Whistleblower pharmacist fined for misconduct after complaint

A Manitoba pharmacist who made complaints against a colleague that led to sanctions against him has now also been fined due to her own conduct.

Portage la Prairie pharmacist Caitlin Giercke was fined $15,000 for dispensing prescriptions for drugs to patients on multiple occasions early and without prescriptions.

The investigation by the College of Pharmacists of Manitoba into Giercke’s conduct was triggered by a complaint she made about her colleague, Glen Pauch, who in June was fined $100,000 after the panel found he had dispensed a massive amount of drugs that could not be accounted for.

On Oct, 25, 2021 Giercke reported concerns about Pauch’s treatment of a patient who was regularly receiving refills of an opioid 17 to 18 days early without authorization. Giercke also said she was concerned Pauch had been misusing prescription medication.

An investigation and decision by the panel, dated June 9, found more than 39,000 doses went unaccounted for while Pauch was consuming drugs and improperly dispensing controlled substances — including opioids oxycodone and hydromorphone, and Concerta, a stimulant prescribed for ADHD — to 11 patients.

The probe prompted a separate investigation into Giercke’s conduct, which found Giercke failed to properly document the drugs she dispensed and did not maintain required records for drugs returned to the pharmacy or received from suppliers between 2020 and 2021.

The charges against Giercke relate primarily to her own pharmacy practice, but some of the charges overlap with Rauch’s conduct.

On 39 occasions narcotic and controlled drugs totalling 12,300 doses were shipped to the pharmacy, but not recorded as received or entered into the inventory, the decision says.

Giercke also admitted she shared her narcotic signature, a unique digital password used both for ordering and receiving narcotics, widely among the pharmacy’s staff, including with Pauch.

According to the decision, Giercke was aware that there were many “significant discrepancies and unexplained shortages” of opioids at the pharmacy, but failed to investigate and report Pauch’s behavior.

“This case is a textbook example of why the role of pharmacy manager is so important for the safe and effective operation of a pharmacy and, more specifically, for the protection of narcotic and controlled substances,” the decision says.

The investigation into both Pauch and Giercke revealed three purchases totalling 22,000 mg of hydromorphone powder were never entered into the system at the pharmacy. Of this amount, 19,223 mg is still unaccounted for.

On May 12, 2021 Giercke dispensed oxycodone tablets to a patient using a prescription Pauch had created himself while waiting on authorization from the patient’s doctor. The doctor later responded to the fax request to indicate that he had sent the prescription to the patient’s usual pharmacy and would not be sending an authorization to Giercke’s pharmacy to fill the prescription.

Giercke filled the prescription anyway and did not adjust the dispensed quantity to account for the tablets Pauch had given the patient earlier that day, the decision said.

Giercke and Pauch worked together at a different pharmacy in Portage la Prairie for eight years before Giercke opened her own dispensary and made a deal with Pauch that he could eventually buy into the business. Giercke would be the pharmacy manager, and Pauch would handle all back office tasks, the decision stated.

Giercke has worked as a pharmacist in Portage la Prairie since 2006. She will be banned from being a preceptor at her pharmacy for two years until the restrictions on her licence are lifted, and must pay $10,000 toward the cost of the investigation. Her pharmacy will be subject to routine inspections.

Meantime, Winnipeg pharmacist Mandeep Kaur must pay $25,000 in fines and investigation fees after the college found she had failed several times to keep an accurate inventory of narcotics like methadone and had lied about a safety assessment.

The investigation found 225 discrepancies in the narcotic counts, many of which involved hundreds or even thousands of doses, the decision says. Methadone is used to treat patients with opioid use disorders and severe, chronic pain.

Other findings detected were that Kaur was not giving patients counselling on medications when they were dispensed, or ensuring her colleagues did the same.

On one occasion, a patient was prescribed seven medications following cardiac surgery. When the prescriptions were filled, one of the medications was out of stock and was missed by the staff pharmacist who filled the prescription. The patient went an unknown time without the medication before suffering a thrombotic event for which surgery was required.

Kaur was also found to have lied about doing a safety self-assessment at the pharmacy that was needed to renew its licence in 2022.

nicole.buffie@winnipegfreepress.com