A Hearing Tribunal issued its written decision on the merits and orders regarding the conduct of a pharmacist who failed to appropriately respond to the concerns of two affected patients when they sought clarification about the administration of hepatitis A vaccine that did not follow the product monograph requirements.
The pharmacist’s omissions were determined by the Tribunal to be acts of unprofessional conduct. In its decision, the Tribunal affirmed the necessity for registrants to comply with all injection preparation and administration requirements. The Tribunal found that in this matter the pharmacist’s actions had, in part, breached his statutory and regulatory obligations to the Alberta College of Pharmacy (ACP), created the potential for patient harm, undermined the integrity of the profession, failed to fulfill the professional and ethical judgement expected and required of an Alberta pharmacist, and warranted sanctions.
As a pharmacist, you must take personal responsibility to ensure that all product monograph recommendations are considered and properly complied with when administering medications by injection, including vaccines, and you must be open in your communications with your patients.
In this matter, the Tribunal imposed penalties even though the pharmacist accepted responsibility for his conduct during the hearing process, there had been no previous history of unprofessional conduct on the part of the pharmacist, and there was no demonstrated patient harm. The Tribunal ordered
- a caution,
- the pharmacist to successfully compete a Canadian Council on Continuing Education in Pharmacy (CCCEP) accredited injections course at his own expense (Note: the pharmacist has completed this course), and
- a payment of $2,000 towards the costs of the investigation and hearing.
Rationale for the Tribunal’s decision is reflected in its following statements:
…the Hearing Tribunal considered that [the pharmacist] should have sought information to ensure he administered the vaccine correctly and as such there was an absence of appropriate treatment and care. Although there was no evidence of harm in this case, his failure to do so could have caused patient harm. [The pharmacist] had an obligation to review the product monograph and was responsible to administer the vaccine appropriately.
With respect to the nature and gravity of the conduct, the Hearing Tribunal was mindful that although there was no patient harm in this instance, there had been the potential of patient harm. The Hearing Tribunal considered that the legislature has given pharmacists the privilege of administering medication and they therefore have a responsibility to do so properly. The onus is on a pharmacist to know the special handling or mixing instructions for any medication they may administer. This is what the public should expect of pharmacists.
Pharmacists and pharmacy technicians – incorporate these lessons into your practice:
- Always make patient care and patient safety central to your practice. Actively seek out information to make informed decisions. Don’t let convenience, expediency, or misguided certainty outweigh the need to provide your patients with appropriate care.
- If you are not certain about all product monograph recommendations, ensure you review these recommendations before you provide the associated drug or service. A summary of the recommendations, such as those found on a drug’s packaging, is not a substitute for the product monograph.
- Do not allow your personal circumstances to negatively affect your professional obligations.
- Actively engage each patient and work with the patient in a manner that builds a relationship and confidence in your professional abilities. When patients ask questions or express concerns about the pharmacy services you provide, listen to and explore their concerns. Don’t be dismissive. When it’s been determined that an error or omission has been made, evaluate your practice and assume responsibility for your actions and professional improvement.
