Dialogue Volume 14 Issue 4 2018 - Page 51

DISCIPLINE SUMMARIES On January 13, 2016, Dr. Chan wrote a prescrip- tion for Relative 1 for 180 Fentanyl patches. As with the previous prescriptions, it bore her passport num- ber and indicated her address to be Dr. Chan’s home address. On the prescription he submitted to the Shoppers Drug Mart pharmacy, Dr. Chan wrote “Pa- tient leaving town, OK to release all supplies now.” When in January 2016, the pharmacist telephoned a number believed to be for the patient, Dr. Chan answered the pharmacist’s call and confirmed that he was the prescribing physician, and that he had written the prescription for Relative 1. The pharma- cist advised Dr. Chan that the prescription he had written would not be filled because it was for his rela- tive. In a separate conversation with the pharmacy owner, it was suggested to Dr. Chan that he have the patient’s family physician write the prescription. Several days later, Dr. Chan asked Dr. X, a clini- cal fellow working under his supervision, to write a prescription for Fentanyl for Relative 1. Dr. Chan approached Dr. X during clinic hours and told her that his relative had been using the medication and he had been prescribing to her for years. Dr. Chan also told Dr. X that he would have asked another col- league to write the prescription, but that there were no other staff doctors around and that he needed it right away. He told her what medication to prescribe, and he specified the dose and quantity. Dr. Chan told Dr. X that he had already presented a prescrip- tion for Fentanyl to the pharmacy, but the pharmacy requested that he have another physician issue the prescription. Dr. X did not assess Dr. Chan’s relative. She did not feel she could refuse Dr. Chan’s request, as Dr. Chan was her supervisor. She wrote the prescription as requested by Dr. Chan. The same day, Dr. Chan submitted the prescription written by Dr. X to the pharmacy to be filled. The pharmacy did not fill the prescription written by Dr. X. Over January 18 and 19, 2016, Dr. Chan and Dr. X exchanged text messages wherein Dr. Chan wrote Dr. X that he ended up not sending the prescription to the pharmacy as the pharmacy returned the stocks. He texted that he is glad that he didn’t have to use it as he felt awkward asking her to write the script, and stated that he will bring his relative to the doctor when he gets home. Several days later, the pharmacy telephoned Dr. X to confirm whether the prescription she had written was valid. Dr. X confirmed having written it, but stated that she had not seen the patient. In the course of the College’s investigation into his prescribing, Dr. Chan provided conflicting or inac- curate information regarding: • His contact with a physician who treated Relative 1 in the foreign country where she resides; • The length of time for which he had been prescrib- ing Fentanyl to Relative 1; • The number of pharmacies at which he had filled Relative 1’s Fentanyl prescriptions; • Where and how he treated and examined Relative 1; and • How he got the Fentanyl to Relative 1. ORDER The Committee ordered the following: a reprimand; a five-month suspension; successful completion of a prescribing course and the PROBE course in ethics. Dr. Chan was also ordered to pay costs to the College in the amount of $6,000. The Committee ordered that Dr. Chan’s prescribing practices be restricted as follows: Dr. Chan shall issue new prescriptions or renew existing prescriptions for any of the following sub- stances only to patients whom Dr. Chan is treating in a hospital setting (including in-patients, clinic patients, and emergency department patients): (a) Narcotic Drugs; and (b) Narcotic Preparations For complete details, please see the full decision at www.cpso.on.ca. Select Find a Doctor and enter the doctor’s name. At the conclusion of the hearing, Dr. Chan waived his right to an appeal and the Committee administered the reprimand. Full decisions are available online at www.cpso.on.ca. Select Find a Doctor and enter the doctor’s name. ISSUE 4, 2018 DIALOGUE 51