Discipline Decisions (Winter 2018)

• That he submitted accounts or charges for services that he knew were false or misleading to the Ontario Drug Benefit program for one or more certain identified drugs and/or products, from on or about November 1, 2013 to on or about June 30, 2014,
• That he falsified pharmacy records relating to his practice in relation to the dispensing of and/or claims made to the Ontario Drug Benefit program for one or more certain identified drugs and/or products, from on or about November 1, 2013 to on or about June 30, 2014,
• 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, the Panel found that he

• Failed to maintain a standard of practice of the profession
• Falsified records relating to his practice
• 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
• 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:
  • 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 regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable and unprofessional

The Panel imposed an Order which included as follows:

1. A reprimand
2. a 12 month suspension of the Member’s certificate of registration, with 1 month of the suspension to be remitted on condition that the Member complete the remedial training specified below. The suspension shall commence on October 12, 2017, and shall run without interruption until September 11, 2018, inclusive. If the Member is required to serve the balance of the suspension, then the remitted portion shall commence on September 12, 2018, and shall run without interruption until October 13, 2018, inclusive;
3. an Order directing the Registrar to impose specified terms, conditions or limitations on the Member’s certificate of registration as follows:

i. the Member must successfully complete, with an unconditional pass, at his own expense and within 11 months of the date the Order is imposed, the ProBE Program on professional / problem-based ethics for health care professionals offered by the Centre for Personalized Education for Physicians.

The Registrar is empowered, in her discretion, to grant a request for an extension of time to complete the remedial training set out in paragraph 3(a) and/or to make any related necessary adjustments to the dates upon which the Member is to serve the remitted portion of his suspension set out in paragraph 2, if the Registrar is of the view that it is in the interests of fairness to do so and that it is not contrary to the College’s mandate to serve and protect the public interest;

ii. The Member 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 based on hourly, or weekly rates only, provided that this term, condition and limitation may be removed by an Order of a panel of the Discipline Committee, upon application by the Member, such application not to be made sooner than four (4) years from the date the Order is imposed;

iii. For a period of four (4) years from the date the Order is imposed, the Member shall be prohibited from acting as a Designated Manager in any pharmacy;

iv. For a period of four (4) years from the date the Order is imposed , the Member 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;

v. For a period of four (4) years from the date the Order is imposed, the Member shall provide his pharmacy employer with a copy of the Discipline Committee Panel’s decision in this matter and its Order; and

vi. For a period of four (4) years from the date the Order is imposed, the Member shall only engage in the practice of pharmacy for an employer who agrees to write to the College within fourteen (14) days of the Member’s commencing employment, confirming that it has received a copy of the required documents identified above, and confirming the nature of the Member’s remuneration.

vii. For a period of four (4) years from the date the Order is imposed, the Member shall not work at nor be employed by any pharmacy in which a family member has a proprietary interest.

4. Costs to the College in the amount of $12,500.

In its reprimand, the Panel noted that integrity and trust are paramount to the profession of pharmacy, and that pharmacists are held in high esteem for the role they play in the provision of healthcare in Ontario.

The Panel expressed its disappointment with the Member’s actions. The Panel pointed out that the Ontario Drug Benefit Program is publically funded and operates on an honour system, and that submitting claims that were false or misleading shows a lack of integrity.

The Panel suggested that the Member’s acts were unbecoming of a pharmacist. The Panel expressed its expectation that the Member has learned from this process, that he will improve his practice of pharmacy, and that he will work hard to regain the trust he has lost through his actions.

The Panel indicated its expectation that the Member will never again appear before a panel of the Discipline Committee.

• Charged excessive dispensing fees and/or co-payments for dispensing less than the full quantity of the drugs prescribed for the patient, [Patient], without agreement of the patient or other valid authorization, in or about August–November 2013

In particular, the Panel found that he

• Failed to maintain the standards of practice of the profession
• Dispensed or sold drugs for an improper purpose
• Charged a fee that is excessive in relation to the service provided
• 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, including sections 4, 5, 6 and/or 15 of the Ontario Drug Benefits Act, R.S.O. 1990, Ch. O.10, as amended; sections 18 and/or 20.2 of O.Reg. 201/96, as amended; and/or section 9 of Drug Interchangeability and Dispensing Fee Act, R.S.O. 1990, c.P.23, 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

At the same hearing on October 26, 2017, the Panel made findings of professional misconduct against Mr. Kula with respect to the following incidents, in that he:

• Dispensed and/or billed prescription and non-prescription medications, without authorization, for certain identified patients, in or about February-August 2014
• Failed to keep records of prescriptions dispensed for certain identified patients, in or about April-September 2014
• Failed to document renewals of prescriptions by a pharmacist for certain identified patients, in or about May-September 2014;
• Dispensed and/or billed prescription and non-prescription medications, without authorization, by relying on “blanket authorizations” from Dr. [Name] to renew prescriptions for certain identified patients, on or about May 27-28, 2014;
• Failed to keep records as required regarding current prescriptions but instead “piggybacking” on old prescriptions for certain identified patients, in or about June-November 2014;
• Falsified claims for medications dispensed to patients at less frequent intervals than claimed for billing purposes for certain identified patients, in or about January-November 2014;
• Dispensed lesser quantities of medications than prescribed without the written agreement of the patients, or failed to keep records of any such agreements, for certain identified patients, in or about January-November 2014;
• Billed and/or dispensed quantities of medications in excess of the quantities required for certain identified patients, in or about April-July 2014;
• Billed and/or dispensed medications for certain identified patients, after the Pharmacy had been advised that the patients were deceased, in or about June-August 2014;
• Failed to provide prescription receipts for medications dispensed for certain identified patients, on or about August 7, 2014;
• Billed for MedsCheck Reviews without justification, or without documenting any such justification, for certain identified patients, on or about January 22, 2014;
• Dispensed medications to patients other than the specific medications identified in the prescription records, including ferrous gluconate and/or risperidone, in or about January-August 2014;
• Failed to sign prescription hardcopies by a pharmacist for as many as 1,115 dispensing or billing transactions for up to 116 patients, in or about April-November 2014;
• Failed to maintain prescription records in a readily-retrievable manner, including the records for certain identified prescriptions;
• Failed to maintain records regarding authorizations for medications dispensed to patients in retirement homes, and/or prescription hardcopies signed by a pharmacist for such transactions, in or about July-August 2014;
• Permitted non-pharmacist staff, [Staff Person 1] and/or [Staff Person 2], to process claims outside the Pharmacy for medications for certain identified patients, in or about April-July 2014

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 that he knew was false or misleading
• Charged a fee that was excessive in relation to the service provided
• 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 4 of the Pharmacy Act, 1991 S.O. 1991, c. 36, as amended; sections 36, 37 and/or 38 of O.Reg. 202/94, as amended; sections 150, 155 and/or 156 of the Drug and Pharmacies Regulation Act , R.S.O. 1990, c. H-4 as amended; and/or sections 54, 55, 56 and/or 57 of O.Reg.58/11, as amended
• Contravened, while in engaged in the practice of pharmacy, a federal or provincial law or municipal by-law with respect to the distribution, sale or dispensing of any drug or mixture of drugs, and in particular, section 9 of the Food and Drugs Act, R.S.C. 1985, c.F-27, as amended; section C.01.041 of the Food and Drug Regulations, C.R.C., c. 870, as amended; sections 9 and/or 10 of the Drug Interchangeability and Dispensing Fee Act, R.S.O. 1990, c.P.23, as amended; section 4 of Ontario Regulation 936, as amended; and/or sections 5, 6 and/or 15 of the Ontario Drug Benefit Act, R.S.O. 1990, c.O.10, as amended; and/or sections 27 and/or 29 of O.Reg. 201/96, as amended
• Permitted, consented to or approved, either expressly or by implication, the commission of an offence against any Act relating to the practice of pharmacy or to the sale of drugs by a corporation of which he was a director
• 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

At the same hearing on October 26, 2017, the Panel made findings of proprietary misconduct against Allen Kula, as director of W.J. Gagne Drugs Limited, c.o.b. as Romana Pharmacy, and/or Designated Manager of Romana Pharmacy in Keswick, Ontario with respect to the following incidents, in that he:

• Failed to keep records of prescriptions dispensed for certain identified patients, in or about April-September 2014
• Failed to keep records as required regarding current prescriptions but instead “piggybacking” on old prescriptions for certain identified patients, in or about June-November 2014
• Dispensed medications to patients other than the specific medications identified in the prescription records, including ferrous gluconate and/or risperidone, in or about January-August 2014
• Failed to sign prescription hardcopies by a pharmacist for as many as 1,115 dispensing or billing transactions for up to 116 patients, in or about April-November 2014
• Failed to maintain certain identified prescription records in a readily-retrievable manner
• Failed to maintain records regarding authorizations for medications dispensed to patients in retirement homes, and/or prescription hardcopies signed by a pharmacist for such transactions, in or about July-August 2014.
• Dispensed and/or billed prescription and non-prescription medications, without authorization, for certain identified patients, in or about February-August 2014
• Falsified claims for medications dispensed to patients at less frequent intervals than claimed for billing purposes for certain identified patients, in or about January-November 2014
• Dispensed lesser quantities of medications than prescribed without the written agreement of the patients, or failed to keep records of any such agreements, for certain identified patients, in or about January-November 2014;
• Dispensed and/or billed prescription and non-prescription medications, without authorization, by relying on “blanket authorizations” from Dr. [Name] to renew prescriptions for certain identified patients, on or about May 27-28, 2014

In particular, the Panel found that Mr. Kula and W.J. Gagne Drugs Limited, as holder of Certificate of Accreditation #303221 for Romana Pharmacy in Keswick, Ontario,

• Failed to keep records required to be kept by the pharmacy respecting the patients and the practice of the pharmacy
• Falsified a record of the pharmacy
• Signed or issued a document that contained a false or misleading statement
• Submitted an account or charge which was false or misleading
• Charged a fee or an amount that was excessive in relation to the service or product provided
• Contravened the Act or the regulations made under the Act, and in particular, sections 150, 155 and/or 156 of the Act, and/or sections 54, 55, 56 and/or 57 of O.Reg. 58/11
• Contravened a law of Canada or Ontario or any municipal by-law with respect to the distribution, purchase, sale or dispensing of any drugs or product in a pharmacy, and in particular, section 9 of the Food and Drugs Act, R.S.C. 1985, c.F-27, as amended; section C.01.041 of the Food and Drug Regulations, C.R.C., c. 870, as amended; sections 9 and/or 10 of the Drug Interchangeability and Dispensing Fee Act, R.S.O. 1990, c.P.23, as amended; sections 5, 6 and/or 15 of the Ontario Drug Benefit Act, R.S.O. 1990, C.O.10, as amended, and/or sections 27 and/or 29 of O.Reg.201/96, as amended
• Engaged in conduct or performed an act relevant to the business of a pharmacy that would reasonably be regarded by members as disgraceful

The Panel imposed an Order which included as follows:

1. A reprimand, to be scheduled within six months of the date of the Order.
2. Directing the Registrar to impose specified terms, conditions or limitations on the Member’s Certificate of Registration requiring:

a. that the Member shall complete successfully, at his own expense and within twelve (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 Registrar is empowered, in her discretion, to grant a request for an extension of time to complete the remedial steps set out in subparagraph 2(a), 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; and

c. that 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.

3. Directing the Registrar to impose specified terms, conditions or limitations on the Certificate of Accreditation for Romana Pharmacy requiring that the practice of pharmacy and related business activities at Romana Pharmacy be monitored by the College for a period of two (2) years from the date of this Order by means of inspections of a representative of the College at such times as the College may determine. The monitoring inspections may be in addition to any of the routine inspections conducted by the College pursuant to the authority of section 148 of the Drug and Pharmacies Regulation Act. Pharmacy staff shall cooperate fully with the College during the inspections. The Pharmacy shall pay to the College in respect of such monitoring the amount of $1,000.00 per inspection, such amount to be paid immediately after each inspection, with the total number of inspections for which the Pharmacy is required to pay, not to exceed four (4) regardless of the number of inspections.

4. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of three (3) months, with one (1) month of the suspension to be remitted on condition the Member complete the remedial training program as specified in subparagraph 2(a) above. The suspension shall commence on November 2, 2017 and continue without interruption until January 1, 2018, inclusive. If the remitted portion of the suspension has to be served, the further suspension shall commence on October 27, 2018 and continue without interruption until November 26, 2018, inclusive, unless the time for completing the remedial steps in subparagraph 2(a) above is extended by the Registrar, in which case, the date on which the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly.

5. Costs to the College in the amount of $20,000.00.

At the time of publication, the reprimand in this matter remains outstanding.

• On November 17, 2015, he attended a shiatsu massage spa with [Name], an employee of the Pharmacy, during work hours, in circumstances where he ought to have known that doing so would make [Name] uncomfortable.

In particular, the Panel found that he:

• Failed to maintain the standards of the profession
• Engaged in conduct relevant to the practice of pharmacy that, having regard to all of the circumstances, would reasonably be regarded by members of the profession as unprofessional

The Panel imposed an Order which included as follows:

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

i. the number of sessions shall be at the discretion of the consultant, but shall be a minimum of 2, and maximum of 3;

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. Successful completion of the course will include completion of an essay, acceptable to the Registrar, addressing the objectives of professional regulation and the importance to the public interest of maintaining professional conduct towards colleagues;

iv. The essay shall be at least 1000 words in length. The Member 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;

v. the Member shall be responsible for the cost of the course;

vi. the Member will request a report from the consultant confirming that the Member has completed the course to the satisfaction of the consultant, and the Member will provide a copy of the report to the College within twelve (12) months of the date of this Order;

b. the Registrar is empowered, in her discretion, to grant a request for an extension of time to complete the remedial steps set out in subparagraph 2(a) 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;

c. that the Member be prohibited from acting as a Designated Manager for any pharmacy, from December 1, 2017 until he has completed the remedial training specified in subparagraph 2(a), as confirmed by the consultant;

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of 2 months, 1 month of which shall be remitted upon the Member successfully completing the remedial training as specified in subparagraph 2(a) above. The suspension shall commence on December 1, 2017, and run until December 31, 2017, inclusive. If the remitted portion of the suspension is required to be served by the Member because he fails to complete the remedial training specified in subparagraph 2(a) above within the time specified, the remainder of the suspension shall commence on November 6, 2018, and continue until December 5, 2018, inclusive unless the time for completing the remedial steps in subparagraph 2(a), above, is extended by the Registrar, in which case, the date the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly;

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

In its reprimand, the Panel noted that, as a member of this profession, the Member is held in high regard by the public, and that he has a moral obligation to conduct himself in a manner that is professional, ethical, and serves the public interest.

The Panel indicated that pharmacists are expected to demonstrate personal and professional integrity and to maintain professional boundaries at all times. These boundaries are based on trust, respect, and the appropriate use of power.

The Panel expressed its hope that the Member has had a chance to reflect on his conduct and that he understands its impact on his colleagues, the profession, and the public. The Panel indicated its expectation that the ethics course ordered will serve as an opportunity for remediation and that it will provide the Member with insight into personal and professional boundaries.

• He made making unwelcome comments of a sexual nature towards his co-worker and patient, [Name]; and/or
• He verbally abused, swore at and/or yelled at his co-worker and patient, [Name]; and/or
• On one or more occasions, he touched inappropriately or attempted to touch inappropriately his co-worker and patient, [Name]; and/or
• In or about December 2014, he wrote his co-worker and patient, [Name], a note in which he said “fuck you” or words to that effect.

In particular, the Panel found that he

• Sexually abused a patient
• 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:

• A reprimand

In its reprimand, the Panel observed that members of the public hold pharmacists in high regard. Pharmacists have a moral obligation to conduct themselves in a manner that is professional and maintains public confidence.

The Panel indicated that pharmacists are expected to demonstrate personal and professional integrity and to maintain professional boundaries at all times. These boundaries are based on trust, respect, and the appropriate use of power. These standards are high.

The Panel explained that, had Mr. Soliman not resigned from practice for the other matters that were drawn to their attention, the Panel would likely have accepted other elements of an order, such as a term of suspension, remediation coursework, costs, and perhaps other components.

The Panel related that, given Mr. Soliman’s signed acknowledgement and undertaking, which irrevocably surrendered his certificate of registration, it accepted the Agreed Statement of Facts, his admission of misconduct, and the Joint Submission on Order.

• She inappropriately provided pharmaceutical treatment to herself and certain identified family members, contrary to the College’s Policy on Treating Self and Family Members
• She dispensed prescription medications without valid authorization in respect of certain identified patients and transactions
• She falsified pharmacy records in respect certain identified prescription transactions
• She failed to keep records as required in respect of certain identified patients

In particular, the Panel found that she

• Failed to maintain the standards of practice of the profession
• Failed to keep records as required
• 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
• 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
• 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 which included as follows:

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

a. that the Member complete successfully with an unconditional pass, at her own expense, and within 12 months of the date the Order is imposed, the ProBE Program on Professional / Problem-based Ethics for Health Care Professionals offered by the Center for Personalized Education for Physicians; and,

b. that the Member complete successfully, at her own expense and within 12 months of the date of this Order, the Ontario College of Pharmacists’ Jurisprudence Exam;

c. 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(a) and/or 2(b), 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;

3. That the Registrar suspend the Member’s Certificate of Registration for a period of three months, with one month of the suspension to be remitted on condition that the Member complete the remedial training as specified in paragraph 2. The suspension shall commence on November 26, 2017, and shall continue until January 25, 2018, inclusive. If the remitted portion of the suspension is required to be served by the Member because she fails to complete the remedial training as specified in paragraph 2, that portion of the suspension shall commence on November 21, 2018, and shall continue until December 20, 2018, inclusive, unless the time for completing the remedial steps in subparagraphs 2(a) and/or 2(b), above is extended by the Registrar, in which case, the date on which the remitted portion of the suspension shall commence, if required, shall be adjusted accordingly.

4. Costs to the College in the amount of $6,000.

In its reprimand, the Panel noted that through this professional misconduct, the Member failed in her obligations to adhere to the standards of practice. The Panel pointed out that the Member knowingly breached the public’s trust and, in doing so, let down the profession of pharmacy.

The Panel related that the standards of practice demand that pharmacists practice to a very high standard, and that this type of conduct can cause the public to mistrust and lose confidence in the profession, and is a risk to the privilege of being a self-regulated profession.

The Panel expressed its trust that the Member has learned from this experience, that she will appropriately change her practice standards, and that she will never again appear before a panel of the Discipline Committee.

• That she submitted accounts or charges for services that she knew were false or misleading to the Ontario Drug Benefit program for:
  • one or more of certain identified drugs and/or products, from on or about July 1, 2010 to on or about June 30, 2012,
  • Ventolin HFA, from on or about July 1, 2010 to on or about June 30, 2012, in circumstances where interchangeable products were dispensed; and/or
  • one or more of the drugs and/or products transferred from Wilson Medical Pharmacy between on or about February 22, 2012 and on or about August 1, 2014;
• That she falsified pharmacy records relating to her practice in relation to the dispensing of and/or claims made to the Ontario Drug Benefit program for:
  • one or more of certain identified drugs and/or products, from on or about July 1, 2010 to on or about June 30, 2012,
  • Ventolin HFA, from on or about July 1, 2010 to on or about June 30, 2012, in circumstances where interchangeable products were dispensed; and/or
  • drugs and/or products transferred from Wilson Medical Pharmacy between on or about February 22, 2012 and on or about August 1, 2014;
• That she 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 she 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, the Panel found that the Member

• Failed to maintain a standard of practice of the profession;
• Falsified records relating to her practice;
• Signed or issued, in her professional capacity, a document that she knew contained a false or misleading statement;
• Failed to keep records as required respecting her patients;
• Submitted 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:
  • Sections 155 and 156 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H-4, as amended, in connection with prescription information and container identification markings;
• 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 with respect to submitting claims for payment to the Ontario Drug Benefit program where no payment was required, and/or that she knew or reasonably ought to have known were false, inaccurate or misleading claims;
  • Sections 155 and 156 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H-4, as amended, in connection with prescription information and container identification markings;
  • Sections 8, 10 and 11 of the Narcotics Safety and Awareness Act, 2010 SO 2010, c 22, with respect to making disclosures to the Narcotic Monitoring System between on or about May 14, 2012 to on or about July 23, 2013 which did not contain the required information regarding the prescriber of the drug dispensed;
• 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:
  • 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 with respect to submitting claims for payment to the Ontario Drug Benefit program where no payment was required, and/or that she knew or reasonably ought to have known were false, inaccurate or misleading claims;
  • Sections 155 and 156 of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c. H-4, as amended, in connection with prescription information and container identification markings;
  • Sections 8, 10 and 11 of the Narcotics Safety and Awareness Act, 2010 SO 2010, c 22, with respect to making disclosures to the Narcotic Monitoring System between on or about May 14, 2012 to on or about July 23, 2013 which did not contain the required information regarding the prescriber of the drug dispensed;
• Engaged in conduct or performed an act or acts relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable and unprofessional.

The Panel imposed an Order which included as follows:

(i) A reprimand;

(ii) A 14 month suspension of the Member’s certificate of registration, with 2 months of the suspension to be remitted on condition that the Member complete the remedial training specified below ;

(iii) An Order directing the Registrar to impose specified terms, conditions or limitations on the Member’s certificate of registration as follows:

i. the Member must successfully complete with an unconditional pass, at her own expense and within 12 months of the date the Order is imposed, the ProBE Program on professional / problem-based ethics for health care professionals offered by the Centre for Personalized Education for Physicians;

ii. for a period of three (3) years the Member shall be prohibited from having a proprietary interest of any kind in a pharmacy, and the Member shall have 60 days from the date of this Order to divest herself of any such proprietary interests, at which time the three year period shall commence;

iii. following the expiry of the three-year period referred to in subparagraph (b) above, the Member’s practice and all activities at any pharmacies in which the Member has a proprietary interest of any kind shall be monitored for a period of two (2) years by the College, by means of practice assessments by a representative or representatives of the College in such number and at such time or times as the College may determine. The practice assessments may be in addition to any of the routine inspections conducted by the College pursuant to the authority of section 148 of the Drug and Pharmacies Regulation Act. The Member shall cooperate with the College during the practice assessments and, further, shall pay to the College in respect of the cost of monitoring, the amount of $1000.00 per assessment, such amount to be paid immediately after completion of each of the assessments, with the total amount paid by the member not to exceed $10,000.00, regardless of the number of assessments;

iv. for a period of five years from the date the Order is imposed, the Member shall be prohibited from:

1. acting as a Designated Manager in any pharmacy; and,

2. receiving any remuneration for her work as a pharmacist other than remuneration based on hourly or weekly rates only or (subject to paragraph (b) above) by reason of having a proprietary interest in a pharmacy;

v. for a period of five years from the date the Order is imposed, the Member shall be required to notify the College in writing of the name(s), address(es) and telephone number(s) of all pharmacy employer(s) within fourteen days of commencing employment in a pharmacy;

vi. for a period of five years from the date the Order is imposed, the Member shall provide her pharmacy employer with a copy of the Discipline Committee Panel’s decision in this matter and its Order; and

vii. for a period of five years from the date the Order is imposed, the Member shall only engage in the practice of pharmacy for an employer who agrees to write to the College within fourteen days of the Member’s commencing employment, confirming that it has received a copy of the required documents identified above, and confirming the nature of the Member’s remuneration;

(iv) Costs to the College in the amount of $15,000.

In its reprimand, the Panel noted that the Member failed to maintain the responsibilities and obligations expected of her as a member of this profession. The Panel indicated that the volume of unsubstantiated claims over a two-year period of time, which amounted to $162,000, is an example of her disregard for the trust that has been placed in her by the public and the profession.

The Panel pointed out that the Member billed claims on behalf of another pharmacy, falsified pharmacy records, and failed as designated manager to participate in the day to day management of the pharmacy, and related that these actions are not acceptable for a member of this profession.

The Panel explained that pharmacy is a self-regulated profession and that pharmacists bear the responsibility to ensure that they maintain the trust of the public and of members. The Panel noted that the practice of pharmacy is a privilege and comes with significant obligations to the public, the profession, and oneself.

The Panel expressed its expectation that, in the future, the Member will practice pharmacy within the standards of this profession, and that she will take this opportunity to reflect on her actions and complete the required remediation. The Panel related its further expectation that, in doing so, she will change the way she practices and will not appear again before a panel of the Discipline Committee.

• He disclosed personal health information of the Pharmacy’s patients by posting prescriptions on Facebook, without consent or other authorization, in respect of:

i. [Patient 1], in or about February, 2016;

ii. [Patient 2], on or about February 20, 2015; and/or

iii. [Patient 3], on or about March 31, 2016;

• He inappropriately consulted on Facebook about prescriptions for the Pharmacy’s patients, instead of with the physicians and other appropriate resources, in respect of:

i. [Patient 1], in or about February, 2016;

ii. [Patient 2], on or about February 20, 2015; and/or

iii. [Patient 3], on or about March 31, 2016; and/or

• On or before May 11, 2016, the Pharmacy’s website made the following offers:

i. “Transfer your prescription today and get your gift”; and/or

ii. “Thursday Special – Hollandview Pharmacy waives the dispensing fee for all patients who do not have drug plans.”

In particular, the Panel found that he

• Failed to maintain a standard of practice of the profession
• Offered or distributed, directly or indirectly, a gift, rebate, bonus or other inducement with respect to a prescription or prescription services
• Engaged in conduct or performed an act relevant to the practice of pharmacy that, having regard to all the circumstances, would reasonably be regarded by members as dishonourable and unprofessional

The Panel imposed an Order which included as follows:

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

(a) that the Member successfully complete, within six (6) months of the date of the order, a course with Gail E. Siskind Consulting Services, or another professional ethics consultant chosen by the College, to be designed by the consultant, for the purpose of addressing the professional and ethical obligations with respect to confidentiality of personal health information; and the following terms shall apply to the course:

(i) the number of sessions shall be at the discretion of the consultant, but shall be at least 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 Agreed Statement of Facts;

c) this Joint Submission on Order; and

d) the Panel’s Decision and Reasons, if and when available; and

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

(b) that the Member:

(i) retain, at the Member’s expense, a practice mentor acceptable to the College, within three (3) months of the date of this Order;

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

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

a) the Notice of Hearing;

b) the Agreed Statement of Facts;

c) this Joint Submission on Order; and

d) the Panel’s Decision and Reasons, if and when available;

(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 from the date of this Order;

(c) 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(a) and 2(b) 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.

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of three (3) months, with two (2) months of the suspension to be remitted on condition the Member complete the ethics course and mentorship program as specified in subparagraphs 2(a) and 2(b) above. The suspension shall commence on January 4, 2018 and continue without interruption until February 3, 2018. If the remitted portion of the suspension has to be served because the Member fails to complete the course specified in paragraph 2(a) as required, then the further suspension shall commence on June 5, 2018 and shall continue to run without interruption until August 4, 2018, inclusive. If the remitted portion of the suspension has to be served because the Member fails to complete the mentorship specified in paragraph 2(b) as required, then the further suspension shall commence on December 5, 2018 and shall continue to run without interruption until February 4, 2019, inclusive. In either case, if the time for completing the remedial steps in subparagraphs 2(a) and 2(b) 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 $5,000.

In its reprimand, the Panel noted that pharmacy is a self regulated profession, which bears the responsibility to ensure that the trust of members is maintained and the public served. The practice of pharmacy is a privilege, which carries with it significant obligations to the public, the profession, and to oneself.

The Panel expressed its view that the misconduct to which the Member admitted is unacceptable to the public and to his fellow pharmacy professionals. Of particular concern to the Panel was the fact that the Member’s misconduct involved patient privacy breaches and the offering of inducements for the purpose of soliciting patients. The Panel indicated that Facebook is not a private forum. Facebook, and other online forums, should never take the place of proper consultation with other healthcare professionals within the circle of care.

The Panel expressed its trust that the Member now realizes the importance of this responsibility as a member of this College and that he will benefit from the remediation in which he has agreed to participate. The Panel voiced its confidence that the Member will return to the profession with more honour and integrity, and that he will not appear before of a panel of the Discipline Committee again.

• Failed to comply with the decision of the Inquiries, Complaints and Reports Committee dated September 16, 2015 (“ICRC decision”) requiring him to complete a specified continuing education or remediation program (“SCERP”) by September 16, 2016;
• Failed to access and read encrypted email communications sent to him by the College regarding the ICRC decision and SCERP on September 16, 2015; October 20, 2015; March 15, 2016; and/or October 7, 2016;
• Failed to respond to the College’s inquiries to him regarding the ICRC decision and SCERP by telephone messages left for him on May 4, May 10, October 4, October 5 and/or October 6, 2016; and/or
• Failed to comply with the commitment he communicated to the College by email on September 29, 2016 that he would ensure he completed the SCERP as soon as possible and provide confirmation to the College that he had.

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 as disgraceful, dishonourable and unprofessional

After further arguments with respect to the Order to be made which were heard on December 14, 2017, the Panel imposed an Order which included as follows:

1. A reprimand
2. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of twelve (12) months or until such time as the Member successfully completes the remedial components set out in paragraphs 3(a), 3(b), and 3(c), below, whichever is later. The suspension shall commence on the date this Order becomes final.
3. Directing the Registrar to impose the following specified terms, conditions or limitations on the Member’s Certificate of Registration:

a. the Member shall complete successfully, within twelve (12) months from the date this Order becomes final, a remedial program with Gail E. Siskind Consulting Services or another professional ethics consultant to be chosen by the College (“the Consultant”), to be designed by the consultant, regarding the issues raised by the facts and findings of professional misconduct in this case; and the following terms shall apply to the course:

i. the number of sessions shall be at the discretion of the Consultant, but shall be a minimum of three (3) meetings.

ii. the manner of attendance at the sessions shall be in person.

iii. the Member shall be responsible for the cost of the program.

iv. the Member shall provide to the Consultant the following documents, in advance of the program, to facilitate the design of the program:

1. the Notice of Hearing;

2. the Agreed Statement of Facts; and

3. the Panel’s Decision and Reasons, if and when available; and

v. the Member will request a report from the Consultant confirming that the Member has completed the course to the satisfaction of the Consultant, and the Member will provide a copy of the report to the College within twelve (12) months of the date this Order becomes final;

b. the Member shall complete successfully, at his own expense, within twelve (12) months of the date this Order becomes final, the ProBE Program on Professional/Problem Based Ethics for Healthcare Professionals by the Center for Personalized Education for Physicians, with an unconditional pass, and the Member shall provide the College with confirmation of such within twelve (12) months of the date this Order becomes final.

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

d. the Member shall complete successfully the Medication System Safety Review for a Community Pharmacist On-Site Assessment program offered by the Institute for Safe Medication Practices Canada, at his own expense, within twelve (12) months following the end of the suspension referred to in paragraph two (2), above.

e. the Member shall be prohibited, for a period of twenty-four (24) months following the end of the suspension referred to in paragraph two (2), above, from acting as a Designated Manager in any pharmacy.

f. the Member’s practice shall be monitored by the College by means of practice reviews for a period of twenty-four (24) months following the end of the suspension referred to in paragraph two (2), above. The practice reviews shall be conducted by a representative(s) of the College at such time(s) as the College may determine, to a maximum of four (4) reviews. The Member shall cooperate with the College and its representative(s) during the practice reviews, which shall be at the Member’s expense, up to a maximum of one thousand dollars ($1,000.00), per review to be paid immediately after the completion of each practice review. The Member shall complete any reassessments, learning plans or other follow-up steps arising from the practice review, as required, and within the timelines required by the practice review.

g. the Registrar is empowered, in her discretion, to grant a request for an extension of time, of up to twelve (12) months, to complete the remedial steps set out in paragraphs 3(a), 3(b) and 3(c), if the Registrar is of the view that it would be in the interest of fairness to do so and that it would not be contrary to the College’s mandate to serve and protect the public interest. If the Registrar grants such an extension, the Member’s certificate of registration will remain suspended in the manner described in paragraph two (2), above.

4. Costs to the College in the amount of twenty thousand dollars ($20,000.00).

In its reprimand, the Panel noted that integrity, trust, and professional conduct are the core of the practice of pharmacy and the delivery of care to the public, and that, in return, the profession is held in high regard by the people of Ontario. The Panel indicated 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 Panel expressed its view that the Member’s conduct showed persistent disregard to the College, which may put the public at risk. It is a fundamental expectation that all members respond to enquiries of the College in a timely manner.

The Panel voiced its expectation that when a member of the profession indicates to their regulator that they will comply with an order made by their regulator, that they will do so. The Panel pointed out that the Member has clearly failed to do so, and has let the profession down.

The Panel expressed its hope that the Member has learned from these experiences, and that he will take this opportunity to reflect on his actions and complete the required remediation. In doing so, the Panel expects that the Member will change the way he relates and responds to his regulator.

The Panel noted its expectation that the Member will not appear again before a panel of the discipline committee.

• In or about the summer of 2008, after having sexual intercourse with an employee of the Pharmacy, he provided her with Plan B (levonorgestrel), an emergency contraceptive, and directed her to take it;
• He contributed to an uncomfortable work environment for employees of the Pharmacy, including, from time to time, intimidating and harassing them, and engaging in a violent outburst on or about December 2, 2015;
• From time to time he brought weapons into the Pharmacy, including a rifle, handguns and machetes; and
• On more than one occasion he removed a handgun from its case while on the premises of the Pharmacy, in the presence of staff of the Pharmacy.

In particular, the Panel found that he

• Failed to maintain the standards of practice of the profession; and
• Engaged in conduct relevant to the practice of pharmacy that, having regard to all of the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable and unprofessional.

The Panel imposed an Order which included as follows:

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 his own expense and within twelve (12) months of the date of this Order, 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 shall successfully complete, within twenty-four 24 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, but with the general aim of addressing the professional conduct issues raised by the facts of this case. The following terms shall apply to the course:

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

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

iii. the Member shall provide to the consultant his evaluation from the ProBE course, and any essay he completed as part of that course, and discuss with the consultant the issues arising from that course.

iv. The Member shall be responsible for the cost of the course.

v. the Member will request a report from the consultant confirming that the Member has completed the course to the satisfaction of the consultant, and the Member will provide a copy of the report to the College within twenty-four (24) months of the date of this Order.

c. that the Member shall successfully complete, at his own expense, and within twenty-six (26) months of the date of this Order, the ProBE Plus Program on Ethics for Healthcare Professionals;

d. that the Member shall be prohibited, for a period of three (3) years from the date the Order is imposed, from acting as a Designated Manager in any pharmacy, and from acting as sole proprietor of a pharmacy, a partner in a partnership that owns a pharmacy, or a director of a corporation that owns a pharmacy.

e. for a period of two (2) years commencing on June 6, 2018:

i. the Member shall notify the College in writing of any employment in a pharmacy, which notification shall include the name and address of the employer and the date on which he began or is to begin employment, within seven (7) days of commencing such employment;

ii. he shall only work for an employer in a pharmacy who provides confirmation in writing from the Designated Manager of the pharmacy to the College, within seven (7) days of him commencing employment at the pharmacy, that the Designated Manager received and reviewed a copy of the panel’s decision and reasons in this matter before he commenced employment;

iii. the terms in clauses 2(f)(i) and (ii) shall apply even if the Member’s employment in the pharmacy is as a relief pharmacist;

3. Directing the Registrar to suspend the Member’s Certificate of Registration for a period of six (6) months of which one (1) month shall be remitted upon the Member successfully completing the remedial training as specified in subparagraphs 2(a), (b) and (c) above. The suspension shall commence on January 6, 2018, and run until June 5, 2018, inclusive. If the remitted portion of the suspension is required to be served by the Member because he fails to complete the remedial training specified in subparagraph 2(a), the remainder of the suspension shall commence on January 6, 2019, and continue until February 5, 2019, inclusive. If the remitted portion of the suspension is required to be served by the Member because he fails to complete the remedial training specified in subparagraph 2(b), the remainder of the suspension shall commence on January 6, 2020, and continue until February 5, 2020, inclusive. If the remitted portion of the suspension is required to be served by the Member because he fails to complete the remedial training specified in subparagraph 2(c), the remainder of the suspension shall commence on March 6, 2020, and continue until April 5, 2020, inclusive.

In its reprimand, the Panel noted that the Member is part of the honourable 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. Pharmacists bear the responsibility to ensure that they maintain the trust of the members and the public they serve.

The Panel expressed the expectation that all pharmacists treat colleagues with respect and act as a positive role model. The Panel related that the Member’s conduct with his colleague, who was in a vulnerable position, was reprehensible and breached professional boundaries, both as a manager and as a pharmacy professional.

The Panel found it highly disturbing that the Member would bring weapons to the pharmacy, where the provision of healthcare to the public takes place, with total disregard for the effects this may have on his staff. This also created an unsafe work environment for his pharmacy staff and for the patients he serves.

The Panel pointed out that, although this was his first appearance before a panel of the Discipline Committee, these actions cannot be condoned. The Panel expressed its expectation that the Member has learned from the experience, will complete the remedial courses, and will return to the profession with an understanding of professional boundaries and conduct that would be expected of a member of this College.

• On or about October 15, 2015, she dispensed a prescription for Oxycodone CR 80mg in doses and/or quantities that were clinically questionable, without taking and/or documenting any steps to assess the propriety of the prescription;
• On or about October 15, 2015, she dispensed a prescription for four benzodiazepines in doses and/or quantities and/or combinations that were clinically questionable, without taking and/or documenting any steps to assess the propriety of the prescription;
• Between about January 19, 2016 and May 10, 2016, she dispensed drugs pursuant to a prescription for client [Patient A] in smaller quantities than prescribed, without written authorization from the person presenting the prescription, contrary to s. 9(1) of the Drug Interchangeability and Dispensing Fee Act, R.S.O. 1990, c. P.23;
• On or about May 24, 2016, she performed the controlled act of prescribing a drug in circumstances where she was not authorized by a health profession act to do so and was otherwise without authorization to do so, with respect to her prescribing of four benzodiazepines;
• On or about May 24, 2016, she performed the controlled act of prescribing a drug without doing the following, which she was required to do:
  • Notifying the patient’s prescriber that she renewed the patient’s prescription, and/or recording in the patient’s record the date on which she notified the patient’s prescriber;
  • Recording all of the information on the prescription and/or the patient record required by ss. 37 and 38 of O. Reg. 202/94 made under the Pharmacy Act, 1991, S.O. 1991, c. 36

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, ss. 36, 37, and 38 of O. Reg. 202/94, as amended, made under the Act, and/or s. 27 of the Regulated Health Professions Act, 1991, and/or s. 4(2) of the 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, s. 9(1) of the Drug Interchangeability and Dispensing Fee Act, R.S.O. 1990, c. P.23, and s. 51(1) of the Benzodiazepines and Other Targeted Substances Regulations, SOR/2000-217, made under the Controlled Drugs and Substances Act, S.C. 1996, c. 19
• 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

On January 8, 2018, the Panel imposed an Order which included as follows:

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

a) that the Member complete successfully, within twelve months of the date of this Order, a program with Gail Siskind, an expert in ethical issues for regulated health care professionals, or such other expert as is acceptable to the College, to be designed by the expert, regarding the issues raised by the facts and findings of professional misconduct in this case, including the role of pharmacists in monitoring, advising on, and recommending changes to, patients’ medication therapy; and the following terms shall apply to the course:

i) the number of sessions shall be at the discretion of the expert, but shall be a minimum of 2 meetings and a maximum of 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 expert, but shall ultimately be at the discretion of the expert;

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

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

i. the Notice of Hearing;

ii. the Agreed Statement of Facts;

iii. this Joint Submission on Order; and

iv. the Panel’s Decision and Reasons, if and when available; and

v) the Member will request a report from the expert confirming that the Member has successfully completed the program requirements to the satisfaction of the expert, and the Member will provide a copy of the report to the College within twelve (12) months of the date of this Order.

b) that the Member complete successfully, at her own expense, within twelve months of the date of this Order, the following course and evaluations: Safe and Effective Use of Opioids for Chronic Non-cancer Pain, offered by the Centre for Addiction and Mental Health;

c) that the Member undergo a Practice Review performed by a Community Practice Assessor employed by the College; the initial Practice Review assessment shall be performed within six months of the date of this Order; the Member shall complete any re-assessments, learning plans, or other follow-up steps arising from the Practice Review as required and within the times required as part of the Practice Review;

3. The Registrar suspend the Member’s Certificate of Registration for a period of 1 month, with the suspension to be fully remitted on condition that the Member complete the remedial training as specified in subparagraphs 2(a), and (b) above.

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

In its reprimand, the Panel noted that pharmacy is an honorable and self-regulated profession, and that pharmacists bear the responsibility of following the standards of practice and accompanying laws and recommendations for detailed record keeping and documentation.

The Panel observed that pharmacists are called upon every day to make decisions and communicate with prescribers. But, in doing so, they must always stay within their scope of practice and understand those limits.

The Panel noted that, in the changing practice climate in which pharmacists find themselves, clinical acumen is paramount in keeping patients safe, especially when it comes to potentially addictive, high risk, and over prescribed medications.

The Panel expressed its hope that this Order and the discipline process will deter similar conduct in the future.