A recent Hearing Tribunal issued its written decision on the merit and orders regarding the conduct of a pharmacist who was found to have been diverting brand-name Cialis and generic Tadalafil. The Tribunal found the pharmacist abused his position of trust by manipulating the inventory records at his pharmacy to conceal his diversions. In doing so, the Hearing Tribunal found that the pharmacist breached the most fundamental elements of trust, integrity, and professionalism.
The requirement for pharmacy registrants to act honestly and ethically is a fundamental part of the covenant of self-regulation.
In this matter the Tribunal imposed significant penalties, even though the medications were diverted solely for the pharmacist’s personal use, there were no allegations of patient harm or risk, and the pharmacist admitted to his unprofessional conduct. The Tribunal ordered the following:
- a four-month suspension, with three months to be held in abeyance pending the pharmacist’s compliance and there being no similar complaints regarding diversion coming to the attention of the complaints director for a period of two years from the decision;
- prior to being eligible to have his practice permit reinstated following the period of suspension, the pharmacist will provide the complaints director with a letter from his treating physician confirming his fitness to practice;
- an order that the pharmacist must disclose the Tribunal’s written decision to the proprietor and licensee of any pharmacy in which he applies to work or works as a pharmacist for three years;
- a condition prohibiting the pharmacist from holding the position of pharmacy owner, proprietor, or licensee for a period of three years;
- a $3,000 fine; and
- the costs of the investigation and hearing to a maximum of $10,000.
The pharmacist’s employment at the pharmacy where the diversions occurred was terminated.
Rationale for the Tribunal’s decision, is reflected in its following statements:
Diversion of Schedule 1 medications from the pharmacy without a prescription represents dishonest conduct that undermines the integrity of the profession and decreases the public’s trust in the profession.
[The pharmacist’s] conduct also demonstrated that he allowed his professional judgment to be impaired and compromised by his self-interest due to his personal situation.
The public should be entitled to expect that pharmacists will not allow their own interests to take precedence over their professional obligations and judgment.
This case involves 8 occasions over a three-year interval (February 2016 to February 2019) where [the pharmacist] diverted drugs from the pharmacy for his personal use. In doing so, he abused his employer’s trust in a manner that undermined his role as a pharmacist.
Pharmacists and pharmacy technicians – review your ethical duties to our profession and yourself
- Understand that the diversion of drugs for any reason can not and will not be tolerated by the profession. Your decision to participate in these activities may result in serious sanctions. These possible sanctions may apply even when “regular” prescription medications are diverted and when the medications are diverted for “personal” use.
- Do not allow your personal circumstances to negatively affect your professional obligations.
- Review and reflect upon your conduct as it relates to the Code of Ethics and your profession.
Licensees – ensure your pharmacy’s drugs are secured
- Ensure that you and your pharmacy staff maintain proper security of your pharmacy’s drugs.
- Appropriately limit access to manual inventory adjustment functionality within your pharmacy.
- Audit, and follow up on, manual adjustments made to drug inventory records.
- Never allow pharmacy system or wholesaler system “passwords” or “logins” to be shared.
- Use appropriate security cameras and retain records of all suspicious activity.
- Understand that controlled substances may not be the only drugs in your pharmacy that require additional security measures. See the lessons learned from the June 26, 2019 Link article about narcotic security and consider these same lessons for other drugs with a higher diversion potential.