Ignoring Red Flags can Lead to Professional Misconduct

Typically, intentional misconduct garners serious sanctions at a College’s Discipline Committee. However, regulated health professionals should also be aware that they can be found to have committed acts of professional misconduct if they “ought to have known” that their conduct was unprofessional, dishonest, or dishonourable. Overlooking “red flags” can bring dishonour to the profession, resulting in serious penalties — as seen in Bijanzadeh v. Ontario College of Pharmacists, 2022 ONSC 3578.

Findings of the Discipline Committee

The member operated a small pharmacy where she was dispensing all the prescriptions. In a period of three years, the member received fraudulent prescriptions and dispensed large quantities of narcotics that “compromised the safety of the public, by flooding the black market with potent, life-threatening drugs.” The member was, unfortunately, “duped” into providing narcotic and prescription medications to a sophisticated trafficking ring.

The Discipline Committee of the College of Pharmacists heard from experts about the role of pharmacists as “gatekeepers” to access potent prescription narcotics. The Discipline Committee found that the member’s conduct was dishonourable because she ought to have known how to authenticate the prescriber, the patient, and the prescriptions. She failed to guard the safety of the public in relation to these drugs by ignoring several red flags:

• An influx of patients to the pharmacy from one physician. For example, of the 5,300 narcotic prescriptions received, 5,000 were attributed to a single physician;
• Five patients in one household all taking the same high-dose narcotic medication;
• Patients who could have had their medication paid for by the ODB Program were paying for narcotic medications with hundreds of dollars of cash; and
• Prescriptions for fentanyl were extremely high and went on for some time with multiple prescriptions and multiple early refills.

The member had no knowledge of the drug trafficking scheme and even assisted police in ensuring that the traffickers were convicted. Yet, the scheme’s success was partly due to the member’s failure to take basic steps to discharge her obligations as a licenced pharmacist. Had she verified the patients, physician, and prescriptions, she might have been able to identify the drug trafficking scheme earlier.

Penalty Imposed

During the penalty phase, counsel for the College of Pharmacists submitted that the only appropriate remedy was a revocation of the member’s licence and a finding that the member was ungovernable. The member argued that revocation was inappropriate, pointing to several mitigating factors, including that she assisted the police and testified in three cases to assist in the conviction of the drug traffickers. The member was willing to complete courses, have her practice monitored, and have her licence suspended for no longer than three months.

The Discipline Committee disagreed with both parties. Instead of a revocation, the Discipline Committee imposed a 14-month suspension of the member’s licence. Moreover, for five years, the member was prohibited from acting as a designated manager at a pharmacy, acting as a narcotic signer at any pharmacy, and acting as a preceptor for pharmacy students in training. She was also required to complete multiple courses and submit to practice monitoring. The member was also required to pay costs to the College in the amount of $61,750. 

The Divisional Court’s Decision on Penalty

The member appealed the penalty decision of the College of Pharmacists to the Divisional Court. The Court dismissed the appeal. It saw no merit in the member’s argument that the College had failed to take into account the member’s personal circumstances.

The Court noted that the 14-month suspension and subsequent five years of conditions on her license meant that she could not continue owning and operating her pharmacy. The penalty would “have a profound effect on her career, and she will be unable to continue with her current business.” However, the Court noted that “the penalty will permit the appellant eventually to return to work in her chosen field, and to resurrect her career, if she applies herself diligently.”

Take Away

This case is a sober reminder that ignoring red flags when one ought to know better can lead to serious consequences with a regulator. In this case, the penalty is harsh given that the member had no actual involvement in the drug trafficking ring, nor did she profit from the scheme. However, the member did not show insight into how her conduct could have harmed the public.

The case is a good reminder for professionals to review their College’s standards of practice and professional guidelines that are relevant to their specialty or business.

Note: our blog is not a substitute for legal advice. If you are facing a complaint with your regulator, please contact us as we maybe able to assist you.

To learn more about Wise Health Law and our services, please contact us!