When in doubt contact PDL

"Always report any incident to PDL no matter how minor you may consider the matter to be."

From all reports, Guild Legal’s Solicitor- Director Paul Baker, made a strong impression on delegates to two recent conferences, the Pharmaceutical Society of Australia’s Offshore Refresher Course in Spain and the Australian Association of Consultant Pharmacy’s ConPharm conference in Coolum, Queensland. Paul has had almost 20 years experience in supporting the legal needs of pharmacists and therefore brings a wealth of knowledge, especially when it comes to professional legal liability issues.
The topic to receive most questions was the legal liability considerations when delivering professional services, especially home medicine reviews or medication management reviews. I’ve written about this issue in the past and Paul’s address to ConPharm was covered in an article published in the July edition of the AJP so I won’t reiterate the keys messages except to emphasise the following. I am a great supporter of pharmacists becoming more involved in professional services—it points to a critical feature of the profession’s future—but it’s critical that those delivering such services take the time and effort required to document every potential issues. Pharmacists may not be specifically trained to write reports or diarise concerns and issues, but they can make the effort and demonstrate intent.
In doing so, it is important to consider the language used. Always remember to convey thoughts without being inflammatory or defamatory. You never know what will be called on as evidence in court.

Material risk

Another issue Paul spoke about was the legal importance of understanding what a material risk was and considerations on how to avoid such risks. In court, a risk is deemed material if a reasonable pharmacist considered it relevant and, importantly, if an individual patient considered it to be relevant in determining whether they wished to take the medication. While common sense and a cautious approach is usually enough to determine whether an action or lack of an action presents a material risk, whenever in doubt, consult your Professional Practice Standards and Code of Professional Conduct and/or contact PDL and Guild Insurance.

Professional indemnity claims

It’s interesting to note the close correlation between Australia and the United States in terms of the types of professional indemnity claims made. For both countries, almost 80 per cent of all claims result from three main causes.
Claims arising from dispensing incorrect medications constitute 35 per cent of all claims in Australia and 36 per cent in the US while incorrect strength of prescribed medication resulted in 29 per cent of all claims in Australia and 27 per cent in the US. Such selection errors, as I’ve repeated in countless pharmacy forums, can be eliminated when a scanner is used during the dispensing process.
Misinterpretation by the pharmacist of the prescriber’s directions led to 15 per cent of all claims in Australia and 16 percent in the US. Interestingly, a further 10 per cent of claims arise from inadequate or incorrect counselling when considering a patient’s medication usage, potential side effects, complications and dosage.
Other less frequent reasons for professional indemnity claims in Australia were:incorrect labelling (4 per cent); dispensing medication to the wrong patient (3 per cent); the pharmacist providing a nonbioequivalent product to that prescribed (2.5 per cent); and dispensing out-of-date medication (1 per cent).

Access to patient data

In this edition of the AJP, national president of the Pharmaceutical Society of Australia, Brian Grogan, discussed the issue of privacy and pointed to reports of some pharmacies allowing pharmaceutical company reps unsupervised access to computer data. This has sometimes been done with computer memory sticks which have the capability of copying much of the computer’s database.

I agree wholeheartedly with Brian that, when in doubt, pharmacists should always refer back to the Professional Practice Standards and Code of Professional Conduct.
It is the pharmacist’s responsibility to protect the rights of their customers and this includes ensuring their personal information remains confidential.
While the decision to share sales data remains with the pharmacist, it should never include identifiable patient data and for this reason, I recommend that any sales rep given approval to access sales information should always be supervised while using the pharmacy’s computer.

Risk management tactics

Beware of interruptions, phone calls and distractions. • Fill only one prescription at a time. • Contact the prescriber to remove all uncertainty. • Work retail hours and take breaks. • Have reasonable expectations of yourself and your staff. • Follow recommended PDL and/or APF dispensing protocol

Maintain appropriate staffing levels. • Do not treat repeat authorisations as original. • For paediatric doses, always confirm age and weight of children. • Ensure the DD Register is maintained and record the receipt and supply of Schedule 8 medications. • Develop appropriate procedures for dealing with out-of-date medications.