An Edmonton pharmacist has been suspended and fined $75,000 after a provincial regulator found his pharmacy improperly filled nearly 1,400 narcotic prescriptions from a disgraced Sherwood Park physician.
Rajeh Abu Zahra, former owner of Edmonton's Boyle McCauley Pharmacy and Home Health Care, has been suspended for three months by the Alberta College of Pharmacy (ACP) and is not allowed to own or operate a pharmacy for two years.
Abu Zahra gave up his licence in November and his suspension started on Dec. 25, college registrar Greg Eberhart told CBC's Radio Active on Thursday. The tribunal delivered its decision in August and handed down the penalties in November.
The tribunal found Abu Zahra developed a routine practice of accepting hundreds of improper prescriptions regardless of circumstance written by Dr. Vincenzo Visconti, and then attempting to get the physician to send the proper paperwork later.
Visconti permanently lost his licence to practice medicine last year after the College of Physicians and Surgeons of Alberta found he was prescribing opioids at rates drastically higher than other doctors.
Visconti was also criminally charged in 2018 for allegedly defrauding the government of Alberta of more than $5,000.
The tribunal found Abu Zahra filled 1,395 prescriptions with improper paperwork from Visctoni between Jan. 1 and May 3, 2018.
Narcotics must be prescribed in Alberta using a secure prescription form, overseen by the College of Physicians and Surgeons of Alberta in partnership with other healthcare regulators.
The medications relevant to the case are part of the most highly protected class, including ketamine and a range of opioids. A pharmacist can only fill a prescription without the proper paperwork in exceptional circumstances.
"The Hearing Tribunal concluded that it is highly unlikely that an individualized legitimate assessment of exceptional circumstances could have occurred 1,395 times," the tribunal concluded in its decision.
The tribunal also found prescription issues were evident "many months prior" to Jan. 1, 2018.
The tribunal heard evidence that Abu Zahra's pharmacy would regularly fill the prescriptions then retroactively seek the proper forms from Visconti.
Abu Zahra told the tribunal that Visconti wanted to deal with one pharmacy for his patients, many of whom lived in the Boyle McCauley neighbourhood. The pharmacy would fill up to 30 prescriptions for Visconti's patients on a daily basis. Multiple patients needed prescriptions filled every week, Abu Zahra said.
As the narcotic prescriptions started to increase dramatically in the fall of 2017 — as opioid deaths hit unprecedented levels in Alberta — so did the backlog of paperwork from Visconti.
Investigators told the tribunal that Abu Zahra asked the college to intervene with regard to the backlog in 2018. Investigators reviewed records of all the times the pharmacy filled narcotics prescriptions from Visconti between January and the beginning of May. The tribunal heard there were roughly 8,100 dispensing events, and 1,395 missing prescriptions.
"The situation escalated and became unmanageable," the tribunal concluded.
In its decision, the tribunal says it is concerned Abu Zahra did not appreciate the potential consequences of his actions, and that he did not fully understand the professional judgment expected from a pharmacist in his position.
Abu Zahra must pass an ethics exam before his suspension is lifted. Abu Zahra must also pay a $5,000 fine and an additional $70,000 to cover the cost of the tribunal hearing.