The Kamsack Rexall pharmacy is one of two Saskatchewan Rexall pharmacies which put patients at risk when employees filled prescriptions in error in 2011 and 2012.
After an investigation by the Saskatchewan College of Pharmacists, the Kamsack Rexall and a Rexall pharmacy in Shaunavon were fined a total of $21,000 and were ordered to pay another $22,000 in legal costs.
The Kamsack Rexall Drug Store was charged with proprietary misconduct on December 4, 2013, according to information from the College.
Although the particulars were different, the situation at Rexall’s Kamsack pharmacy in many ways paralleled that at its pharmacy located in Shaunavon and the submissions made to the discipline committee were very much along the same line, the information said.
Initial contact between the College and Rexall in connection with its Kamsack pharmacy began in mid-June 2011, it said. The initial focus of the discussion between the College and Rexall was personnel changes in certain Rexall pharmacies in Saskatchewan including the Kamsack pharmacy.
The regional manager for Rexall advised he would be serving as the pharmacy manager in Kamsack, it said. He outlined the personnel problems in Kamsack, indicating the Kamsack Rexall pharmacy had been staffed by a series of relief pharmacists. Further, there was significant turnover of pharmacy assistance.
At the direction of the registrar of the College a field officer attended at the Kamsack pharmacy on two occasions in late November 2011. In early December the College received an unsolicited telephone call from a home care service in Kamsack expressing concerns about dispensing errors made at the Kamsack pharmacy. A written complaint form was invited and received. In mid-December 2011, the registrar of the College forwarded a letter to the pharmacy manager, outlining the College’s concerns and the need for both a short term and long term plan to address the problems.
In early January 2012 the College received three completed complaint forms about the practices at the Kamsack pharmacy. One came from a home care supervisor. The other two were by local residents. The complaints from home care alleged dispensing errors in March, June and October 2011. The complaints from the two local residents related to poor service, a loss of prescription and delays. These problems and concerns all arose in the fall of 2011.
In late May, 2012, the College received further incident reports from a local home care provider relating to errors made in February, 2012. Three more incident reports were received in June, 2012. According to a representation made by legal counsel for Rexall, the problems at the Kamsack pharmacy were resolved by June, 2012.
Rexall admitted to the allegations and the discipline committee accepted its plea. The company agreed to pay the fi ne and agreed that for a period of three years the pharmacy would be subject to up to three inspections by a field officer with each of the inspections to cost $1,000.
The College’s decision and order says that through the period of approximately March 2011 to June, 2012, the management and operation of the Kamsack Rexall pharmacy was deficient and inadequate as follows:
The level of staffing for both pharmacists and pharmaceutical support staff was insufficient given the volume of prescriptions dispensed;
Pharmacy assistants were poorly trained and oriented or not trained or oriented at all;
Prescriptions were dispensed without the full and proper monitoring of pharmacists;
Pharmacists and pharmacy assistants were not trained or were not properly trained on the pharmacy computer software system;
Patient interaction and counselling was limited and insufficient;
The dispensary was disorganized as there were no systems or inadequate systems to address workflow;
There were no regular and routine counts or reviews of narcotics and controlled drugs;
Prescriptions were lost or misfiled causing inconvenience and treatment delays to patients;
There were long delays in completing and dispensing compliance packaging leading to delayed treatment for patients;
There were long delays in completing and dispensing prescriptions leading to delayed treatment for patients and inconvenience;
Pharmacists’ initials on prescription labels did not necessarily mean that particular pharmacist had dispensed the prescription;
Patients and customers were frequently unable to contact the pharmacy by telephone as the telephone was not answered, and
There was no mechanism to document medication errors, adverse events and close calls and to manage those errors and events.
The committee also found the Shaunavon Rexall’s manager guilty of professional incompetence.
