Discipline Decisions, Summer 2018

Discipline Decisions (Summer 2018)

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Magdy Salama (OCP #209088)

Following three separate hearings, held on September 23 and 24, 2015, a Panel of the Discipline Committee made findings of professional misconduct against Mr. Magdy Salama:

  1. While engaged in the practice of pharmacy as director, shareholder, Designated Manager and/or dispensing pharmacist at Finch Medical Pharmacy in Toronto;
  2. While engaged in the practice of pharmacy as director, shareholder, Designated Manager and/or dispensing pharmacist at Hanin Drug Mart in Toronto, Ontario;
  3. While engaged in the practice of pharmacy as director, shareholder, Designated Manager and/or dispensing pharmacist at Danforth Medical Pharmacy in Toronto, Ontario
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For each of the three hearings, the Panel made findings against Mr. Salama with respect to the following incidents:

  • That he submitted accounts or charges for services that he knew or reasonably ought to have known were false or misleading to the Ontario Drug Benefit program;
  • That he falsified pharmacy records relating to his practice in relation to claims made to the Ontario Drug Benefit program;
  • That he 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; and/or
  • That he failed to actively and effectively participate in the day-to-day management of the Pharmacy, including but not limited to, drug procurement and inventory management, record keeping and documentation, professional supervision of pharmacy personnel and billing.

In particular, for each of the three hearings, the Panel found that Mr. Salama:

  • Failed to maintain a standard of practice of the profession;
  • Falsified records relating to his practice;
  • Signed or issued, in his professional capacity, a document that he knew contained a false or misleading statement;
  • Submitted accounts or charges for services that he knew to be 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 sections 5, 6 and 15(1)(b) of the Ontario Drug Benefits Act, R.S.O. 1990, c. O.10, as amended, and/or Ontario Regulation 201/96 made thereunder;
  • 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 or unprofessional.

After submissions related to the three hearings, all heard on April 11, 2018, the Panel made three separate Orders, each related to the findings of professional misconduct made against Mr. Salama on September 24, 2015. Each of the three Orders included as follows:

  1. Reprimanding Mr. Salama in writing, in the form attached to the Decision and Reasons for Decision;
  2. Directing the Registrar to revoke Mr. Salama’s certificate of registration;
  3. Requiring Mr. Salama to pay a fine of $35,000 to the Minister of Finance;
  4. Costs to the College in the amount of $29,000.00.

In each of the three reprimands, the Panel noted that Mr. Salama stole from the people of Ontario, betrayed his profession, and undercut the public’s confidence in the profession.

The Panel observed that Mr. Salama’s actions exemplify disgraceful, dishonourable and unprofessional conduct, and that his misconduct has had a detrimental impact on pharmacists’ professional relationship with the public they serve.

The Panel expressed its view that Mr. Salama has brought shame upon himself and the profession of pharmacy.


John Alma (OCP #17752)

At a hearing on May 18, 2018 a Panel of the Discipline Committee made findings of professional misconduct against Mr. Alma with respect to the following incidents:

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  • In about June or July 2015, he engaged in inappropriate conduct toward a co-worker. Particulars of the conduct found to be inappropriate include:
    • massaging the co-worker’s shoulders and/or neck without permission
    • bringing the co-worker chocolates and/or roses
    • calling the Pharmacy when he was not working to discuss personal matters with the co-worker
    • saying to the co-worker “you look good in any old thing you throw on” or words to that effect
    • writing the co-worker a note that contained the words “My dearest Chinaman,” “If you don’t stop analysing me with your mental powers – I will be forced to touch you – severely,” and was signed “Madly” or words to that effect

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

Mr. Alma agreed to permanently resign as a member of the College while this discipline proceeding was pending.

The Panel imposed an Order which included as follows:

  1. A reprimand
  2. Costs in the amount of $1,500.00.

In its reprimand, the Panel noted that the public holds the profession in high regard, conferring confidence and trust in its members. As such, this valued position requires members to conduct themselves in a manner that is respectable, responsible, and trustworthy. The Panel clarified that not only do fellow members of the profession, the public, and patients expect the highest level of behaviour, but so do employees.

The Panel related that, as a practicing member, Mr. Alma was required to keep informed on current issues. The topic of harassment and unacceptable behaviour is such an issue. The Panel indicated that using language in a note that refers to “touching you severely” falls well outside of acceptable behaviour.

The Panel found it unfortunate that Mr. Alma ended his career in front of a Discipline Panel and expressed its trust that this event has caused him to partake in some self-reflection.


Mustafa Salem (OCP #604014)

At a hearing on June 15, 2018, a Panel of the Discipline Committee made findings of professional misconduct against Mr. Salem with respect to the following:

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  • That he failed to comply with an undertaking he gave to the College on July 14, 2015, and in particular, failed to enter into a monitoring contract with the College or a third party agreed to by the College concerning the conditions under which he may practice pharmacy.

In particular, the Panel found that he

  • Contravened a term, condition or limitation on his certificate of registration
  • Failed to maintain a standard of practice of the profession
  • Failed to carry out or abide by an undertaking given to the College
  • Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable and unprofessional

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

  • That he failed to comply with an order of a panel of the Discipline Committee of the Ontario College of Pharmacists dated September 18, 2015 and, in particular, he failed to successfully complete the ProBE Program on Ethics for Healthcare Professionals with an unconditional pass, at his expense, within 12 months of obtaining a certificate of registration.

In particular, the Panel found that he

  • Contravened a term, condition or limitation imposed on his certificate of registration
  • Failed to maintain a standard of practice of the profession
  • Failed to comply with an order of a panel of the Discipline Committee of the Ontario College of Pharmacists
  • Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable and unprofessional

The Panel imposed an Order which included as follows:

  1. A reprimand
  2. An Order directing the Registrar to revoke Mr. Salem’s Certificate of Registration

In its reprimand, the Panel noted that the practice of pharmacy is a privilege, which carries with it significant obligations to the public, the profession, and to oneself. Integrity and trust are paramount to the profession.

The Panel observed that members of the College are expected to adhere to all procedures and standards of practice governing pharmacy. The Panel pointed out that compliance with undertakings and orders issued by the Discipline Committee is essential to protect the public.

The Panel indicated that Mr. Salem’s conduct was unacceptable and has brought discredit to the profession of pharmacy.


Sara Etemad-Rad (OCP #603101)

At a hearing on June 22, 2018, a Panel of the Discipline Committee made findings of professional misconduct against Ms. Etemad-Rad with respect to the following incidents:

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  • That she billed at 7-day intervals for medications in blister packs that were actually dispensed to patients at 14-day or 28-day intervals for patients [Patient 1] and [Patient 2]; and,
  • That she failed to have written policies in place regarding blister packs, otherwise known as multi-medication compliance aids

In particular, the Panel found that she

  • Failed to maintain a standard of practice of the profession
  • Engaged in conduct or performed an act or acts relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members of the profession as unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand

2. An Order directing the Registrar to suspend the Member’s certificate of registration for a period of 1 month, to be fully remitted if the Member successfully completes the mentoring at subparagraph 3(a) below. If the suspension is required to be served by the Member because she fails to complete the mentoring specified in subparagraph 3(a), below, the suspension shall commence on March 1, 2019 and continue until March 31, inclusive.

3. An Order directing that the following terms, conditions or limitations be imposed on the Member’s certificate of registration:

a) the Member shall complete successfully, within six (6) months from the date this Order becomes final (subject to paragraph 7 below), 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 billing, record keeping, preparation of blister packs and the duty to create written policies and procedures and ensure that they are adhered to within a pharmacy; and the following terms shall apply to the mentorship:

i. the Member shall retain, at her own expense, a practice mentor within three (3) months of the date of this Order;. The Member is entitled to provide to the College two names of proposed practice mentors within seven (7) days of this Order. The College will review the two suggested mentors within three (3) weeks of receiving their names and will either accept them or reject them. If both practice mentors are rejected, the College shall assign a practice mentor.

ii. the Member meet at least two (2) 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 billing, record keeping, preparation of blister packs and the duty to create written policies and procedures and ensure that they are adhered to within a pharmacy, and any other issues raised by the facts and findings of professional misconduct in this case, 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 six (6) months from the date of this Order;

iii. the Member shall provide the practice mentor with the following documents related to this proceeding:

a. the Notice of Hearing;
b. the Agreed Statement of Facts;
c. the Joint Submission on Order; and
d. 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;

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 seven (7) months from the date of this Order;

b) that the Member’s practice, and the operation of any pharmacy in which she has a proprietary interest, will be monitored by the College for a period of one (1) year from the date of this Order on the following terms:

i. the monitoring will be by means of two (2) inspections conducted by a representative of the College at such times as the College may determine;

ii. the monitoring inspections may be in addition to any routine inspections conducted by the College pursuant to the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H.4., s. 148;

iii. the Member shall cooperate fully during such inspections; and,

iv. the Member shall pay to the College in respect of such monitoring inspections the amount of $1,000.00 per inspection, after each inspection; and

4. An Order directing the Member to pay a fine of $348.33 to the Minister of Finance.

5. Costs in the amount of $3,500.00.

In its reprimand, the Panel noted that pharmacy is a self-regulated profession. The practice of pharmacy is a privilege that carries with it significant obligations to the public, the profession, and oneself.

The Panel emphasized that although the Member’s pharmacy operation may have been busy and hectic, she is always expected to meet the standards of practice of the profession and conduct herself in an ethical and professional manner. The Panel expressed its concern, given the Member’s years of experience, that she failed in her responsibilities as a pharmacist and designated manager by failing to have proper policies and procedures in place, which resulted in inappropriate billing to the Ontario Drug Benefit plan.

The Panel indicated its hope that this Order and the discipline process will be sufficient to deter similar conduct in the future and will motivate the Member to provide the best possible care to her patients.


Nataliya Ivasiv (OCP #220077)

At a hearing on June 27, 2018, a Panel of the Discipline Committee made findings of professional misconduct against Ms. Ivasiv, in her capacity as a Designated Manager, with respect to the following incidents, in or about September 2011 – April 2013:

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  • False and/or unsubstantiated claims submitted by the Pharmacy to the Ontario Drug Benefit Program totalling approximately $60,000, including the claims for:
    • 12 identified drug and other health products for which quantities claimed exceeded quantities acquired;
    • extemporaneous mixtures comprised of equal parts of two or more different creams, and/or a duplication of a commercially available product, for certain identified prescriptions;
    • nutrition products for which the nutrition products forms were missing, expired or incomplete, and/or the patient eligibility criteria were not met, for certain identified prescriptions; and/or
    • “no substitution” claims for which the required Health Canada reporting forms were either not obtained and/or not retained for certain identified prescriptions; and/or
  • False and/or misleading records created at the Pharmacy in relation to the billing and/or dispensing transactions described above.

In particular, the Panel found that the Member

  • Failed to maintain a standard of practice of the profession
  • Failed to keep records as required
  • 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, the Ontario Drug Benefit Act, R.S.O. 1990, c.O.10, sections 5, 6 and/or 15, and/or O.Reg.201/96, sections 27 and/or 29
  • Engaged in conduct or performed an act relevant to the practice or pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand

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

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

b. the Member shall be prohibited from acting as the Designated Manager at any pharmacy for a period of two (2) years from the date of this Order;

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

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

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

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

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of six (6) months, with two (2) months of the suspension to be remitted on condition the Member complete the remedial training program as specified in paragraph 2(a) above. The suspension shall commence on June 28, 2018 and continue without interruption until October 27, 2018. If the remitted portion of the suspension has to be served because the Member fails to complete the ProBE Program as specified in subparagraph 2(a) above, the further suspension shall commence on June 28, 2019 and continue without interruption until August 27, 2019. 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. Requiring the Member to pay Costs to the College in the amount of $7,500.00

In its reprimand, the Panel noted that the Member is part of the honourable profession of pharmacy, to which integrity and trust are paramount. The Panel expressed its extreme disappointment with the Member’s failure to maintain a standard of practice of the profession.

The Panel observed that the role of Designated Manager is one of heavy responsibility, including the obligation to conduct one’s own behavior to the highest standard and to ensure the entire operation of the pharmacy is delivered according to the same standard.

The Panel relayed its expectation that the Member has learned from this process.


The full text of these decisions is available at www.canlii.org.

CanLii is a non-profit organization managed by the Federation of Law Societies of Canada. CanLii’s goal is to make Canadian law accessible for free on the Internet.


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