Discipline Decisions (October 2021)

The Panel found that Mr. Odigie committed professional misconduct in that:

• Between about May 29, 2017 and April 18, 2018, he dispensed (or permitted, consented to or approved, expressly or impliedly, the dispensing of) medication to patient [Patient A] in strengths that were inappropriate having regard to the prescribed dose, without an appropriate clinical, therapeutic, or other basis, with respect to certain identified medication;
• Between about May 29, 2017 and April 18, 2018, he charged (or permitted, consented to or approved, expressly or impliedly, the charging of) amounts to the Ontario Drug Benefit Program that were excessive in relation to the service or product provided, and in particular, he charged dispensing fees for dispensing medication to patient [Patient A] in strengths that were inappropriate having regard to the prescribed dose, without an appropriate clinical, therapeutic, or other basis, with respect to certain identified medication;
• Between about January 1, 2018 and July 17, 2018, he dispensed (or permitted, consented to or approved, expressly or impliedly, the dispensing of) medication to patient [Patient B] in strengths that were inappropriate having regard to the prescribed dose, without an appropriate clinical, therapeutic, or other basis, with respect to certain identified medication;
• Between about January 1, 2018 and July 17, 2018, he charged (or permitted, consented to or approved, expressly or impliedly, the charging of) amounts to the Ontario Drug Benefit Program that were excessive in relation to the service or product provided, and in particular, he charged dispensing fees for dispensing medication to patient [Patient B] in strengths that were inappropriate having regard to the prescribed dose, without an appropriate clinical, therapeutic, or other basis, with respect to certain identified medication.

In particular, the Panel found that he:

• Failed to maintain a standard of practice of the profession;
• Charged a fee or amount that was excessive in relation to the service or product provided;
• 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.

Referral 2

The Panel found that Mr. Odigie committed professional misconduct in that:

• Between about January 1, 2018 and February 12, 2019, he practised the profession while in a conflict of interest, and in particular, he practised as dispensing pharmacist and/or Designated Manager at the Pharmacy, while the Pharmacy engaged in financial transactions with an individual ([Name]), who was authorized to give instructions to the Pharmacy’s bank(s) and who was authorized to and did sign cheques on the Pharmacy’s bank account(s), and while all or substantially all the Pharmacy’s patients were referred to the Pharmacy by [Name];
• Between about January 1, 2018 and February 12, 2019, he dispensed (or permitted, consented to or approved, expressly or impliedly, the dispensing of) medication to certain identified patients in combinations of strengths that were inappropriate having regard to the patients’ prescribed doses and the available strengths of the medications, without an appropriate clinical, therapeutic, or other reasonable basis;
• Between about January 1, 2018 and February 12, 2019, he dispensed (or permitted, consented to or approved, expressly or impliedly, the dispensing of) medication to certain identified patients on a daily basis, without an appropriate clinical, therapeutic, or other reasonable basis for dispensing daily;
• Between about January 1, 2018 and February 12, 2019, he charged (or permitted, consented to or approved, expressly or impliedly, the charging of) amounts to the Ontario Drug Benefit Program that were excessive in relation to the service or product provided, and in particular, he charged dispensing fees for dispensing medication to certain identified patients in combinations of strengths that were inappropriate having regard to the patients’ prescribed doses and the available strengths of the medications, without an appropriate clinical, therapeutic, or other basis;
• Between about January 1, 2018 and February 12, 2019, he charged (or permitted, consented to or approved, expressly or impliedly, the charging of) amounts to the Ontario Drug Benefit Program that were excessive in relation to the service or product provided, and in particular, he charged dispensing fees for dispensing medication to certain identified patients on a daily basis, without an appropriate clinical, therapeutic, or other reasonable basis for dispensing daily;
• Between May 7, 2018 and May 11, 2020, he provided (or permitted, consented to or approved, expressly or impliedly, the provision of) false or misleading information to an Ontario College of Pharmacists investigator in the course of their investigation into his conduct, and/or he failed to cooperate with the investigator’s investigation into his conduct, including without limitation with respect to certain identified information, contrary to ss. 76(3) and/or 76(3.1) of the Health Professions Procedural Code, being Schedule 2 to the Regulated Health Professions Act, 1991.

In particular, the Panel found that he:

• Failed to maintain a standard of practice of the profession;
• Practised the profession while in a conflict of interest;
• Charged a fee or amount that was excessive in relation to the service or product provided;
• Contravened the Pharmacy Act, 1991, the Drug and Pharmacies Regulation Act, the Regulated Health Professions Act, 1991, the Narcotic 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:
  • ss. 76(3) and/or 76(3.1) of the Health Professions Procedural Code, being Schedule 2 to the Regulated Health Professions Act, 1991;
• 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.

Following findings made on March 8, 2021, and after further submissions with respect to the Order to be imposed, which were heard on June 16, 2021, 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 Member’s Certificate of Registration, and in particular:

a. that the Member complete successfully, with an unconditional pass, at his own expense and within twelve (12) months of the date this Order becomes final, the ProBE Program on Professional/Problem Based Ethics offered by the Center for Personalized Education for Professionals;

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

i. 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

ii. acting as a Designated Manager in any pharmacy;

c. that for a period of three years from the date this Order becomes final, the Member 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;

3. That the Registrar suspend the Member’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 Member complete the remedial training as specified in paragraph 2(a). The suspension shall commence on the date this Order becomes final, and shall continue for eleven (11) months thereafter without interruption. If the remitted portion of the suspension is required to be served by the Member because he fails to complete the remedial requirement specified in paragraph 2(a), that portion of the suspension shall commence on the date that is twelve (12) months from the date this Order becomes final, and shall continue for one (1) further month thereafter without interruption. If the time for completing the remedial steps in paragraph 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 $15,000.

In its reprimand, the Panel noted that Mr. Odigie is a member of the honourable profession of pharmacy. Integrity and trust are paramount to this profession as pharmacists provide care to the public and, in return, they are held in high regard for the role they play in the provision of healthcare in Ontario.

The Panel found it necessary to impress upon Mr. Odigie the seriousness of his misconduct. The fact that he would purposely, without clinical reason, dispense psychiatric medications in irregular strengths to make up the total dose of the medication is, in itself, deplorable. The fact that he would do this for the purpose of financial gain is reprehensible. On behalf of the public and Mr. Odigie’s pharmacist peers, this Panel expressed that it was appalled with his conduct.

The Panel explained that the practice of pharmacy is a privilege, which carries with it significant obligations to the public, the profession, and to oneself. The result of Mr. Odigie’s misconduct is that he has eroded the public trust in the pharmacy profession and has cast a very dark shadow over his own integrity.

The Panel relayed its hope that this hearing will give Mr. Odigie the opportunity to pause for reflection on his disgraceful conduct, which is now part of his College record. The Panel suggested that, should Mr. Odigie decide to not change his practice, he will no doubt appear before a Panel of Discipline Committee in the future where the outcome will be quite different. The Panel expressed its sincere hope that he will amend his ways and will not appear in front of such a Panel in the future.

The Panel found that Ms. Khan, while engaged in the practice of pharmacy as a dispensing pharmacist at [Pharmacy A] and/or at [Pharmacy B], committed professional misconduct in that she:

• Was found guilty of an offence that is relevant to her suitability to practise with respect to findings of guilt made on December 18, 2017, by the Ontario Court of Justice at Oshawa in relation to the following counts:
  • Theft of Oxycocet exceeding $5,000, contrary to section 334(a) of the Criminal Code of Canada;
  • Fraud with respect to Oxycocet exceeding $5,000, contrary to section 380(1)(a) of the Criminal Code of Canada;
  • Theft of Oxycocet not exceeding $5,000, contrary to section 334(b) of the Criminal Code of Canada; and/or
  • Fraud with respect to Oxycocet not exceeding $5,000, contrary to section 380(1)(b) of the Criminal Code of Canada;
• In the period from in or about February 17, 2017, to April 29, 2017, she misappropriated at least 11,830 tablets of Ratio-Oxycocet and/or Sandoz-Oxycodone Acetaminophen, without authorization or record, from [Pharmacy A];
• In the period from in or about April 5, 2016, to December 10, 2016, she misappropriated at least 78,045 tablets of Ratio-Oxycocet, without authorization or record, from [Pharmacy B];
• In the period from in or about February 17, 2017, to April 29, 2017, she submitted approximately 28 false claims, for which there were no valid prescriptions and for which payment was not required, to the Ontario Drug Benefit program (“ODB”) from [Pharmacy A]; and/or
• In the period from in or about April 5, 2016, to December 10, 2016, she submitted approximately 304 false claims, for which there were no valid prescriptions and for which payment was not required, to the ODB from [Pharmacy B].

In particular, the Panel found that she:

• Was found guilty of an offence that is relevant to her suitability to practice;
• 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;
• Falsified a record relating to her practice;
• Signed or issued, in her professional capacity, a document that she knew contained a false or misleading statement;
• Submitted an account or charge for services that she knew was 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:
  • Section 155 of the Drug and Pharmacies Regulation Act;
• 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 G.03.002, and/or G.03.012 of the Food and Drug Regulations, C.R.C., c. 870, as amended, to the Food and Drugs Act, R.S.C., 1985, c. F-27, as amended;
  • Section 4 of the Controlled Drugs and Substances Act, S.C. 1996, c. 19, as amended;
  • Section 31 of the Narcotic Control Regulations, C.R.C., c. 1041, as amended, to the Controlled Drugs and Substances Act, S.C. 1996, c. 19, as amended;
  • Section 8 of the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c.22, as amended, and the Notice issued thereunder, and/or section 11 of the Narcotic Safety and Awareness Act, 2010, S.O. 2010 C.22, as amended;
  • Section 15 of the Ontario Drug Benefit Act, R.S.O. 1990, C. O.10, as amended;
  • Sections 334(a), 334(b), 380(1)(a), and/or 380(1)(b) of the Criminal Code of Canada;
• Knowingly permitted the premises in which a pharmacy was located to be used for unlawful purposes;
• 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.

Referral 2

The Panel found that Ms. Khan, while she employed as a dispensing pharmacist, committed professional misconduct in that she:

• Failed to maintain the professional boundaries of the pharmacist-patient relationship when she engaged in a non-professional, personal relationship with the patient, [Name], from in or about [Specified Date 1] to in or about Specified Date 2]; and/or
• Engaged in sexual abuse of the patient, [Name], on one or more occasions, from in or about [Specified Date 1] to in or about [Specified Date 2].

In particular, the Panel found that she:

• Failed to maintain a standard of practice of the profession;
• Sexually abused a patient;
• Abused a patient verbally or physically;
• 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. That the Registrar is directed to revoke the Member’s certificate of registration;
3. Costs to the College in the amount of $32,000.

In its reprimand, the Panel noted that pharmacy is a highly respected profession. As a pharmacist, Ms. Khan failed in her moral obligation to conduct herself in a manner that is professional and to maintain the confidence of the public.

The Panel pointed out that Ms. Khan’s shameful and deceitful conduct, which involved the falsification of records and theft of large amounts of narcotics, put the public at risk by contributing to the opioid crisis.

The Panel observed that pharmacists are expected to demonstrate personal and professional integrity and to maintain professional boundaries at all times. These boundaries are based on trust and respect. Ms. Khan’s conduct undermines the foundation of the trust that exists between pharmacy professionals and their patients.

The Panel explained that pharmacy is a self-regulated profession, the practice of which is a privilege, and which comes with significant obligations to the public, the profession and oneself. The Panel expressed its view that Mr. Khan’s actions warrant the legislated mandatory revocation.

• Failed to conduct, and/or maintain a record of, adequate inventory counts and/or reconciliations for narcotics and/or other controlled substances and/or to report losses to Health Canada as required from in or about January 2017 to in or about December 2018;
• Submitted false claims, falsified records, and/or failed to keep records as required with respect to approximately 51 claims for MedsCheck reviews between in or about November 2017 and in or about December 2018;
• Submitted claims for dispensing fees for compliance packages at more frequent intervals than the compliance packages were being dispensed for one or more patients from in or about January 2018 to in or about March 2019;
• Failed to dispose of expired medications and/or failed to have adequate systems in place to ensure expired medications were removed from stock from in or about August 2018 to in or about December 2018;
• Returned to stock, resold, and/or re-dispensed a drug that was previously sold or dispensed, with respect to one or more of certain identified prescriptions from in or about July 2017 to in or about March 2019;
• Failed to cancel prescriptions that were returned to stock, resold, and/or re-dispensed, with respect to one or more of certain identified prescriptions from in or about July 2017 to in or about March 2019;
• Dispensed medications without accurately recording the Drug Identification Number and/or the identity of the manufacturer on the prescription hardcopy, label, and/or in the pharmacy’s electronic records from in or about July 2018 to in or about December 2018;
• Requested, accepted, and/or failed to repay loans to patients from in or about 2012 to in or about 2019.

In particular, the Panel found that he:

• Failed to maintain a standard of practice of the profession;
• Practised the profession while in a conflict of interest;
• Failed to keep records as required respecting his patients and/or practice;
• Falsified a record relating to his practice and/or a person’s health record;
• 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 an account or charge for services or products that he knew and/or ought to have known was false or misleading;
• 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 42 and/or 43 of the Narcotic Control Regulations, as amended, and/or
  • section 7 of the Benzodiazepines and Other Targeted Substances Regulations, as amended;
• Returned to stock, resold, and/or re-dispensed a drug that was previously sold or dispensed;
• 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 or unprofessional.

The Panel imposed an Order, as follows:

1. A reprimand;

2. Directing the Registrar to suspend the Member’s certificate of registration for a period of 10 months with one month to be remitted on the condition that the Member completes the remedial training specified in subparagraph 3(a) within 12 months of the date of the Order. The suspension shall commence on June 30, 2021 and shall continue without interruption until March 31, 2022, inclusive. If the remitted portion of the suspension is required to be served by the Member because he fails to complete the remedial requirement specified in subparagraph 3(a), that portion of the suspension shall commence on July 1, 2022 and continue until July 31, 2022, inclusive;

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

a. The Member 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 Physicians;

b. For a period of 18 months from the date of this Order, the Member shall be prohibited from acting as a Designated Manager in any pharmacy;

c. For a period of three years from the date of this Order, the Member shall be required to notify the College in writing of the name(s), address(s) and telephone number(s) of all employer(s) within 14 days of commencing employment in a pharmacy;

d. For a period of three years from the date of this Order, the Member shall provide his pharmacy employer with a copy of the Discipline Committee Panel’s decision in this matter and its Order;

e. If the Member acts as a Designated Manager following the 18-month prohibition specified in paragraph 3(b), the Member shall complete four comprehensive inventory reconciliations, acceptable to the College, for all narcotics and other controlled substances in any pharmacy at which he acts as Designated Manager. The first inventory reconciliation shall be completed and submitted to the College no later than six months from the date on which the Member begins acting as Designated Manager, and the remaining inventory reconciliations shall be completed and submitted to the College every six months thereafter. For clarity, all four inventory reconciliations shall be completed within 24 months of the date on which the Member resumes acting as a Designated Manager and each inventory reconciliation shall cover the six-month period preceding the previous inventory reconciliation;

f. The Member shall successfully complete, within 12 months of the date the suspension in paragraph 2 is completed, a mentorship, with a mentor approved by the College, regarding the issues raised by the facts and findings of professional misconduct in this case, including but not limited to: narcotics reconciliations, recordkeeping, billing of compliance packages, conflicts of interest, professional boundaries with patients, MedsCheck processes and documentation, and systems and processes for return to stock medications and the disposal of expired medications. The mentorship must comply with the following terms:

i. Within three months following the completion of the suspension in paragraph 2, the College shall assign the Member a practice mentor and the Member shall retain the practice mentor at his own expense;

ii. The Member 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 Member’s practice with respect to the issues outlined in paragraph 3(f) above, and identifying areas in the Member’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 12 months following the completion of the suspension in paragraph 2;

iii. The Member 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 Member shall develop with the practice mentor a learning plan to address the areas of the Member’s practice requiring remediation;

v. The Member shall demonstrate to the practice mentor, in a manner directed by and acceptable to the practice mentor, that the Member has achieved success in meeting the goals established in the learning plan; and

vi. The Member shall 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 completion of the suspension in paragraph 2.

4. Costs to the College in the amount of $15,000.

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

The Panel observed that Mr. Satija failed to maintain the standards of practice of the profession and practised the profession while in a conflict of interest. He falsified records and failed to keep records as required by law. He submitted charges for MedsChecks and compliance packages that were ineligible. He breached federal and provincial law, including narcotics control regulations. He returned to stock a drug that was previously dispensed. He failed to have a policy in place to identify and remove expired drugs.

In summary, Mr. Satija failed in his role as a designated manager and a member of the profession.

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