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Unregulated pharmacy team members must be supervised

May 4, 2022
Lessons Learned: licensees are responsible for the supervision and conduct of unregulated pharmacy employees.

A recent Hearing Tribunal issued its written decision on the merit and orders regarding the conduct of a pharmacist who was a pharmacy licensee during the period of the alleged unprofessional conduct. Central to the allegations were concerns that an unregulated employee of the pharmacy had, without authorization, administered drugs by injection (vitamin B12 and flu shots) to patients on two separate occasions, and then created inaccurate patient records and third-party insurer claims. The second incident occurred after the licensee had become aware of the first and took some action to address the matter. However, the unauthorized injections, and associated improper conduct, reoccurred after the pharmacist was no longer the licensee of the pharmacy. In carrying out his responsibilities as the licensee, the pharmacist failed to properly supervise the unregulated employee and failed to inform the pharmacy’s new licensee of the previous unauthorized injections.

The Hearing Tribunal found that through the pharmacist’s actions and inactions, the potential for patient harm was created, the integrity of the profession was undermined, and the public’s trust in the profession was decreased. The Hearing Tribunal found the pharmacist’s conduct was unprofessional and as a licensee he had engaged in misconduct.

The Hearing Tribunal also noted that the pharmacist was remorseful, accepted responsibility for his conduct, had no previous findings of unprofessional conduct, and fully cooperated with the investigation and hearing.

Even though the pharmacist admitted his responsibility for the allegations and acknowledged that he failed to exercise the professional and ethical conduct expected and required of an Alberta pharmacist and licensee, the Tribunal ordered the following penalties:

  • a practice permit suspension for a period of three months,
  • a fine of $2,500,
  • the pharmacist to provide a copy of the written decision to any pharmacy employer or licensee of any pharmacy where he works as a pharmacist for three years, and
  • a payment of $10,000 towards the costs of the investigation and hearing.

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

While no patient came to any apparent harm in this case, without consequential change in supervisory consistency and effectiveness, the potential for harm in the future could be significant. This case illustrates the importance of supervision in all aspects of the practice of pharmacy.

The public must have the confidence that all Alberta pharmacists and pharmacies operate in accordance with the legislation that relates to the practice of pharmacy in Alberta and the Standards and Code of Ethics set forth by the Alberta College of Pharmacy. 

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 (SOLP) with regard to your responsibilities when operating a pharmacy. Relevant sections and standards can be found in the Hearing Tribunal’s written decision.
  2. Review the training and supervision requirements found in the SOLP and Standards of Practice for Pharmacists and Pharmacy Technicians (SPPPT). Ensure that unregulated employees are always properly supervised. Unregulated employees cannot perform restricted activities and must be supervised directly when supporting pharmacists and pharmacy technicians in providing restricted activities.
  3. Review and consider your ethical responsibilities outlined in Principles 1 and 10 of the Code of Ethics. Always hold the best interests of your patients to be your primary concern and take all appropriate steps to ensure the actions of your unregulated staff do not interfere with these requirements.
  4. Complete Parts A and B of the ACP Licensee Education Program (LEP) to learn more about the duties and responsibilities of a licensee.
  5. Ensure that only authorized individuals can access the pharmacy information systems. When adjustments to inventory are made by an authorized individual, reasons for the adjustments must be documented and reviewed by the licensee.
  6. Ensure that all pharmacy team members wear an accurate name tag so that members of the public can clearly differentiate regulated and unregulated personnel.   
  7. Ensure that the restricted title “pharmacy technician” is not used by a pharmacy team member who is an unregulated employee (e.g., pharmacy assistant).