy, and in such circumstances:
1. the Registrant shall notify the College, in writing, if he no longer has a proprietary interest in a pharmacy or is no longer acting as a Designated Manager of a pharmacy at any point(s) during any time( s) that the CARs Period remains active; and
2. if the CARs Period is paused at any time(s), the Registrant shall notify the College, in writing, when he obtains a proprietary interest in a pharmacy or begins acting as Designated Manager of a pharmacy, at which point the CARs Period shall resume and shall continue until a total period of 3 years has been achieved;
iii. the CARs will be conducted by means of attendances by a representative of the College at the pharmacy where the Registrant acts as Designated Manager or holds a proprietary interest in, at such times as the College may determine;
iv. during any CAR, the College representative will be entitled to review and examine the Registrant’s practice, or the practice and operation of any pharmacy in which the Registrant holds a proprietary interest or acts as Designated Manager, with respect to any issue relevant to the Discipline Committee Panel’s decision in this matter;
v. the CARs are in addition to any routine inspections conducted by the College pursuant to the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H.4., s. 148, and are not a substitute for such inspections;
vi. the Registrant shall fully cooperate with the College representative during the CARs; and
vii. the Registrant shall pay to the College the amount of $1,000.00 per CAR, immediately after each CAR is completed, with the total amount to be paid by the Registrant not to exceed $6,000, regardless of the number of CARs and/or attendances conducted by the College.
4. Costs to the College in the amount of $30,000.00.
In its reprimand, the Panel noted that, as a pharmacist, the Registrant is a member of a highly respected profession within the health care system and the community at large. This includes the First Nations communities served by the pharmacy where he was practising. 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 the frequency and volume of the Registrant’s inappropriate billings are clearly a flagrant abuse of the system. The roles of pharmacy director and Designated Manager are ones of heavy responsibility. The Panel indicated that the Registrant failed in his duties as a pharmacy director and a Designated Manager.
The Panel pointed out that practising pharmacy is a privilege that is granted to those who possess the knowledge, skill, and judgement to practice safely, ethically, and professionally. The Panel expressed its hope that the suspension and remediation ordered will provide the Registrant with an opportunity to prevent this type of conduct from occurring in his future pharmacy practice.
The Panel explained that the Registrant’s admission to the allegations is a first step towards his rehabilitation, and that he must change his ways and learn from this experience. The Panel relayed its expectation that he will not appear again before a Panel of the Discipline Committee of the Ontario College of Pharmacists.
Riham Basyouny (OCP #618694)
At a hearing on March 3, 2023, a Panel of the Discipline Committee made findings of professional misconduct against Riham Basyouny, while engaged in the practice of pharmacy as dispensing pharmacist, Designated Manager, shareholder and/or director at Clairhurst Medical Pharmacy and/or Charles Pharmacy, both in Toronto, Ontario, from about January 1, 2021 to August 1, 2021, in that she:
- Processed prescriptions from Clairhurst Pharmacy at Charles Pharmacy for billing purposes, in relation to certain identified prescriptions;
- Failed to maintain accurate records, in relation to certain identified prescriptions;
- Failed to ensure that containers in which prescription drugs are dispensed are labelled in accordance with s. 156(3) of the Drug and Pharmacies Regulation Act, with respect to certain identified prescriptions.
In particular, the Panel found that the Registrant:
- Failed to maintain the standards of practice of the profession;
- Signed or issued, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement;
- Submitted an account or charge for services or products that she knew or ought to have known was false or misleading;
- Contravened section 156(3) of the Drug and Pharmacies Regulation 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 of the profession as 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. That the Registrant successfully complete, at her own expense and within 12 months of the date of this Order, all six of the College’s current Jurisprudence e- Learning Modules and the Jurisprudence Exam;
b. That the Registrant successfully complete, within 13 months of the date of this Order, a mentorship, with a mentor approved by the College, regarding the issues raised by the facts and findings of professional misconduct in this case. The mentorship must comply with the following terms:
i. Following the date of this Order, the College shall assign the Registrant a practice mentor and the Registrant shall retain the practice mentor at her own expense;
ii. The Registrant shall meet at least three times with the practice mentor, at a place to be determined by the practice mentor, for the purpose of reviewing the Registrant’s practice and identifying areas in the Registrant’s practice with respect to these issues that require remediation. These meetings shall take place from time to time, at the discretion of the practice mentor, for a period of up to 12 months;
iii. The Registrant shall provide the practice mentor with the following documents related to this proceeding:
1. the Notice of Hearing, the Agreed Statement of Facts, and this Joint Submission on Order; or
2. the Panel’s Decision and Reasons, if and when available.
iv. The Registrant shall develop with the practice mentor a learning plan to address the areas of the Registrant’s practice requiring remediation;
v. The Registrant shall demonstrate to the practice mentor, in a manner directed by and acceptable to the practice mentor, that the Registrant has achieved success in meeting the goals established in the learning plan; and
vi. The Registrant shall make best efforts to ensure that the practice mentor reports the results of the mentorship program in writing to the College, after its completion, which report shall be delivered no later than 14 months following the date of this Order.
c. The Registrant’s practice is to be subject to Compliance Audit Reviews (CARs) by the College at any pharmacy in which she has a proprietary interest and/or is the Designated Manager. The following terms shall apply to the CARs:
i. the College will be entitled to conduct any CAR for a period of 12 months following the completion of the mentorship program described in paragraph 2(b), above (“CARs Period”);
ii. if the Registrant ceases to have a proprietary interest in any pharmacy and also ceases be a Designated Manager at any time within the 12 months specified in subparagraph 2(c)(i) above, such that the College is unable to conduct any CARs, then the CARs Period shall be paused and shall resume on the date on which the Registrant again obtains a proprietary interest in a pharmacy and/or commences acting as a Designed Manager, and in such circumstances:
1. the Registrant shall notify the College, in writing, if she no longer holds a proprietary interest in any pharmacy and is no longer a Designated Manager in a pharmacy at any point(s) during any times that the CARs Period remains active; and
2. if the CARs Period is paused at any time(s), the Registrant shall notify the College, in writing, when she again obtains a proprietary interest in a pharmacy and/or commences acting as a Designated manager, at which point the CARs Period shall resume and shall continue until a total period of 12 months has been achieved;
iii. the CARs will be conducted by means of attendances, either virtually or in person, by a representative of the College at any pharmacy in which the Registrant holds a proprietary interest and/or at which the Registrant is acting as a Designated Manager at such times as the College may determine;
iv. the CARs are in addition to any routine inspections conducted by the College pursuant to the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H.4., s. 148, and are not a substitute for such inspections;
v. the Registrant shall fully cooperate with the College representative during the CARs; and
vi. the Registrant shall pay to the College in respect of such CAR the amount of $1,000.00 per CAR, immediately after each CAR is completed, with the total amount to be paid by the Registrant not to exceed $3,000, regardless of the number of CARs and/or attendances conducted by the College.
3. The Registrar is directed to suspend the Registrant’s certificate of registration for one month. The suspension shall be suspended as of the date of this Order and shall remain suspended provided that the Registrant completes the remedial program specified in subparagraphs 2(a) and (b) as required. In the event that the Registrant fails to complete the remedial program specified in subparagraphs 2(a) and (b), the suspension shall commence on May 4, 2024, and shall continue until June 3, 2024, inclusive, unless the time for completing the remedial program in subparagraphs 2(a) and (b) is extended by the Registrar, in which case, the date on which 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 engaged in conduct that is unprofessional, failed to maintain the standards of practice of the profession, and contravened provincial laws and regulations. The Panel observed that the Registrant processed prescriptions from one pharmacy at another pharmacy for billing purposes, failed to maintain accurate records, and failed to ensure proper labelling of the containers in which prescription products are dispensed.
The Panel pointed out that the Registrant is the owner and operator of the two pharmacies where her misconduct occurred. As an experienced and longstanding College registrant, she should have known better. The Panel expressed its hope that the Registrant has learned from this experience and that she will never again appear before a discipline panel.
David Berko (OCP #625551)
At a hearing on March 29, 2023, a Panel of the Discipline Committee made findings of professional misconduct against David Berko, while engaged in the practice of pharmacy as Designated Manager and/or dispensing pharmacist at the […] Pharmacy in […], Ontario, in the period from about [Identified Date A] to [Identified Date B], in that he failed to maintain appropriate professional boundaries with a patient, […].
In particular, the Panel found that he:
- Failed to maintain a standard of practice of the profession;
- 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, as follows:
1. A reprimand;
2. Directing the Registrar to suspend the Registrant’s Certificate of Registration for a period of three months with one month to be remitted on the condition that the Registrant completes the remedial program specified in subparagraphs 3(a) and (b) within 18 months of the date of the Order. The suspension shall commence on August 1, 2023, and shall continue until September 30, 2023 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 subparagraphs 3(a) and (b), that portion of the suspension shall commence on September 29, 2024 and shall continue until October 28, 2024, inclusive. If the time for completing the remedial steps in subparagraphs 3(a) and (b) is extended by the Registrar, the date on which the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly;
3. That the Registrar is directed to impose specified terms, conditions or limitations on the Registrant’s certificate of registration, and in particular:
a. That the Registrant shall successfully complete, at his own expense and within 12 months of the date of this Order, the ProBE Program on Professional/Problem Based Ethics for healthcare professionals, with an unconditional pass;
b. That the Registrant shall successfully complete, at his own expense and within 18 months of the date 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 (the “Siskind Course”). The Siskind Course shall be commenced following successful completion of the ProBE program. The following terms shall apply to the Siskind Course:
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 Registrant and the consultant, but shall ultimately be at the discretion of the consultant;
iii. the Registrant shall provide to the consultant the following documents, in advance of the Siskind Course, to facilitate the design of the Siskind Course:
1. his essay and any and all evaluations from the ProBE program;
2. the Notice of Hearing;
3. the Agreed Statement of Facts;
4. this Joint Submission on Order; and
5. the Panel’s Decision and Reasons, if and when available;
iv. successful completion of the course will include completion of an essay, acceptable to the Registrar, addressing the issues raised in this matter; and
v. the consultant shall agree to confirm to the College once the Registrant has completed the Siskind Course to the satisfaction of the consultant.
4. Costs to the College in the amount of $15,000.00.
In its reprimand, the Panel noted that the Registrant’s conduct has been found to be unprofessional. He breached the standards of practice by failing to maintain professional boundaries with a patient.
The Panel acknowledged the unique and challenging circumstances of practicing pharmacy in a remote community; however, it expressed its expectation that pharmacists remain mindful of their professional obligations and always respect professional boundaries in any circumstance.
The Panel relayed its confidence that these proceedings have impressed upon the Registrant the seriousness of his misconduct. The Panel indicated that the remedial opportunities required of the Registrant will enhance his understanding of his legal and ethical obligations, and will assist him in his pharmacy practice moving forward.
The Panel expressed its expectation that the Registrant will not appear before a panel of the Discipline Committee again.
Amany Mourid (OCP #603482)
Following a hearing held on July 22, 2020, and May 25, 2021, a Panel of the Discipline Committee made findings of professional misconduct against Amany Mourid, while engaged in the practice of pharmacy as director, shareholder, Designated Manager and/or dispensing pharmacist at St. Mary Pharmacy, Ontario (“the Pharmacy”), in that she:
- Submitted and/or permitted, consented to or approved, either expressly or by implication, the submission of accounts or charges for services that she knew were false or misleading to the Ontario Drug Benefit program; and falsified and/or permitted, consented to or approved, either expressly or by implication, the falsification of pharmacy records relating to her practice in relation to the dispensing of and/or claims made to the Ontario Drug Benefit program through the Pharmacy, for:
i. one or more of certain identified drugs and/or products from on or about September 1, 2014 on or about August 31, 2016;
ii. one or more of certain identified MedsCheck reviews submitted from on or about August 23, 2012 to on or about August 23, 2016, which were non-compliant with the guidelines of the Ministry of Health and Long Term Care;
iii. one or more of certain identified chronic use medications submitted on or after October 1, 2015, with respect to which there was missing and/or incomplete frequent dispensing documentation;
iv. one or more influenza vaccines administered to ineligible patients under the age of 18 and/or with respect to which there was missing documentation, including RX# […], […], […] and/or […];
v. one or more of certain identified “Limited Use” products, which did not meet the clinical criteria for reimbursement specified in the Ontario Drug Benefit Formulary;
vi. one or more prescriptions for deceased patients, including RX# […], […], […], […], […], […], […], […], […] and/or […];
vii. one or more invalid extemporaneous preparations, including RX# […], […], […], […], […] and/or […];
viii. one or more of certain identified transactions, in which the patient’s Ontario Drug Benefit eligibility card was not obtained or retained by the Pharmacy; and/or
ix. one or more nutritional products, including RX# […], […], […], […], […], […], […], […], […], […], […], […], […], […] and/or […] for a patient who did not meet the eligibility criteria specified in the Ontario Drug Benefit Formulary;
- Failed to ensure that the Pharmacy complied with all legal requirements, including but not limited to, requirements regarding record keeping, documentation, and billing the Ontario Drug Benefit Plan;
- Failed to keep records of monthly Ontario Drug Benefit eligibility cards or a copy of the cards with respect to each person for whom a drug was dispensed, as required by section 29 of Ontario Regulation 201/96, under the Ontario Drug Benefits Act, R.S.O. 1990, c. O.10, as amended, from on or about October, 2014 to on or about June, 2016;
- Submitted to the Ontario College of Pharmacists and/or the Ministry of Health and Long Term Care invoices, receipts and/or other documentation that she knew, or ought to have known, was false, misleading or unreliable to substantiate the purchase and/or transfer of one or more of certain identified drugs and/or products.
In particular, the Panel found that she:
- Failed to maintain a standard of practice of the profession;
- Failed to keep records as required respecting her patients;
- Falsified and/or permitted, consented to or approved, either expressly or by implication, the falsification of records relating to her practice;
- Signed or issued, in her professional capacity, and/or permitted, consented to or approved, either expressly or by implication, the signing or issuing of a document that she knew contained a false or misleading statement;
- Submitted and/or permitted, consented to or approved the submission of accounts or charges for services that she knew to be false or misleading;
- Contravened the Pharmacy Act,1991, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991 or the regulations under those Acts and in particular:
(a) Sections 155 and 156 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:
(a) Sections 5, 6, 15(1)(b) and/or 17(2) of the Ontario Drug Benefits Act, R.S.O. 1990, c. O.10, as amended, and/or Ontario Regulation 201/96 made thereunder;
(b) Sections 155 and 156 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H-4, as amended;
- Permitted, consented to or approved, either expressly or by implication, the contravention of 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:
(a) Sections 5, 6, 15(1)(b) and/or 17(2) of the Ontario Drug Benefits Act, R.S.O. 1990, c. O.10, as amended, and/or Ontario Regulation 201/96 made thereunder;
(b) Sections 155 and 156 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H-4, as amended;
- Engaged in conduct or performed an act or acts relevant to the practice of pharmacy that, having regarding to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable and unprofessional.
The Panel imposed the following Order in a decision dated August 10, 2021:
1. A reprimand;
2. That the Registrar be directed to impose the following conditions on the Member’s Certificate of Registration:
a. That the Member shall successfully complete, with an unconditional pass, at her own expense and within twelve (12) months of the date that this Order becomes final, the ProBE Program on Professional/Problem Based Ethics for Healthcare Professionals and any related evaluations offered by the Centre for Personalized Education for Physicians;
b. 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 particularly as it relates to the practice of pharmacy. 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:
a) The Notice of Hearing;
b) The Panel’s Decision and Reasons.
c. 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.
3. That the order issued by the Panel on December 3, 2020 prohibiting the Member from acting as a Designated Manager in any pharmacy be extended for a period of three (3) years from the date this Order becomes final. The Member must arrange for a pharmacist, acceptable to the College, to act as Designated Manager of the St. Mary Pharmacy (Accreditation #300945), which is owned and operated by a corporation for which the Member is the sole director and shareholder;
4. The Designated Manager suspension shall continue thereafter until the date on which the College is notified that the Member has successfully completed a mentorship program regarding the role and responsibilities of a Designated Manager. The mentorship program shall include the following terms:
a. The Member shall retain, at her own expense, a mentor acceptable to the College;
b. The Member shall meet at least five (5) times with the mentor, for the purpose of reviewing the Member’s practice with respect to the role and responsibilities of a Designated Manager;
c. To this end, the Member shall provide the mentor with the following documents related to this proceeding:
i. a copy of the Notice of Hearing;
ii. a copy of the Amended Agreed Statement of Facts;
iii. a copy of this Order; and
iv. a copy of the Decision and Reasons of the Discipline Panel.
d. The Member shall develop a learning plan with the mentor to comprehensively address the role and responsibilities of a Designated Manager. The learning plan shall include, but is not limited to, successful completion by the Member of the College’s Designated Manager e-Learning Module and its associated Certificate of Completion;
e. The Member shall demonstrate to the mentor that she has successfully achieved all of the goals of the learning plan; and
f. The Member shall require the mentor to report the results of the Mentorship Program to the College. Such report shall include, but is not limited to:
i. the Member’s Certificate of Completion of the College’s Designated Manager e-Learning Module;
ii. the learning plan; and
iii. the mentor’s assessment of the Member’s success in meeting the goals of the learning plan.
5. That the Member’s Certificate of Registration be suspended for a period of twelve (12) months, with two (2) months remitted upon completion of the following courses outlined in this Order above – 2(a), 2(b) and 2(c). The suspension shall commence on the date that this Order becomes final;
6. Costs to the College in the amount of $39,516.89.
The reprimand in this matter remains outstanding.
The full text of these decisions will be available at www.canlii.org.
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