Licensees: Narcotic security is your responsibility

A recent Hearing Tribunal issued its written decision on the merit and orders relating to the conduct of a pharmacy licensee regarding the requirements for the licensee to properly protect and secure the pharmacy’s narcotics.

During a narcotic inspection conducted by Health Canada’s Office of Controlled Substances (OCS), it was determined that there were approximately 1150 Statex 25mg tablets missing and unaccounted for at the licensee’s pharmacy. The subsequent ACP investigation determined that the licensee had failed to take reasonable steps to protect and secure narcotics in the pharmacy, ensure adequate systems and procedures were in place to identify the loss, detect the loss, and determine what happened to the narcotics and identify any likely suspects. The Hearing Tribunal found that the pharmacist, as the licensee, was the person most responsible for the pharmacy’s narcotic security. In examining the licensee’s errors and omissions in this matter, the Hearing Tribunal found that, as a pharmacist, his conduct was unprofessional and, as a licensee, he had engaged in misconduct. The hearing tribunal found that his actions had harmed the integrity of the profession and warranted sanctions.

The Tribunal also noted that the licensee had fully cooperated with the OCS inspection and ACP investigation and he had subsequently implemented changes to the pharmacy’s narcotic security to help prevent a reoccurrence of this situation.

The licensee admitted his responsibility for all the allegations and acknowledged that he failed to properly ensure the security of the pharmacy’s narcotics. With this being considered, the tribunal ordered

• the pharmacy to be monitored by an ACP field officer who shall conduct three pharmacy visits each year, for a period of two years. The licensee shall be responsible for the costs of each visit [note: the total cost of the six visits shall be approximately $4,500];
• a fine of $5,000; and
• a payment of the costs of the investigation and hearing to a maximum of $8,000.

Rationale for the Tribunal’s decision is reflected in its following statements:

From the Tribunal’s May 15, 2019 decision:

The Tribunal considers that the findings of unprofessional conduct and the very significant financial repercussions will provide specific deterrence to the Investigated Member to ensure this doesn’t happen again. These findings will also provide general deterrence to the membership; emphasizing the importance of ensuring proper security, procedures, and documentation.

Licensees – incorporate these lessons into your practice:

1. Review the Pharmacy and Drug Act , the Pharmacy and Drug Regulation, and the Standards for the Operation of Licensed Pharmacies (especially Standard 5.11 and 5.12) with regard to your responsibilities in the ensuring narcotic security.
2. Review and discuss your obligations and the requirements of the pharmacy with your pharmacy’s owner and pharmacy staff to ensure that the pharmacy has the resources needed to meet these obligations.
3. Never share narcotic “passwords” or “logins.”
4. Use appropriate security cameras.
5. Implement and maintain a perpetual inventory for narcotics.
6. Conduct routine and random narcotic audits and ensure that all identified discrepancies are investigated and resolved.
7. After dispensing a narcotic, pharmacy staff should back-count and verify the remaining pharmacy stock against the narcotic’s recorded perpetual inventory.
8. Keep all clutter in the dispensary to a complete minimum. A disorganized dispensary creates an environment in which diversion is more possible to occur and remain undetected.
9. Review on-hand pharmacy narcotic inventory needs and endeavor to keep smaller amounts of narcotics in stock. Maintaining smaller quantities on-hand will allow pharmacy staff to more rapidly identify trends regarding changes in narcotics being received and/or being dispensed. In addition, more periodic narcotic orders resulting from lower on-hand stock levels will result in a greater opportunity for more staff members to be involved in narcotic security and therefore reduce the likelihood of any narcotic diversion by an individual.
10. Implement and review inventory trending software functionalities that alert the pharmacy licensee to changes in narcotic ordering and receiving patterns.

Review and implement the applicable drug security tips outlined in the Winter 2010 ACP News supplement.