Discipline Committee of the  
Ontario College of Pharmacists  
Citation: Ontario (College of Pharmacists) v. Awad, 2022 ONCPDC 3  
Date: 2022-01-28  
IN THE MATTER of the Regulated Health Professions Act, 1991, S.O. 1991, c.18, as amended, and  
the regulations thereunder, as amended;  
AND IN THE MATTER of the Pharmacy Act, 1991, S.O. 1991, c.36, as amended, and the regulations  
thereunder, as amended;  
AND IN THE MATTER of the Drug and Pharmacies Regulation Act, R.S.O. 1990, c.H.4, as  
amended, and the regulations thereunder, as amended;  
AND IN THE MATTER of allegations of proprietary/professional misconduct/incompetence before  
the Discipline Committee of the Ontario College of Pharmacists as referred by the  
Accreditation/Inquiries, Complaints and Reports Committee against Amani Awad;  
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BETWEEN:  
ONTARIO COLLEGE  
OF PHARMACISTS  
Jordan Glick and Jordan Stone  
For Ontario College of Pharmacists  
Katharine Neufeld  
Attending for Ontario College of Pharmacists  
- and -  
AMANI AWAD  
(REGISTRATION #210760)  
Andrew Rogerson  
For the Member  
Amani Awad, R.Ph.  
In Attendance  
Stephen Ronan, Jennifer Hunter,  
and Nadia Marotta  
Independent Legal Counsel  
Panel Members:  
Heard: September 14 to 18, 2020;  
Chris Aljawhiri, R.Ph., Chair  
Christine Henderson, Public Director  
David Breukelman, Public Director  
Devinder Walia, Public Director  
December 9, 11, 15, 17, and 18, 2020;  
February 16 to 19 and 22, 2021; March 11,  
2021; April 20, 2021; and July 12, 2021  
Decision Released: January 28, 2022  
Written Decision Date: January 28, 2022  
Awad, Amani  
Registration #210760  
Page 2 of 61  
DECISION AND REASONS FOR DECISION  
Notice of Publication Ban  
In the hearing of the Ontario College of Pharmacists and Amani Awad, the Discipline  
Committee made orders as follows:  
1. That no person shall publicly disclose, publish, or broadcast the name of any  
patient(s) referred to at a hearing in this proceeding or in documents filed as  
exhibits in this proceeding, or any information that could disclose the identity of any  
patient(s), pursuant to subsection 45(3) of the Health Professions Procedural Code to  
the Regulated Health Professions Act.  
2. That no person shall publically disclose, publish, or broadcast the following  
information, referred to during the motion heard on April 20, 2021, throughout  
these proceedings or in documents filed as exhibits in these proceedings:  
a. the name of the affiant who swore affidavits dated February 16, 2021, and  
March 12, 2021, for the purpose of the Motion,  
b. the names and health information respecting the affiant’s children, and  
c. the words that are redacted in the email written by the affiant and sent to  
Mr. J. Glick, counsel for the College, that relate to the complaint made to  
the Law Society of Ontario respecting Member’s counsel,  
pursuant to subsection 45(3) of the Health Professions Procedural Code, Schedule 2 to the  
Regulated Health Professions Act, 1991.  
I. Introduction  
This matter was heard by a Panel of the Discipline Committee on September 14 to 18,  
2020; December 9, 11, 15, 17, and 18, 2020; February 16 to 19 and 22, 2021; March 11,  
2021; April 20, 2021; and July 12, 2021, electronically by way of videoconference  
pursuant to the Hearings in Tribunal Proceedings (Temporary Measures Act), 2020 and  
the Discipline Committee Rules of Procedure.  
II. The Allegations  
The allegations against the Member as stated in the Notice of Hearing, dated August 6,  
2020 (Exhibit 1), are as follows:  
1.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
Awad, Amani  
Registration #210760  
Page 3 of 61  
amended, and subsection 2(1)2 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(2) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacist at John Garland Pharmacy (the “Pharmacy”) in  
Etobicoke, Ontario, she failed to maintain a standard of practice of the profession  
in that she:  
a. failed to keep records as required respecting her patients and/or practice with  
respect to one or more of the drugs and/or products listed in Appendix “A” and  
Appendix “B” from in or about January 2015 to in or about September 2017;  
b. falsified a record relating to her practice and/or a person’s health record with  
respect to one or more of the drugs and/or products listed in Appendix “A” and  
Appendix “B” from in or about January 2015 to in or about September 2017;  
c. signed or issued, in her professional capacity, a document that she knew or  
ought to have known contained a false or misleading statement with respect to  
one or more of the drugs and/or products listed in Appendix “A” and Appendix  
“B” from in or about January 2015 to in or about September 2017; and/or  
d. submitted an account or charge for services that she knew or ought to have  
known was false and misleading with respect to one or more of the drugs and/or  
products listed in Appendix “A” and Appendix “B” from in or about January  
2015 to in or about September 2017.  
2.  
3.  
4.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
amended, and subsection 2(1)15 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(13) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacist at the Pharmacy in Etobicoke, Ontario, she failed to  
keep records as required respecting her patients and/or practice with respect to one  
or more of the drugs and/or products listed in Appendix “A” and Appendix “B”  
from in or about January 2015 to in or about September 2017.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
amended, and subsection 2(1)16 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(14) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacy at the Pharmacy in Etobicoke, Ontario, she falsified a  
record relating to her practice and/or a person’s health record with respect to one or  
more of the drugs and/or products listed in Appendix “A” and Appendix “B” from  
in or about January 2015 to in or about September 2017.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
Awad, Amani  
Registration #210760  
Page 4 of 61  
amended, and subsection 2(1)17 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(15) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacist at the Pharmacy in Etobicoke, Ontario, she signed or  
issued, in her professional capacity, a document that she knew and/or ought to have  
known contained a false or misleading statement with respect to one or more of the  
drugs and/or products listed in Appendix “A” and Appendix “B” from in or about  
January 2015 to in or about September 2017.  
5.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
amended, and subsection 2(1)20 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(16) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacist at the Pharmacy in Etobicoke, Ontario, she submitted  
an account or charge for services or products that she knew and/or ought to have  
known was false or misleading for one or more of the drugs and/or products listed  
in Appendix “A” and Appendix “B” from in or about January 2015 to in or about  
September 2017.  
6.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
amended, and subsection 2(1)23 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(21) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacist at the Pharmacy in Etobicoke, Ontario, she  
contravened the Pharmacy Act, 1991, the Drug and Pharmacies Regulation Act,  
the Regulated Health Professions Act, 1991, the Narcotics Safety and Awareness  
Act, 2010, the Drug Interchangeability and Dispensing Fee Act or the Ontario  
Drug Benefit Act or the regulations under those Acts, and in particular:  
a. sections 155(1), 156, 163, and 166 of the Drug and Pharmacies Regulation Act,  
section 20(1) of Ontario Regulation 264/16, and sections 40(1) and 54(1) of  
Ontario Regulation 58/11 with respect to:  
i.  
dispensing and/or billing for drugs and/or products without a  
prescription authorized by a prescriber for one or more of the drugs  
and/or products listed in Appendix “A” and Appendix “B” from in or  
about January 2015 to in or about September 2017; and/or  
ii.  
failing to keep records as required for one or more of the drugs and/or  
products listed in Appendix “A” and Appendix “B” from in or about  
January 2015 to in or about September 2017.  
7.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
Awad, Amani  
Registration #210760  
Page 5 of 61  
amended, and subsection 2(1)26 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(22) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacist at the Pharmacy in Etobicoke, Ontario, she  
contravened a federal, provincial or territorial law with respect to the distribution,  
sale or dispensing of any drug or mixture of drugs, with respect to the distribution,  
purchase, sale, dispensing or prescribing of any drug or product, the administering  
of any substance, or the piercing of the dermis, whose purpose is to protect or  
promote the public health, and/or that is otherwise relevant to her suitability to  
practise, and in particular:  
a. sections 155(1), 156, 163, and 166 of the Drug and Pharmacies Regulation Act,  
section 20(1) of Ontario Regulation 264/16, and sections 40 and 54(1) of  
Ontario Regulation 58/11 with respect to:  
i.  
dispensing and/or billing for drugs and/or products without a  
prescription authorized by a prescriber for one or more of the drugs  
and/or products listed in Appendix “A” and Appendix “B” from in or  
about January 2015 to in or about September 2017; and/or  
ii.  
failing to keep records as required for one or more of the drugs and/or  
products listed in Appendix “A” and Appendix “B” from in or about  
January 2015 to in or about September 2017.  
b. sections 5, 6, and 15(1) of the Ontario Drug Benefit Act and section 27 of  
Ontario Regulation 201/96 with respect to:  
i.  
submissions of claims for payment to the Ontario Drug Benefit Program  
where no payment was required and/or that she knew or ought  
reasonably to have known were false, inaccurate or misleading for one  
or more of the drugs and/or products listed in Appendix “A” and  
Appendix “B” from in or about January 2015 to in or about September  
2017.  
8.  
She committed an act or acts of professional misconduct as provided by subsection  
51(1)(c) of the Health Professions Procedural Code of the Pharmacy Act, 1991, as  
amended, and subsection 2(1)39 of Ontario Regulation 130/17, as amended, and/or  
subsection 1(30) of Ontario Regulation 681/93, as amended, in that, while engaged  
in the practice of pharmacy as director, shareholder, owner, designated manager,  
and/or dispensing pharmacist at the Pharmacy in Etobicoke, Ontario, she engaged  
in conduct or performed an act relevant to the practice of pharmacy that, having  
regard to all the circumstances, would reasonably be regarded by members as  
disgraceful, dishonourable or unprofessional, in that she:  
a. failed to keep records as required respecting her patients and/or practice with  
respect to one or more of the drugs and/or products listed in Appendix “A” and  
Appendix “B” from in or about January 2015 to in or about September 2017;  
Awad, Amani  
Registration #210760  
Page 6 of 61  
b. falsified a record relating to her practice and/or a person’s health record with  
respect to one or more of the drugs and/or products listed in Appendix “A” and  
Appendix “B” from in or about January 2015 to in or about September 2017;  
c. signed or issued, in her professional capacity, a document that she knew or  
ought to have known contained a false or misleading statement with respect to  
one or more of the drugs and/or products listed in Appendix “A” and Appendix  
“B” from in or about January 2015 to in or about September 2017; and/or  
d. submitted an account or charge for services that she knew or ought to have  
known was false and misleading with respect to one or more of the drugs and/or  
products listed in Appendix “A” and Appendix “B” from in or about January  
2015 to in or about September 2017.  
APPENDIX “A”  
Prescription No.  
902728  
907220  
915321  
924547  
929209  
942786  
951304  
959940  
973846  
990703  
928738  
933213  
937481  
Medication  
1
2
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Symbicort 200mcg  
Fenofibrate E 145mg  
Fenofibrate E 145mg  
Fenofibrate E 145mg  
3
4
5
6
7
8
9
10  
11  
12  
13  
Awad, Amani  
Registration #210760  
Page 7 of 61  
Prescription No.  
947627  
915298  
955692  
959941  
964251  
969043  
907474  
919613  
928740  
937483  
959942  
973734  
991738  
907475  
973845  
978254  
982395  
987528  
991736  
995284  
1000450  
1005038  
1013587  
Medication  
Fenofibrate E 145mg  
Fenofibrate E 145mg  
Fenofibrate E 145mg  
Fenofibrate E 145mg  
Fenofibrate E 145mg  
Fenofibrate E 145mg  
Benzaclin  
14  
15  
16  
17  
18  
19  
20  
21  
22  
23  
24  
25  
26  
27  
28  
29  
30  
31  
32  
33  
34  
35  
36  
Benzaclin  
Benzaclin  
Benzaclin  
Benzaclin  
Benzaclin  
Benzaclin  
Clindoxyl  
Abilify 5mg  
Abilify 5mg  
Abilify 5mg  
Abilify 5mg  
Abilify 5mg  
Abilify 5mg  
Abilify 5mg  
Abilify 5mg  
Abilify 5mg  
Awad, Amani  
Registration #210760  
Page 8 of 61  
Prescription No.  
990701  
Medication  
37  
38  
39  
40  
41  
42  
43  
Boost 1.5 Plus  
Boost 1.5 Plus  
Boost 1.5 Plus  
Boost 1.5 Plus  
Boost 1.5 Plus  
Boost 1.5 Plus  
Boost 1.5 Plus  
992691  
997315  
1003973  
1008557  
1012659  
1017875  
APPENDIX “B”  
Drugs and Products  
Abilify 5mg  
Benzaclin  
Boost 1.5 Plus  
Ensure 1.5 Plus  
Clindoxyl  
Fenofibrate E 145 mg  
Symbicort 200mcg  
College Counsel advised the Panel that the College was not calling any evidence in  
relation to allegation 7(b) of the Notice of Hearing that the Member contravened section  
6 of the Ontario Drug Benefit Act.  
Awad, Amani  
Registration #210760  
Page 9 of 61  
III. Member's Position  
The Member denied all of the allegations set out in the Notice of Hearing.  
IV. Overview  
The Member registered as a pharmacist with the College on April 7, 2000.  
From March 31, 2009 until July 28, 2016, the Member was a director and 33%  
shareholder of St. Mary and St. Philopatir (Marcurius) Drugs Ltd-Toronto, a corporation  
that owned and operated John Garland Pharmacy (the “Pharmacy”). Each shareholder  
held an equal number of shares in the corporation. The Member was the Designated  
Manager of the Pharmacy from April 27, 2009 to July 28, 2016. The corporation closed  
on July 28, 2016.  
From July 28, 2016, the Member was the sole director and shareholder of St. Mary and  
St. Philopatir (Marcurius) Drugs Ltd-Etobicoke, a corporation that owns and operates the  
Pharmacy. The Member was the Designated Manager at the Pharmacy from July 21,  
2016 to January 30, 2020. The Member resumed the role of Designated Manager on  
February 14, 2020.  
On April 19, 2017, the College received a complaint regarding the Member and the  
Pharmacy. The Complainant alleged that the Member had billed the Ontario Drug Benefit  
Program for medications that he was not prescribed and never received. The Complainant  
submitted a copy of his patient medical record from the Pharmacy and highlighted the  
medications and/or products that he did not receive.  
The College’s position is that the Member submitted false claims by billing for  
prescriptions that were not authorized by a prescriber and by billing for prescriptions that  
were never dispensed. The Member submitted approximately $38,000 in unsubstantiated  
claims to the Ontario Drug Benefit Plan with respect to the Complainant. The College  
also took the position that the Member falsified records and forged documents in  
response to the College’s investigation to try and cover up her false billings.  
The Member denied all of the allegations. The Member took the position that she  
dispensed all of the products that she billed for the Complainant. She suggested that the  
complaint was made out of revenge, after she asked the Complainant to change  
pharmacies.  
In addition to the motion brought by the College seeking a publication ban, the Member  
brought the following four motions during the course of the hearing;  
1.  
Motion heard on September 17, 2020, with written reasons dated January 7, 2022,  
[Ontario (College of Pharmacists) v. Awad, 2022 ONCPDC 1]. The Member  
requested an Order recusing the Panel Chair. The motion was dismissed;  
Awad, Amani  
Registration #210760  
Page 10 of 61  
2.  
3.  
Motion heard on September 17, 2020, with reasons delivered orally. The Member  
requested an Order for a finding of contempt by a witness, [Physician A], for  
breaching the Panel’s order. The motion was dismissed;  
Motion heard on December 15, 2020, with reasons delivered orally and in writing.  
(See Appendix A) The Member requested an Order adjourning the hearing until  
the Complainant attended the hearing, so that Member’s counsel could continue  
his cross-examination of the Complainant. In the alternative, the Member  
requested that the Complainant be provided with a laptop at his home to continue  
giving his evidence. The motion was dismissed.  
4.  
Motion heard on April 20, 2021, with written reasons dated September 17, 2021,  
[Ontario (College of Pharmacists) v. Awad, 2021 ONCPDC 35]. The Member  
requested an Order, among other things, for a stay of the proceedings for abuse of  
process, and the disqualification of College Counsel and Independent Legal  
Counsel. The Motion was dismissed in part.  
V. The Issues  
The Panel identified the following issues to be considered in relation to the allegations:  
Did the Member engage in professional misconduct by:  
1. Submitting an account or charge for services or products that she knew and/or  
ought to have known was false or misleading;  
2. Falsifying a record relating to her practice and/or a person’s health record;  
3. Failing to keep records as required respecting her patients and/or practice;  
4. Failing to maintain the standards of practice of the profession;  
5. Signing or issuing, in her professional capacity, a document that she knew  
and/or ought to have know contained a false or misleading statement;  
6. Contravening the Drug and Pharmacies Act, the Ontario Drug Benefit Act, or  
regulations under those Acts;  
7. Contravening a federal, provincial or territorial law; or  
8. Engaging in conduct or performing an act relevant to the practice of pharmacy  
that, having regard to all the circumstances, would reasonably be regarded by  
members of the profession as disgraceful, dishonourable or unprofessional.  
Awad, Amani  
Registration #210760  
Page 11 of 61  
Onus and Standard of Proof  
The College bears the onus of proving the allegations against the Member, on a balance  
of probabilities, based on sufficiently clear, cogent and convincing evidence as set out in  
F. H. v. McDougall, 2008 SCC 53 at paras. 40 and 46.  
The Evidence  
The Panel is mindful that its findings are to be made exclusively on the evidence that was  
admitted at the hearing.  
Section 49 of the Health Professions Procedural Code, (“Code”), which is Schedule 2 to  
the Regulated Health Professions Act, 1991, (“RHPA”), provides that, “Despite  
the Statutory Powers Procedure Act, nothing is admissible at a hearing that would be  
inadmissible in a court in a civil action and the findings of a panel shall be based  
exclusively on evidence admitted before it.”  
Assessing Credibility and Reliability  
In making its findings, the Panel assessed the credibility and reliability of the evidence  
and assigned weight to that evidence. The Ontario Divisional Court, in R. v. H.C., 2009  
ONCA 56 provided guidance in addressing the distinction between credibility and  
reliability when dealing with testimonial evidence. As the Court stated at para. 41:  
Credibility and reliability are different. Credibility has to do with a witness’s  
veracity, reliability with the accuracy of the witness’s testimony. Accuracy  
engages consideration of the witness’s ability to accurately  
i.  
observe;  
recall; and  
recount  
ii.  
iii.  
events in issue. Any witness whose evidence on an issue is not credible cannot  
give reliable evidence on the same point. Credibility, on the other hand, is not  
a proxy for reliability: a credible witness may give unreliable evidence: R. v.  
Morrissey (1995), 22 O.R. (3d) 514, at 526 (C.A.).  
The Panel is mindful that it must assign weight to a witness’ evidence, in part or in full,  
and that it may accept some, all, or none of a witness’ evidence.  
The Panel took guidance from the decision in, Re Pitts and Director of Family Benefits  
Branch of the Ministry of Community & Social Services, [1985] OJ No 2578 with respect  
to factors to consider when assessing credibility and reliability.  
Awad, Amani  
Registration #210760  
Page 12 of 61  
VI. Decision and Reasons on Findings  
Having considered the evidence, the onus and standard of proof, the Panel finds that the  
Member committed professional misconduct as set out in the allegations in paragraphs 1  
to 8 of the Notice of Hearing.  
With respect to the allegations set out in paragraph 8 of the Notice of Hearing, the Panel  
finds that the Member engaged in conduct or performed acts relevant to the practice of  
pharmacy that, having regard to all the circumstances, would reasonably be regarded by  
members of the profession to be disgraceful, dishonourable, and unprofessional.  
Issue 1: Did the Member engage in professional misconduct by submitting an account  
or charge for services or products that she knew and/or ought to have known was  
false or misleading for one or more of the drugs and/or products listed in Appendix  
“A” and Appendix “B” from in or about January 2015 to in or about September  
2017?  
This issue relates to the allegations set out in paragraph 5 in the Notice of Hearing.  
The Evidence  
The Panel received evidence from witnesses and documentary evidence in the form of  
pharmacy records. These records relate to prescriptions received by the Complainant at  
the Pharmacy.  
The Complainant’s Evidence  
The Complainant, a witness called by the College, is a former patient of the Member and  
the Pharmacy. In early 2017, he requested a copy of his full patient history report from  
the Pharmacy. When he eventually received a copy of his patient history report for parts  
of 2016 and 2017, he noticed that a variety of medications were billed to the Ontario  
Drug Benefit Program that he did not receive.  
The Complainant testified to the Official Pharmacy Receipts report (Exhibit 12 pp. 203-  
214), where he identified several products and prescriptions which were billed to the  
Ontario Drug Benefit Program but were never received by him. He testified that he did  
not receive:  
i) 24 cans of Boost billed on September 19, 2016;  
ii) Abilify prescriptions billed on May 27, June 24, July 25, August 29 and  
September 26, 2016; and  
iii) Fenofibrate prescriptions billed on January 16, February 23, March 12, and April  
25, 2016.  
Awad, Amani  
Registration #210760  
Page 13 of 61  
The Complainant testified that where there was billing for 120 cans of Boost, he actually  
received only 80 cans of Ensure. The billing for 120 cans of Boost was from October  
2016 to March 2017.  
The Complainant testified that he did receive Symbicort once in 2016 from the  
Pharmacy, and BenzaClin once in 2015 and once in 2016.  
[Physician A’s] Evidence  
[Physician A], a witness called by the College, is a physician who has practiced medicine  
since 1975, and in Canada since 1986. He specializes in the area of psychiatry. [Physician  
A] testified that the Complainant is one of his patients. [Physician A] testified that he  
received a fax from the College, from [Complaints Officer Y], asking him to verify  
certain prescriptions that were attributed to him.  
[Physician A] testified that he did not authorize several prescriptions for the Complainant  
attributed to him; for instance, prescriptions for Abilify and Symbicort. He testified that  
several of his prescriptions that were provided by the Member to the College had been  
altered.  
[Physician A], testified that he stopped prescribing Abilify for the Complainant in  
October 2015, and then resumed prescribing it for the Complainant on August 9, 2017.  
[Physician B’s] Evidence  
[Physician B], a witness called by the College, is a physician who has been a licensed  
doctor for approximately 15 years. He practices in the area of family medicine.  
[Physician B] testified that the Complainant is one of his patients, and he testified that he  
received a fax from the College, from [Complaints Officer Y], asking him to verify  
certain prescriptions that were attributed to him.  
[Physician B] testified that he did not authorize several prescriptions for the Complainant  
attributed to him. These prescriptions included prescriptions for Symbicort dated April  
20, October 26, 2015 and May 2016; Fenofibrate on March 20, and November 27, 2015;  
and Lipidil on November 27, 2015.  
In addition, [Physician B] testified that he did not provide the authorizations for Boost  
products on September 9 and October 1, 2016.  
[Physician C’s] Evidence  
[Physician C], a witness called by the Member, is a family physician who has practiced  
medicine since 1992. [Physician C] testified that he has known the Member from  
between 5 to 10 years. His current practice is located [near] the Member’s Pharmacy,  
Awad, Amani  
Registration #210760  
Page 14 of 61  
[redacted]. [Physician C] testified that he had on occasion treated the Complainant, but  
has only remote memories of him, as the Complainant is not one of his regular patients.  
[Physician C] testified that on February 25, 2015, he wrote a prescription for “BenzaClin  
gel or Clindoxyl gel whichever is covered” for the Complainant. [Physician C] testified  
that he was not prescribing both products and that if the Pharmacy filled both products, it  
would be contrary to what he had prescribed.  
[Physician C] testified that BenzaClin is a benign cream with no concern for abuse or  
overuse associated with it. He testified that if he received a refill request for BenzaClin  
from a pharmacy, he assumed that the request was legitimate. He would authorize the  
refill request without seeing a need to contact the patient or the pharmacy.  
[Physician C] testified that he authorized several refill requests for BenzaClin for the  
Complainant received from the Pharmacy. He said that he has no knowledge whether the  
refills he authorized for BenzaClin were dispensed to the Complainant.  
[Complaints Officer Y’s] Evidence  
[Complaints Officer Y], a witness called by the College, was employed as a Complaints  
Officer at the College from May 2014 to July 2019. She is currently employed as a  
Community Practice Advisor at the College. In June 2017 [Complaints Officer Y] was  
assigned to investigate a complaint made by the Complainant against the Member.  
As part of the investigation into the Member, [Complaints Officer Y] requested from the  
Member, among other things, purchases and sales records for the products that the  
Complainant said that he did not receive in order to complete a purchase and sales  
analysis.  
[Complaints Officer Y] testified that the Member did not provide her with all of the  
purchases and sales records that she had requested to complete a purchase and sales  
analysis. As a result, she obtained purchase records directly from Kohl & Frisch, the  
Pharmacy’s supplier. In addition to obtaining purchase records for the products at issue,  
[Complaints Officer Y] testified that she also obtained purchase records for all Ensure  
products, since the Member had indicated to her that she billed for Boost products, but  
dispensed Ensure products.  
[Complaints Officer Y] testified that she did not contact McKesson to obtain purchase  
records because when she had requested purchase records from the Member, the Member  
had only provided her with information from Kohl & Frisch.  
After completing an initial purchase and sales analysis, [Complaints Officer Y] provided  
the Member with the purchase and sales analysis and the additional documents that she  
had obtained from Kohl & Frisch. In response, the Member provided, among other  
things, email communications between herself and [McKesson Employee], a McKesson  
representative, which set out that the Pharmacy did not have purchase records of any of  
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the products at issue during the review period with exception of Ensure products. A  
summary of the Ensure purchases was provided to the College.  
[Complaints Officer Y] testified that she updated her purchase and sales analysis to  
include the information received from the Member to create her final purchase and sales  
analysis.  
[Complaints Officer Y] testified that in conducting her final purchase and sales analysis,  
she used the information and documentation that was provided to her from Kohl &  
Frisch, information provided from the Member for her sales, and information from the  
McKesson invoices relating to Ensure products provided by the Member.  
[Complaints Officer Y] testified that the results of the final purchase and sales analysis  
revealed that the total value of the Ontario Drug Benefit Program claims submitted by the  
Pharmacy that cannot be substantiated with purchase records was $38,173.34, for the  
products analyzed during the review period. This amount does not include dispensing  
fees that the Pharmacy would have received for billing those products. [Complaints  
Officer Y] testified that she was not provided with an opening inventory balance for any  
of the products considered in the final purchase and sales analysis.  
The Member’s Evidence  
The Member registered with the College as a pharmacist on April 7, 2000. At all relevant  
times, the Member was the sole shareholder, director, Designated Manager and a  
dispensing pharmacist at the Pharmacy. The Complainant was a patient of the Member  
and the Pharmacy. The Member testified that the complaint made by the Complainant  
was made out of revenge, after she had asked the Complainant to change pharmacies.  
The Member denied that from about 2015 until March 2017, she filled more than $38,000  
worth of products that were not prescribed and not dispensed to the Complainant.  
The Member testified that the Complainant received Abilify every month during the  
relevant time period. The Member rejected [Physician A’s] evidence that he stopped  
prescribing Abilify for the Complainant, from October 2015 to August 9, 2017.  
The Member acknowledged that she billed for 120 cans of Boost 1.5 monthly from  
October 2016 to March 2017. According to the Member, the Complainant received all of  
the billed products. The Member rejected the Complainant’s evidence that he was given  
80 cans of Ensure every month, and not 120 cans.  
The Member acknowledged that even though Boost was prescribed, the Pharmacy  
sometimes dispensed Ensure products. The Member explained that because the  
Complainant had requested Ensure, Ensure was dispensed in place of Boost.  
The Member rejected the Complainant’s evidence that he was given Symbicort only once  
in 2016.  
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The Member testified that the Pharmacy ordered products from Kohl & Frisch, the main  
supplier, and from McKesson, the second supplier.  
The Member gave the following evidence regarding the McKesson purchase records:  
i) The Pharmacy did not purchase a lot of products from McKesson.  
ii) McKesson did not provide her with any purchase records, and therefore she could  
not provide the College with any records.  
iii) She did not provide all of the purchase invoices from McKesson to the College.  
She noted that whenever she found a McKesson invoice in the Pharmacy, she sent  
it to the College.  
iv) She did not contact McKesson to obtain purchase records for the products at issue  
for the relevant time period.  
v) She testified that she contacted [McKesson Employee] at McKesson requesting  
purchase records for the products at issue for the relevant time period. The  
Member testified that [McKesson Employee] informed her that the Pharmacy did  
not purchase any of the products at issue during the relevant time period with the  
exception of Ensure products. The Member testified that the information provided  
by [McKesson Employee] was incorrect and stated that she would produce  
records to support her position that McKesson was wrong.  
The Member testified that she had two different account numbers with McKesson. The  
Member did not provide [McKesson Employee] with the second account number.  
The Member acknowledged that to date, she has not provided the College with any  
documents that would substantiate any other purchases from McKesson for the products  
at issue during the relevant time period.  
During the Member’s cross-examination, College Counsel suggested to the Member that  
she did not provide any further records or another account number because she did not  
purchase any of the products at issue during the relevant period. In answer, the Member  
denied this suggestion.  
With respect to the Pharmacy’s inventory, the Member’s evidence was that the opening  
inventory balance on January 1, 2015, for the relevant products amounted to $6,224.88.  
The Member testified that she provided this figure to Paul Mandel, the forensic  
accountant she retained. The Member testified that she could not recall if she provided  
any closing inventory balances to Paul Mandel.  
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The Member gave the following evidence regarding the difference between the  
Pharmacy’s purchases and its sales for the products at issue during the relevant period.  
According to the Member’s calculations, the Pharmacy sold:  
350 more tablets of Abilify 5 mg than it had purchased;  
3315 more grams of BenzaClin than it had purchased;  
1420 more items of Ensure 1.5 Plus and Boost 1.5 Plus than it had purchased;  
1380 more grams of Clindoxyl than it had purchased;  
610 more tablets of Fenofibrate E 145mg than it had purchased; and  
214 more inhalers of Symbicort 200mcg than it had purchased.  
Paul Mandel’s Evidence  
Paul Mandel, a witness called by the Member, is a forensic accountant who is a partner at  
RSM Canada Consulting, a professional services firm specializing in accounting, tax, and  
consulting. He testified that his specific group practices in the area of business valuation,  
litigation support and forensic accounting. He holds several degrees and designations  
including a Master of Business Administration and a Chartered Accountant. He testified  
that he has been qualified as an expert witness to give evidence in court over 20 times.  
The Member sought to have Mr. Mandel provide expert evidence. The Member  
submitted that the purpose of Mr. Mandel’s evidence was to analyse the inventory details  
that were put into evidence by the College. The Member’s position was that the Panel  
needed an expert to explain accounting principles, and to explain that [Complaints  
Officer Y’s] evidence was not in accordance with any accepted norm of accounting  
valuation. The Member submitted that Mr. Mandel’s qualifications include his expertise  
as an accountant, and his expertise of business valuation and inventory.  
The College objected to Mr. Mandel being qualified as an expert with respect to anything  
dealing with pharmacy inventory calculations, analysis or management, or anything to do  
with pharmacy practice or inventory. The College did not object to Mr. Mandel being  
qualified as an expert on general accounting principles.  
The College did object to Mr. Mandel giving opinion evidence on anything to do with the  
calculation, analysis or management of pharmacy inventory.  
The College argued that Mr. Mandel has no expertise respecting pharmacy analysis,  
management or inventory. The College’s position was that Mr. Mandel testified that he  
had no expertise with respect to calculating or analysing pharmacy inventory.  
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The second basis of the College’s objection was that Mr. Mandel’s expert opinion is not  
necessary in this case. A purchase and sales analysis consists of adding up the purchases  
and sales and calculating the difference. The College’s position was that purchase and  
sales analyses have been dealt with many times before this Discipline Committee, and  
expert opinion is not necessary to assist the Panel.  
The Panel noted that in his evidence, Mr. Mandel agreed with College Counsel that he  
has no particular knowledge of the laws and regulations governing pharmacies or policies  
involving the Ontario Drug Benefit Program. He agreed with College Counsel during his  
cross-examination that he had never previously been qualified as an expert for calculating  
the inventory at a pharmacy. He also agreed with College Counsel that he had never in  
the past prepared an expert report calculating a pharmacy’s inventory for a purchase and  
sales analysis. In addition he had never given a speech or published an article about  
pharmacy inventory.  
After considering the parties’ submissions respecting qualifying Mr. Mandel as an expert  
witness, the Panel concluded that Mr. Mandel was not qualified to give expert evidence  
in the areas of pharmacy-specific inventory, pharmacy-specific management or  
pharmacy-specific purchase and sales analysis. Mr. Mandel’s Litigation Report, which  
the Member expected to rely upon as an expert report, was not admitted into evidence.  
Mr. Mandel gave the following evidence regarding general accounting principles.  
Mr. Mandel testified that, according to general accounting principles, to reconcile a  
business’ purchases and sales of a particular product, you need to look at the business’  
opening inventory and closing inventory and all sources of purchases.  
Mr. Mandel testified that if a business purchases small quantities of product on an as  
needed basis, and does not stockpile inventory, it is less likely that the business would  
have a large opening or closing inventory.  
Mr. Mandel testified that opening inventory and closing inventory numbers can offset  
each other when calculating differences in purchases and sales. For instance, if opening  
and closing inventory are identical, then those figures would cancel each other out.  
Mr. Mandel gave evidence that:  
i) The Member told him that she was unable to provide the purchases and sales  
records for the relevant time period. Mr. Mandel testified that he was not provided  
with the Pharmacy’s sales reports that the Member provided to the College.  
ii) The Member did not provide him with purchase records from McKesson. The  
Member told him that the purchase invoices from McKesson for the period under  
review are not available. However, the Member advised him that the Pharmacy  
had made purchases from McKesson.  
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iii) The Member did not provide him with the emails that she had received from  
[McKesson Employee], which made clear that the Pharmacy did not purchase the  
products under review with the exception of Ensure products.  
iv) The Member provided him with an inventory listing at January 1, 2015, but he  
does not believe an inventory count was done to support this balance. He also  
added that he was advised by the Member that she did not perform any inventory  
counts or other testing of inventory balances. The inventory balances recorded on  
the financial statements are an estimate.  
The College’s Position  
The College argued that the Member engaged in professional misconduct when she  
submitted charges for products that she knew or ought to have known were false or  
misleading by charging for products that were never dispensed. The College submitted  
that the Member billed the Ontario Drug Benefit Program for products on behalf of the  
Complainant that were never dispensed. The College submitted that the Member sold  
approximately $38,000 more of the products than she purchased, meaning she billed for  
products that were not dispensed. The College took the position that these are charges for  
products that the Member clearly knew were false or misleading.  
In support of its position, the College relied on the final purchase and sale analysis  
conducted by [Complaints Officer Y], which revealed a discrepancy of approximately  
$38,000 between the Pharmacy’s purchases and sales. The College submitted that while  
the Member claims this amount is inaccurate because [Complaints Officer Y’s] final  
purchase and sales analysis did not include an opening inventory, closing inventory, and  
McKesson purchases, the College’s position is that those arguments are without merit  
because:  
i.  
[Complaints Officer Y’s] final purchase and sales analysis included purchases  
from McKesson for Ensure products based on invoices from McKesson that were  
provided by the Member;  
ii.  
The Member provided [Complaints Officer Y] with information from McKesson  
indicating that the Pharmacy did not purchase any of the products at issue during  
the review period with the exception of Ensure products;  
iii. The Member told [Complaints Officer Y] that she did not purchase much product  
from McKesson;  
iv.  
v.  
The Member has had years to provide purchase records from McKesson, but has  
failed to do so. If other records existed, they would be before the Panel.  
The Pharmacy purchased small quantities of the products at issue on an as-needed  
basis. Given this purchasing pattern, the Pharmacy would not have a large  
opening or closing inventory of any of the products. The opening and closing  
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inventory figures would also likely be similar and would largely offset one  
another; and  
vi.  
While the opening inventory numbers the Member provided are fabricated, even  
if those figures were accepted and it was also assumed that the Member had no  
closing inventory (which is improbable), the quantity of unsubstantiated billings  
would still amount to approximately $35,000.  
The College submitted that the results of a purchase and sales analysis are sufficient to  
establish a finding of professional misconduct. The College noted that in College of  
Pharmacists v. Kothari, 2015 ONCPDC 7, the Panel found Mr. Kothari guilty of  
professional misconduct exclusively on the basis of a purchase and sales analysis, where  
Mr. Kothari did not provide any evidence to explain the discrepancy.  
The College’s position is that when a member is confronted with billing discrepancies, a  
regulated health professional is expected to justify their billing through records and  
explanations. In this case, the College has demonstrated on the evidence, that a massive  
discrepancy exists respecting products billed versus products available, and the Member  
needs to provide an explanation to reconcile her billings. If the Member cannot, then a  
finding of professional misconduct should be made.  
Lastly, the College argued that Member engaged in professional misconduct when she  
submitted charges for services that she knew or ought to have known were false or  
misleading by charging dispensing fees for medications that were never dispensed. The  
College submitted that the dispensing fee is a fee for service, for checking and dispensing  
a medication. The Member would clearly have known that these dispensing fees were  
false and misleading, since she did not dispense a drug to earn that fee.  
The Member’s Position  
The Member denied that she submitted charges for products that she knew or ought to  
have known were false or misleading. The Member denied billing more than $38,000 of  
drugs and pharmacy products that were not dispensed.  
The Member’s position is that [Complaints Officer Y’s] investigation into this matter was  
not impartial and that she failed to investigate this matter comprehensively. For example,  
the Member pointed out that, in conducting her final purchase and sales analysis,  
[Complaints Officer Y] only obtained records from one of the Pharmacy’s suppliers. The  
Member argued that while the College complained about not having the figures, the  
College has vast powers to obtain records. The Member questioned why the College did  
not use those powers to obtain all of the documents.  
The Member referred the Panel to Mr. Mandel’s Litigation Report, which sets out  
concerns regarding the methodology applied by the College with respect to the final  
purchase and sales analysis conducted. Among other things, at page 5 the Report stated  
that:  
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We have the following concerns with respect to the methodology applied by the OCP:  
i) The approach fails to consider that [the Pharmacy] likely had an opening and  
closing inventory balance of the drugs under review; and  
ii) The approach only considered purchases from one supplier, Kohl & Frisch, when  
we understand that [the Pharmacy] had a second significant supplier of drugs.  
Without considering the impact of opening and closing inventory, and additional  
suppliers of drugs, the methodology appears to be flawed as the simple purchases  
and simple sales presented would never be expected to match from an accounting  
perspective.  
At page 6, the Litigation Report concluded that:  
From an accounting point of view, if you only look at purchases from one  
supplier and do not consider the second supplier as well as the opening and  
closing inventory balances for the period under review, the methodology to  
reconcile the drug sales to drug purchases is flawed. It is improper to draw any  
negative inferences from the fact that the subject drug purchases, as presented, do  
not equal the drug sales over the Period under Review.  
The Member argued that at the very least, no one is able to calculate the Pharmacy’s  
inventory.  
The Member submitted that even on the barest balance of probabilities, the Panel just has  
the evidence of [Complaints Officer Y] and Mr. Mandel. It would be an error of mixed  
fact and law to accept [Complaints Officer Y’s] evidence.  
Analysis  
i) Methodology Applied by the College - Purchase and Sales Analysis  
The Member argued that [Complaints Officer Y] failed to investigate this matter  
comprehensively and was not impartial. The Member claimed that the purchase analysis  
performed by [Complaints Officer Y] considered purchase invoices from only one of the  
Pharmacy’s suppliers. In addition, the Member argued that the final purchase and sales  
analysis failed to consider the opening and closing balances of the drugs under review. In  
support of her position, the Member relied on the evidence of Mr. Mandel, a forensic  
accountant who was proffered as an expert witness.  
As mentioned above, the Panel found that Mr. Mandel was not qualified to give expert  
evidence in the areas of pharmacy-specific inventory, pharmacy-specific management or  
pharmacy-specific purchase and sales analysis. The Panel did however, consider his  
evidence regarding general accounting principles.  
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Registration #210760  
Page 22 of 61  
Mr. Mandel testified that, to reconcile a business’ purchases and sales of a particular  
product, one needs to look at the business’ opening inventory and closing inventory and  
all sources of purchases. The Panel accepts Mr. Mandel’s evidence on these points, as  
credible and reliable.  
The Panel will first consider the Member’s argument, that in conducting her final  
purchase and sales analysis, [Complaints Officer Y] obtained purchase records from only  
one of the Pharmacy’s suppliers.  
[Complaints Officer Y] testified that she had obtained purchase records directly from  
Kohl & Frisch, after the Member failed to provide all of the purchase records that  
[Complaints Officer Y] had requested. [Complaints Officer Y] said that she did not  
contact McKesson to obtain purchase records because when she had previously requested  
purchase records from the Member, the Member had only provided her with information  
from Kohl & Frisch.  
[Complaints Officer Y] testified that the Member provided her with information, which  
included communications with McKesson, indicating that the Pharmacy did not have  
purchase records of any of the products at issue during the review period with exception  
of Ensure products. A summary of the Ensure purchases was provided to the College.  
[Complaints Officer Y] testified that in conducting her final purchase and sales analysis,  
she used the information provided to her from Kohl & Frisch, information that was  
provided by the Member respecting the Pharmacy’s sales, and information in McKesson  
invoices relating to Ensure products provided from the Member. The Panel accepts  
[Complaints Officer Y’s] evidence on these points, as true and credible.  
The Panel finds that the Member’s position, namely that while conducting the final  
purchase and sales analysis [Complaints Officer Y] only considered purchases from one  
supplier, is without merit. The Member may be accurate in that [Complaints Officer Y]  
only obtained records from one of the Pharmacy’s suppliers. However, under the  
circumstances in this case, the Panel is satisfied that the evidence establishes that the final  
purchase and sales analysis considered the Pharmacy’s purchase records from all sources,  
contrary to the Member’s claims.  
The Member testified that the information provided by [McKesson Employee], that the  
Pharmacy did not purchase any of the products at issue for the relevant time with  
exception for Ensure products, is inaccurate. However, she has not provided any evidence  
to support these claims. The Member also testified that she would provide additional  
purchase records and prove that the information received from McKesson was wrong.  
The Member testified that she had a second McKesson account, implying that additional  
purchase records from this second account exist, and that these purchase records were not  
considered in the final purchase and sales analysis.  
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Registration #210760  
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The Member has not provided any further documents or purchase records from  
McKesson to substantiate her claims. Facing serious allegations involving submitting  
accounts for products that she knew or ought to have known were false or misleading, it  
would be critical for the Member to produce these records, yet she has failed to do so.  
The Panel agrees with the College’s position on this issue. If additional records that  
would assist the Member in her defense existed, the Member would have produced them.  
The Panel is also troubled by the inconsistencies in the Member’s evidence regarding  
obtaining purchase records from McKesson. First, the Member testified that McKesson  
could not provide her with any purchase records, therefore she could not provide the  
College with any purchase records. Also, she testified that she did not contact McKesson  
to obtain any purchase records. However, she later testified that she contacted [McKesson  
Employee] at McKesson, who provided her with information regarding purchases made  
by the Pharmacy. This information was later provided by the Member to the College.  
The Panel is of the view that these inconsistences are material, and as such, reduce the  
credibility and reliability of the Member’s testimony. These inconsistencies on a material  
issue, demonstrate a certain carelessness with the truth and undermine the Member’s  
credibility and reliability.  
The Member failed to provide her own forensic accountant with all of the McKesson  
purchase records relating to this matter, including the emails from [McKesson Employee]  
that confirmed that the Pharmacy did not purchase many of the products under review.  
The Panel finds it troubling that the Member did not cooperate with her own accountant,  
a witness to these proceeding, who was intended to support her position. The Panel finds  
the Member’s actions in this regard demonstrates evasive behaviour, which undermines  
the credibility and reliability of her evidence.  
For these reasons, the Panel is satisfied that in conducting the final purchase and sales  
analysis, [Complaints Officer Y] considered purchase records from all sources of  
purchases. The Member’s claim that the final purchase and sales analysis did not consider  
purchase records from all sources is unfounded.  
The Panel will now consider the Member’s position that, in conducting the final purchase  
and sales analysis, the College failed to consider that the Pharmacy had an opening and  
closing inventory balance of the drugs under review.  
[Complaints Officer Y’s] evidence was that she was not provided with any opening  
inventory balances for any of the products considered in the final purchase and sales  
analysis. The Panel accepts her evidence as credible and reliable on this point.  
The Member’s evidence regarding the opening inventory balances for the products at  
issue on January 1, 2015 amounted to $6,224.88. The Member did not provide evidence  
on any closing balances for that year. The Panel notes that the Member did not provide  
Mr. Mandel with the closing inventory balance for the year 2015.  
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Registration #210760  
Page 24 of 61  
The Panel notes that Mr. Mandel’s evidence was that he was provided with an inventory  
listing at January 1, 2015 from the Member, but he does not believe an inventory count  
was done to support this balance. He added that he was advised by the Member that she  
did not perform any inventory counts or other testing of inventory balances. The  
inventory balances recorded on the financial statements are an estimate.  
Mr. Mandel’s evidence was that if a business purchases small quantities of product on an  
as needed basis, and does not stockpile inventory, it is less likely that the business would  
have a large opening or closing inventory. He also gave evidence that opening inventory  
and closing inventory numbers can offset each other when calculating differences in  
purchases and sales; i.e., if an opening and closing inventory are identical, then those  
figures would cancel each other out. The Panel accepts Mr. Mandel’s evidence on these  
points, as credible and reliable.  
There was no evidence before the Panel that the Pharmacy purchased large quantities of  
inventory, or stockpiled inventory for the products at issue.  
The Panel agrees with the College that given the Pharmacy’s purchasing pattern, the  
Pharmacy would not have a large opening or closing inventory of any of the products at  
issue. The opening and closing inventory figures would likely be similar, largely  
offsetting one another.  
The Member’s position, that in conducting the final purchase and sales analysis, the  
College failed to consider that the Pharmacy had an opening and closing inventory  
balance of the drugs under review, is without merit.  
The Panel finds no evidence to support the Member’s claims that [Complaints Officer  
Y’s] investigation into the Member was not impartial.  
The Panel concludes that the final purchase and sales analysis conducted by [Complaints  
Officer Y] was comprehensive and accepts the results of the final purchase and sales  
analysis.  
ii) Unsubstantiated Billings  
The Panel accepts [Complaints Officer Y’s] evidence that the results of her final purchase  
and sales analysis revealed that the total value of the Ontario Drug Benefit Program  
claims submitted by the Pharmacy that cannot be substantiated with purchase records was  
$38,173.34, for the products analyzed during the review period.  
The evidence establishes that the Member’s own calculations revealed a significant  
discrepancy between the Pharmacy’s purchases and sales for the products at issue during  
the relevant period. The Member’s evidence in this regard was corroborated by  
[Complaints Officer Y’s] calculations and the final purchase and sales analysis, which  
revealed similar discrepancies for the products at issue.  
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Registration #210760  
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The Panel accepts the evidence that the pharmacy records establish, among other things,  
that the following drugs and products were paid for by the Ontario Drug Benefit Program  
respecting the Complainant:  
i) Abilify monthly between January 2015 to March 2017, with the exception of  
October 2015 and January 2017;  
ii) 120 units of Boost 1.5 Plus monthly from October 2017 to March 2017;  
iii) Symbicort on more than one occasion each year in 2015 and 2016; and  
iv) BenzaClin on more than one occasion each year in 2015 and 2016.  
The Panel accepts the Complainant’s evidence that he did not receive among other things,  
Abilify prescriptions billed on May 27, June 24, July 25, August 29 and September 26,  
2016. The Panel finds the Complainant’s evidence to be credible and reliable on these  
points.  
[Physician A’s] evidence, that he stopped prescribing Abilify for the Complainant in  
October 2015, and resumed on August 9, 2017, was credible and reliable. [Physician A]  
testified that he keeps records of all prescriptions he gives to patients. The Panel is of the  
view that [Physician A] has direct knowledge respecting his prescribing of Abilify for the  
Complainant. [Physician A’s] evidence is supported by the Complainant who said that he  
had not received Abilify on several occasion in 2016 and [Complaints Officer Y’s] final  
purchase and sales analysis which found that the Pharmacy had sold more Abilify than it  
purchased.  
The Panel accepts the Complainant’s evidence that he did not receive 120 cans of Boost  
1.5 monthly, but instead he received 80 cans of Ensure. The Panel also accepts the  
Complainant’s evidence that he did not receive Fenofibrate prescriptions billed on  
January 16, February 23, March 12, and April 25, 2016. The Panel found the  
Complainant’s evidence to be credible and reliable on these points.  
The Panel accepts [Physician B’s] evidence that he did not authorize several prescriptions  
that the Member attributed to him. These include prescriptions for Fenofibrate, Symbicort  
and Boost. The Panel found [Physician B’s] evidence to be truthful and reliable.  
[Physician B’s] evidence is supported by the Complainant who testified that he did not  
receive several prescriptions for Fenofibrate, Symbicort and Boost during the relevant  
time period. Also, [Physician B’s] evidence is supported by [Complaints Officer Y’s]  
final purchase and sales analysis which concluded that the Pharmacy sold more  
Fenofibrate, Symbicort and Boost than it purchased.  
The Panel accepts [Physician C’s] evidence that he authorized several refill requests for  
BenzaClin for the Complainant made by the Pharmacy. He assumed that such requests  
were legitimate and authorized the request for refills without contacting the Pharmacy.  
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He also had no knowledge as to whether the refills authorized for BenzaClin were  
dispensed to the Complainant. The Panel finds [Physician C’s] evidence to be credible  
and reliable.  
The Panel accepts the Complainant’s evidence, that he received BenzaClin from the  
Pharmacy once in 2015, and once in 2016. The Complainant’s evidence is supported by  
[Complaints Officer Y’s] final purchase and sales analysis which concluded that the  
Pharmacy sold more BenzaClin than it purchased.  
The Panel is satisfied that the evidence establishes that the Member submitted claims for  
prescriptions that were never dispensed to the Complainant. In addition, the Panel is  
satisfied that the evidence establishes that the Member charged dispensing fees for  
prescriptions that were never dispensed.  
Under the circumstances in this case, considering the totality of the evidence respecting  
Issue 1, the Panel is satisfied that the College has discharged its onus and proven the  
allegations set out in paragraph 5 in the Notice of Hearing on a balance of probabilities.  
Issue 2: Did the Member engage in professional misconduct by falsifying a record  
relating to her practice and/or a person’s health record?  
In this section, the Panel considers whether the Member falsified a record relating to her  
practice and/or a person’s health record. This issue relates to the allegations set out in  
paragraph 3 in the Notice of Hearing, that while she engaged in the practice of pharmacy  
as a director, shareholder, owner, designated manager, and/or dispensing pharmacist at  
the Pharmacy, she falsified a record relating to her practice and/or a person’s health  
record with respect to one or more of the drugs and/or products listed in Appendix “A”  
and Appendix “B” in the Notice of Hearing.  
The Evidence  
The Complainant’s Evidence  
Regarding his interactions with the Pharmacy staff, the Complainant testified:  
i) That the Pharmacy never had to call any doctor on his behalf to make any sort of  
confirmation or change regarding his prescriptions; and  
ii) That he never became stressed or aggressive in the Pharmacy. He denied that after  
he was told that one of his treating doctors had stopped prescribing Abilify for  
him, he became stressed and aggressive. The Complainant testified that “no one  
has ever had to call the doctor from the pharmacy's office to talk about any  
situation like this. A situation like this has never even arisen.”  
[Physician A’s] Evidence  
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Registration #210760  
Page 27 of 61  
[Physician A] testified that he keeps records for all the prescriptions that he writes for his  
patients. For verbal authorizations, which he said that he rarely gives, he documents such  
authorizations on the patient’s chart. He also keeps copies of written prescriptions in the  
patient’s chart.  
[Physician A] testified that he has not provided any verbal authorizations to the Pharmacy  
or to the Member regarding the Complainant, and he has no record of doing so.  
[Physician A] testified that his receptionist does not give verbal authorizations for  
prescriptions on his behalf. He explained that if a pharmacist calls his office seeking a  
verbal prescription, the call is transferred to him.  
[Physician A] testified that he stopped prescribing Abilify for the Complainant in October  
2015, and then restarted prescribing it on August 9, 2017.  
With respect to the prescriptions that he was asked to verify by [Complaints Officer Y],  
[Physician A] testified that the prescriptions he wrote had been altered. In particular, he  
testified about the following prescriptions.  
i) Prescription dated March 12, 2015 (Exhibit 15, p. 444)  
[Physician A] testified that he wrote a prescription on March 12, 2015 for the  
Complainant. He testified that his original prescription was altered in two ways.  
First, the date was changed from March 12, 2015 to March 12, 2016, and second,  
Symbicort had been added to the prescription. [Physician A] testified that he did not  
prescribe Symbicort in his original prescription. He also noted that it is not his  
practice to prescribe non-psychiatric medications for his patients. However, he will  
make an exception if the patient's family physician is on holidays or is sick.  
[Physician A] was asked by College Counsel, about the date change on the  
prescription (Exhibit 15, p. 445), from March 12, 2015 to March 12, 2016, and  
whether he had made that change. [Physician A] testified he had not done so.  
ii) Prescription dated October 16, 2015 (Exhibit 15, p. 446)  
[Physician A] testified that he wrote a prescription on October 16, 2015 for the  
Complainant. He testified that his original prescription had been altered in two  
ways. First, the date was changed from October 16, 2015 to May 16, 2016, and  
second, the words “Stop Abilify & Seroquel” were removed and “Rx Abilify 5mg  
Seroquel 25 mg” were inserted.  
iii) Prescription dated May 12, 2016 (Exhibit 15, p. 448)  
[Physician A] testified that he wrote a prescription dated May 12, 2016. He testified  
that his original prescription was altered by the addition of Abilify, the crossing off  
of Gabapentin, and the alteration of the Seroquel XR dose. [Physician A] testified  
that he did not provide a verbal authorization for Abilify as was indicated in the  
prescription that he received from the College for confirmation (Exhibit 15, p. 449).  
Also, he did not recall speaking to anyone at the Pharmacy about the notes made on  
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Registration #210760  
Page 28 of 61  
the prescription that the Member provided to the College: "Dr said to stop Abilify  
5mg; patient said no he can’t stop it", “Call d doctor to ok” and “1 + 6 R”.(sic)  
[Physician A] testified that he did not provide a verbal authorization for Abilify as set out  
in the Doctor Authorization Request dated December 20, 2016 (Exhibit 3, p. 436). He  
added that it is not his practise to provide a verbal order in response to fax request made  
by a pharmacy. Instead, his practice is to sign the fax request and fax it back to the  
pharmacy.  
[Physician B’s] Evidence  
[Physician B] testified that in his practise, he almost never gives verbal authorizations.  
He makes exceptions in life saving situations, or if a pharmacist contacts him regarding  
confusion over a prescription. He explained that if he were to authorize a prescription  
following a request made by a pharmacy, he would either send the authorization directly  
through the electronic medical record, or he would sign an authorization request in  
writing and fax it back to the pharmacy. [Physician B] testified that a receptionist at his  
office would not give verbal authorizations for prescriptions on his behalf.  
[Physician B] gave evidence that he did not authorize several prescriptions attributed to  
him. With respect to the prescriptions that [Physician B] was asked to verify by  
[Complaints Officer Y], [Physician B] testified that he did not provide an authorization  
for the following:  
i) Boost on the Nutritional Product Form dated September 9, 2016; a 6-month  
supply of Boost. [Physician B] added that it is not his practise to give verbal  
authorizations, and that it is not his practice to authorize a 6-month supply for  
Boost (Exhibit 5, p. 423);  
ii) Boost 1.5 Plus dated September 9, 2016; 24 cans, 2 cans daily. [Physician B]  
added that it is not his practise to give verbal authorizations (Exhibit 5, p. 424);  
iii) Boost 1.5 Plus dated October 1, 2016; “1 can QID x 6 month” (Exhibit 5, p. 425);  
iv) Symbicort on April 20, 2015, and October 26, 2015 (Exhibit 5, pp. 415 and 416);  
and  
v) Fenofibrate on March 20, 2015 and November 27, 2015 (Exhibit 5, pp. 419 and  
420).  
[Pharmacy Employee 1’s] Evidence  
[Pharmacy Employee 1], a witness called by the Member, testified that she has worked in  
the role of a pharmacy technician at the Pharmacy since [Specified Date]. In cross-  
examination, she testified that she is not registered with the College as a pharmacy  
technician.  
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Registration #210760  
Page 29 of 61  
[Pharmacy Employee 1], while testifying at the virtual hearing, was sitting at a table next  
to the Member in the same room, with no physical barriers between them. [Pharmacy  
Employee 1], being a long-time employee of the Member, and in a subordinate position  
to the Member, may have been motivated to testify in a manner favourable to the  
Member. This factor respecting motivation and this witness’ testimony is particularly  
problematic given the circumstances under which [Pharmacy Employee 1] gave her  
evidence respecting allegations of professional misconduct against her employer.  
[Pharmacy Employee 1] testified that when she receives a verbal authorization from a  
doctor’s office, she records the date on which the authorization was received. In cross-  
examination, she added that for verbal authorizations she records the date, the time, and  
the person who is calling.  
In answer to a question during her cross-examination, she acknowledged that in her role  
as a pharmacy assistant, she was not authorized to receive verbal prescriptions.  
In particular, she testified about the following prescriptions.  
i) [Physician A’s] prescription dated May 12, 2016 (Exhibit 53)  
[Pharmacy Employee 1] testified that the prescription written by [Physician A] for  
the Complainant did not contain the medication Abilify. When the Complainant  
was made aware of this, he became restless, impatient and difficult to deal with.  
According to [Pharmacy Employee 1], the Complainant stated that he “needs [his]  
Abilify…[he] cannot go without this medication”. [Pharmacy Employee 1]  
testified that she then contacted [Physician A’s]office, and after several attempts,  
she received a verbal prescription for Abilify from [Physician A’s] secretary. She  
also received a verbal prescription for Symbicort. [Pharmacy Employee 1]  
testified that after she received the verbal prescriptions, the Member then wrote  
the verbal prescription onto [Physician A’s] original prescription.  
During her cross-examination, [Pharmacy Employee 1] testified that the date that  
she received the verbal prescriptions for Abilify and Symbicort was not recorded  
on the prescription. This was because the verbal prescriptions were received on  
the same date listed on the prescription presented by the Complainant. Also,  
[Pharmacy Employee 1] testified that the Member had signed the prescription  
indicating that the Member had received the verbal prescriptions. [Pharmacy  
Employee 1] testified that the “A” next to the letters “Rx” on the prescription  
represented the Member’s signature.  
ii) [Physician B’s] Nutritional Product Form dated September 9, 2016 (Exhibit 55)  
[Pharmacy Employee 1] testified that after receiving the Nutritional Product Form  
from the Complainant, she contacted [Physician B] because he had forgotten to  
write the quantity and instructions on the Nutritional Product Form, and to obtain  
a prescription from [Physician B].  
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Registration #210760  
Page 30 of 61  
In answer to a question during her cross-examination, [Pharmacy Employee 1]  
testified that after contacting [Physician B] regarding the missing information, she  
received a verbal authorization for Ensure from [Physician B].  
Also, during her cross-examination, [Pharmacy Employee 1] acknowledged that  
although the Nutritional Product Form authorized Boost Plus products to be  
dispensed, the Pharmacy would dispense Ensure products. She testified that both  
Ensure and Boost are nutrition products, and they do the same thing.  
The Member’s Evidence  
The Member gave the following evidence regarding prescriptions involving [Physician  
B]and the nutritional products prescribed to the Complainant:  
i) The Member testified that she billed for 120 cans of Boost a month from October  
2016 to March 2017, and said that the Complainant had received that amount.  
ii) Regarding the Nutritional Product Form for Boost from [Physician B] dated  
September 9, 2016 (Exhibit 5, p. 422), the Member testified that the Pharmacy  
contacted [Physician B’s] office after receiving a Nutritional Product Form that  
was missing the quantity and directions. According to the Member, [Physician  
B’s] receptionist at the time said, “because the doctor is busy now, give him 24  
until I get back to you.” The Member testified that she then gave the Complainant  
24 units of Ensure until [Physician B’s] receptionist called back with a quantity  
for the Ensure prescription.  
iii) Regarding the verbal prescription for Boost from [Physician B] dated September  
9, 2016 (Exhibit 5, p. 424), the Member testified that this prescription represents a  
verbal authorization received from [Physician B] on September 9, 2016 for 24  
cans of Boost, with the direction of 2 cans daily. The Member testified that this  
verbal authorization was received on the same date as the Nutritional Product  
Form (Exhibit 5, p. 422).  
iv) Regarding the verbal prescription for Boost from [Physician B] dated October 1,  
2016 (Exhibit 5, p. 425), the Member, during her cross-examination, refused to  
respond to College Counsel’s suggestion that this verbal prescription was a  
forgery. She testified that the Nutritional product Form, Exhibit 5, p. 423, can  
explain everything better than” her and declined to make any further comments.  
v) The Member testified that the Complainant was given Ensure plus because he  
requested it. She acknowledged that now she knows that if the doctor writes a  
prescription for Boost, she should give Boost, and if the doctor writes a  
prescription for Ensure, she should give Ensure.  
The Member gave the following evidence regarding prescriptions involving [Physician  
A] that she provided to the College:  
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Registration #210760  
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i) Regarding [Physician A’s] prescription dated March 12, 2016 (Exhibit 15, p.  
445), the Member, during her cross-examination, initially denied that the  
prescription was altered. She later testified that if this prescription was altered, it  
was because she was “scared at the time”. She added that she “didnt mean to  
fraud”, rather, “[she] meant to have something for the patient to let him continue  
taking Abilify”. (sic)  
The Member testified that she added Symbicort after she received a verbal  
authorization.  
ii) Regarding [Physician A’s] prescription dated May 12, 2016 (Exhibit 15, p. 449),  
the Member testified that she wrote Abilify on the prescription after receiving a  
verbal authorization from the doctor. During her cross-examination, the Member  
clarified that it was her assistant who received the verbal authorization. The  
Member then noted the verbal prescription onto [Physician A’s] original  
prescription. The Member denied that this prescription had been altered.  
The Member testified that she added the notes on the prescription; “Dr said to  
stop Abilify” and “patient said no he can’t stop it”.  
In answer to College Counsel’s suggestion during her cross-examination, that the  
prescription on Exhibit 15, p. 449 did not have Abilify on it because the  
Complainant was taken off Abilify in October 2015, the Member testified that  
[Physician A] did not take the Complainant off of Abilify.  
iii) When asked by College Counsel about [Physician A’s] prescription dated May  
16, 2016 (Exhibit 15, p. 447) and whether the prescription had been altered, the  
Member denied that this prescription was altered.  
While the Member acknowledged that she billed the Ontario Drug Benefit Program for  
Abilify for the Complainant every month from 2015 to 2017, she denied that these  
billings were for prescriptions that were not authorized by [Physician A].  
The Member gave the following evidence regarding the pharmacy records that she  
provided to the College in response to [Complaints Officer Y’s] request:  
i) The Member testified that she provided [Complaints Officer Y] with all of the  
prescriptions requested, with the exception of two prescriptions; and  
ii) The Member acknowledged that in response to the College’s records request, she  
printed the prescription hardcopies directly from the computer, added her  
comments, and then provided the hardcopies to the College.  
The Member gave the following evidence regarding prescription hardcopies relating to  
prescription #0990703, dated September 19, 2016 (Exhibit 10, p.127):  
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Registration #210760  
Page 32 of 61  
i) The Member acknowledged that in one version of the prescription hardcopy,  
[Physician A’s] name was crossed off and [Physician B’s] name was inserted in  
writing. The Member stated that [Physician A’s] name was inputted by mistake.  
She later corrected the mistake by writing in [Physician B’s] name on the  
hardcopy.  
ii) The Member acknowledged that the two prescription hardcopies relate to the  
same prescription, and the two prescription hardcopies contain different markings.  
The Member acknowledged that the two prescription hardcopies contain her  
signature.  
iii) During the Member’s cross-examination, College Counsel suggested that based  
on the Complainant’s date of birth, and the date of dispensing recorded on the  
prescription hardcopies, September 19, 2016, the Complainant would have been  
48 years old on the dispensing date rather than 49 years old as recorded on the  
prescription hardcopies. In answer to College Counsel’s suggestion, the Member  
testified that the reason for this discrepancy was that the age was initially entered  
incorrectly, and then was corrected later.  
iv) In answer to College Counsel’s suggestion that both the prescription hardcopies  
are reprints and not the original hardcopy, the Member testified that she cannot  
remember.  
v) The Member denied that she printed the hardcopies and inputted the checkmarks  
after the College had requested the records.  
[Fillware Technologies Owner’s] Evidence  
[Fillware Technologies Owner], a witness called by the College, is the founder and owner  
of Fillware Technologies Inc., which operates Fillware Rx Management (“Fillware Rx”),  
a pharmacy management software. Fillware Rx is the pharmacy management software  
used by the Pharmacy.  
[Fillware Technologies Owner] gave the following evidence regarding the circumstances  
in which a hardcopy printed on the pharmacy software could contain an incorrect patient  
age. His evidence was that if the age of the patient on the prescription hardcopy is  
different than the age the patient would have been on the recorded date of dispensing, this  
could be as a result of the hardcopy being printed after the date of dispensing, or the  
patient file being modified to change the age of the patient. Where the patient’s age on  
the hardcopy is older than the patient’s age on the recorded dispensing date, it is likely  
because the hardcopy was printed after the date the medication was dispensed.  
[Complaints Officer Y’s] Evidence  
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Registration #210760  
Page 33 of 61  
As part of the College’s investigation, [Complaints Officer Y] testified that the College  
requested pharmacy records relating to the Complainant from the Member, including  
original prescriptions and computer hardcopies for a number of prescriptions that the  
Complainant had identified as not having been received by him. The College also  
requested prescription hardcopies to identify any markings that would have been on the  
hardcopy. In total, the College was seeking records relating to 43 prescriptions.  
After reviewing the Pharmacy records provided by the Member, [Complaints Officer Y]  
testified that she observed that:  
i) For 31 of the 43 prescriptions, the Complainant’s age was incorrect on the  
prescription hardcopy;  
ii) For 16 of the 43 prescriptions, the Member provided duplicate prescription  
hardcopies that contained different written markings; and  
iii) For 8 of the 43 prescriptions, the name of the prescriber on the hardcopy and/or  
authorization was incorrect. The name [Physician A] on the hardcopy and/or  
authorization was manually changed in pen to [Physician B].  
[Complaints Officer Y] testified that for all of the 43 prescriptions at issue, the  
Pharmacy’s records indicated that the prescriptions were billed to the Ontario Drug  
Benefit Program. The Member was the dispensing and counselling pharmacist for all 43  
prescriptions at issue.  
The College’s Position  
The College argued that the Member falsified records of verbal authorizations to justify  
claims that were not authorized or dispensed to the Complainant. The College relied on  
[Physician A’s] and [Physician B’s] evidence, submitting that neither of these doctors  
provided the Member with verbal authorizations to dispense certain prescriptions relating  
to the Complainant. The College argued that the records the Member provided to the  
College for the purpose of its investigation, which the Member said resulted from verbal  
authorizations from [Physician A] and [Physician B], were falsified.  
The College argued that the Member falsified written prescriptions by altering [Physician  
A’s] written prescriptions to justify her unwarranted billing of Abilify and Symbicort.  
The Member also altered a fax refill request for Symbicort from [Physician B] dated May  
2016.  
The College argued that the Member falsified prescription hardcopies. Because the  
Member did not dispense the medications she billed for, she did not print, mark, or sign  
certain hardcopies at the time that she submitted the claims. To try to cover up her false  
billings, she reprinted, signed and marked the hardcopies in response to the College’s  
investigation. According to the College, the Member reprinted, signed and marked the  
hardcopies months or years after the date the medication was purportedly dispensed,  
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Registration #210760  
Page 34 of 61  
falsely indicating that those markings were made at the time of dispensing. The Member  
took these steps without realizing that the patient’s age on the prescription hardcopy  
would change.  
The College submitted that this is why 31 of the 40 prescription hardcopies provided  
contained an incorrect age for the Complainant. The College’s position is that the  
Member falsified prescription hardcopies after the fact to make it appear that she had  
dispensed medications when she had not dispensed them.  
Lastly, the College argued that the Member falsified records by submitting claims for  
payment for medications that were never dispensed. This resulted in the creation of false  
records at the Pharmacy, including false drug usage reports and false prescription  
hardcopies.  
The Member’s Position  
The Member denied the allegations that she altered or falsified physician authorizations.  
The Member questioned the credibility of [Physician A’s] and [Physician B’s] evidence.  
The Member took the position that both doctors were covering up the fact that their  
receptionists were approving prescriptions over the telephone, and that they encouraged  
or at least condone this practice.  
Analysis  
Falsification of Verbal Authorizations  
The College took the position that the Member falsified records of verbal authorizations  
to justify claims that were not authorized. The College referred the Panel to a Nutritional  
Product Form dated September 9, 2016, which the Member testified resulted from a  
verbal authorization from [Physician B] for 6 months of Boost for the Complainant. The  
College also referred the Panel to verbal authorizations relating to prescriptions dated  
September 9, 2016 and October 1, 2016, which the Member claimed were authorized by  
way of verbal authorizations from [Physician B] for Boost for the Complainant.  
[Physician B’s] evidence was that he did not provide verbal authorization for Boost on  
the Nutritional Product Form dated September 9, 2016 (Exhibit 5, p. 423). [Physician B]  
testified that it is not his practice to give verbal prescriptions. Further, he said that he  
would not have prescribed Boost for six months. [Physician B] testified that he did not  
provide authorizations for the verbal prescriptions dated September 9, 2016 and October  
1, 2016 (Exhibit 5, pp. 424 and 425). With respect to the September 9, 2016 prescription,  
he said that he almost never gives verbal authorizations, and that he would not give a  
verbal authorization for Boost. The Panel accepts [Physician B’s] evidence on these  
points as credible and reliable.  
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Registration #210760  
Page 35 of 61  
The Panel notes that in his evidence [Physician B] testified that if he was to authorize a  
prescription request made by a pharmacy, he would sign the authorization and send it  
back to the pharmacy by fax.  
[Physician B’s] evidence was that he did not provide verbal authorizations for Symbicort  
on April 20, 2015, and October 26, 2015 (Exhibit 5, pp. 415 and 416) or for Fenofibrate  
on March 20, 2015 and November 27, 2015 (Exhibit 5, pp. 419 and 420). [Physician B’s]  
evidence was that he would prescribe a 90-day supply with 3 repeats for routine  
medications like Fenofibrate, and not a 6-month supply for the medication as it appeared  
on the March 20, 2015 prescription, which the Member testified was authorized by him  
on a verbal authorization.  
[Physician B’s] evidence is supported by the Complainant, who testified that he did not  
receive several prescriptions for Fenofibrate, Symbicort and Boost. [Physician B’s]  
evidence is also supported by [Complaints Officer Y’s] final purchase and sales analysis  
which found the Pharmacy sold more Fenofibrate, Symbicort and Boost than it had  
purchased.  
The Member testified that she had received verbal authorizations from [Physician B] for  
certain prescriptions that [Physician B] testified were not provided by him. However, the  
Panel has concerns about the credibility and reliability of the Member’s evidence on this  
issue.  
At times the Member refused to answer certain questions or was evasive in answering  
questions put to her in cross-examination on this issue. When asked by College Counsel  
about the September 9, 2016 Nutritional Product Form and authorization for the October  
1, 2016 prescription, she testified that “the nutritional form can explain everything better  
than” [her] and declined to give any further information or explanation.  
The Member’s evidence about receiving verbal authorizations from [Physician B] was  
contradicted by [Physician B]. He testified that he did not authorize Boost products for  
the Complainant on September 9, 2016 and October 1, 2016. The Member’s evidence  
was also contradicted by the Complainant, who testified that he did not receive the 24  
cans of Boost that the Member claimed had been authorized on September 9, 2016, along  
with certain other prescriptions. Under the circumstances in this case, and considering the  
totality of the evidence on this issue, the Member’s evidence concerning receiving verbal  
authorizations from [Physician B] regarding the drugs or products at issue was not  
credible.  
The Panel accepts [Physician B’s] evidence that he did not provide the verbal  
authorizations for prescriptions for the Complainant. In particular, [Physician B] did not  
provide verbal authorizations for:  
i) Boost 1.5 Plus on September 9, 2016; 24 cans, 2 cans daily, (Exhibit 5, p. 424);  
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Registration #210760  
Page 36 of 61  
ii) Boost on the Nutritional Product Form dated September 9, 2016; a 6-month  
supply, (Exhibit 5, p. 423);  
iii) Boost 1.5 Plus on October 1, 2016; “1 can QID x 6 month” (Exhibit 5, p. 425);  
iv) Symbicort on April 20, 2015, and October 26, 2015 (Exhibit 5, pp. 415 and 416);  
and  
v) Fenofibrate on March 20, 2015 and November 27, 2015 (Exhibit 5, pp. 419 and  
420).  
The Panel is satisfied that the evidence establishes, that on more than one occasion, the  
Member falsified records of verbal authorizations. The Member created false records of  
receiving verbal authorizations, falsely indicating that she had received verbal  
authorizations from [Physician B], when she had not. The Panel finds the Member’s  
conduct in this regard amounts to professional misconduct.  
There is no credible evidence to support the Member’s position that [Physician B] was  
trying to cover up for the fact that his receptionist was approving prescriptions over the  
telephone, on his behalf.  
Altering Written Prescriptions  
The College argued that the Member falsified written prescriptions to justify her  
unsubstantiated billings. The College pointed to several of [Physician A’s] prescriptions  
that were provided by the Member to the College, which the Member claimed had been  
authorized verbally by [Physician A]. The College’s position regarding these  
prescriptions is that [Physician A] did not provide verbal authorizations. Rather, the  
College submitted that the Member had altered [Physician A’s] original written  
prescriptions, to indicate that she had received a verbal prescription, when she had not.  
i) [Physician A’s] Original Prescription dated May 12, 2016  
[Physician A] testified that he wrote a prescription for the Complainant for Cymbalta,  
Gabapentin, Clonazepam, and Seroquel XR, which he dated May 12, 2016. [Physician A]  
testified that his original prescription (Exhibit 15, p. 448) was altered by the addition of  
Abilify. The Member and her pharmacy assistant, [Pharmacy Employee 1], had testified  
that [Physician A] provided a verbal authorization for the addition of Abilify on this  
prescription. The verbal authorization for the addition of Abilify to [Physician A’s]  
original prescription was recorded on the prescription shown at Exhibit 15, p. 449.  
[Physician A] was shown the prescription at Exhibit 15, p. 449. [Physician A] testified  
that he did not provide a verbal authorization for Abilify on the prescription at Exhibit 15,  
p. 449. In addition, [Physician A] testified that he did not make any of the notes that had  
been added to the prescription, nor did he speak to anyone at the Pharmacy regarding the  
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Registration #210760  
Page 37 of 61  
notes which had been added to his original prescription: "Dr said to stop Abilify 5mg;  
patient said no he can’t stop it", “Call d doctor to ok” and “1 + 6 R”.(sic)  
[Physician A] appeared truthful when he testified about these issues and the Panel accepts  
his evidence on these points as credible and reliable.  
In addition, [Physician A’s] evidence is consistent with the Complainant’s testimony who  
stated that he was not dispensed Abilify, and by [Complaints Officer Y’s] purchase and  
sales analysis which found that the Pharmacy sold more Abilify than it had purchased.  
The Member denied altering [Physician A’s] prescription (Exhibit 15, p. 449). In her  
testimony the Member acknowledged that she wrote Abilify on the prescription after her  
pharmacy assistant, [Pharmacy Employee 1], received a verbal authorization from  
[Physician A’s] office. The Member’s version of events was corroborated by [Pharmacy  
Employee 1’s] evidence, who also testified about [Physician A’s] prescription dated May  
12, 2016 (Exhibit 53).  
Regarding [Physician A’s] prescription dated May 12, 2016 (Exhibit 53), [Pharmacy  
Employee 1] testified that when she received the prescription from the Complainant, the  
prescription did not contain the medication Abilify. She testified that when the  
Complainant was made aware of this, he became restless, impatient and difficult to deal  
with. She then contacted [Physician A’s] office, and after several attempts, she testified  
that she received a verbal prescription for Abilify from [Physician A’s] secretary.  
[Pharmacy Employee 1] also said that she received a verbal authorization for a  
prescription for Symbicort.  
During her cross-examination, when asked by College Counsel where the date of the  
verbal authorization had been noted on the prescription for Abilify and Symbicort,  
[Pharmacy Employee 1] testified as follows: “the prescription had already date. It was the  
same time that prescription's been written.” (sic) When pressed further by College  
Counsel, who pointed out that the Member did not write the date on which the verbal  
prescriptions for Abilify and Symbicort were received, she answered, “It was already the  
date in the prescription was at same time the prescription had written.” (sic)  
When asked to show where the Member signed her name indicating that she had received  
the verbal prescription, [Pharmacy Employee 1] testified that the “A” next to the letters  
“Rx” on the prescription, represented the Member’s signature. When pressed further by  
College Counsel, who stated that the “A” is for Abilify, [Pharmacy Employee 1]  
answered, “No, A for last name and it’s close to the R”. (sic) [Pharmacy Employee 1]  
added, “Beside that Abilify, there is another A where it says RX. In the time of  
frustration and the way that the [Complainant] was asking, she just write A to give him  
his medication.”  
After carefully reviewing the witnesses’ testimony and documentary evidence respecting  
[Physician A’s] prescriptions dated May 12, 2016 found at Exhibit 53 and Exhibit 15, p.  
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449, the Panel does not accept that the Member’s signature, her initials or the date of a  
verbal prescription are contained on the prescriptions.  
Under the circumstances in this case, the Panel finds that [Pharmacy Employee 1’s]  
evidence was not credible. The Panel finds that she was untruthful about the Member  
having placed her signature or initials on [Physician A’s] prescription dated May 12,  
2016, after receiving verbal authorizations.  
[Pharmacy Employee 1] testified about Exhibit 53, saying that she received a verbal  
prescription for Symbicort. However, in the version of the prescription that the Member  
provided to the College, Exhibit 15, p. 449, the verbal authorization for Symbicort is  
crossed out. Also, the Panel observed that in the version of the prescription found in  
Exhibit 53, the documentation and notes are absent from this prescription, when  
compared to the prescription found in Exhibit 15, p. 449, which did contain certain  
documentation.  
The Panel is troubled by the existence of two different versions of the prescription. The  
Panel was not provided with an explanation as to why the Member provided the College  
with a different version of the prescription than that which can be found in the  
Respondent’s Book of Documents. The Panel is troubled by this observation, and is of  
the view that the existence of two different versions of [Physician A’s] original  
prescription raises issues around the credibility and reliability of the evidence given by  
the Member and [Pharmacy Employee 1].  
The Panel is satisfied that the evidence establishes that [Physician A’s] original  
prescription dated May 12, 2016 was altered by the Member. The Member attempted to  
create a false record to indicate that she had received a verbal authorization for Abilify  
from [Physician A], when she had not.  
There is no credible evidence to support the Member’s contention that [Physician A] was  
trying to cover up for the fact that his receptionist was approving prescriptions over the  
telephone, on his behalf.  
ii) [Physician A’s] Original Prescription Dated March 12, 2015  
[Physician A] testified that he wrote a prescription on March 12, 2015 for the  
Complainant. [Physician A] testified that his original prescription (Exhibit 15, p. 444)  
was altered in two ways. First, the date was changed from March 12, 2015 to March 12,  
2016, and second, Symbicort was added to his original prescription. [Physician A] was  
forthright in giving his evidence and stated that he did not provide a verbal authorization  
for Symbicort or change the date of his original prescription.  
In Exhibit 15, p. 445, the prescription provided by the Member to the College when her  
records were requested, the date of [Physician A’s] prescription had been changed from  
March 12, 2015 to March 12, 2016, and Symbicort had been added. As noted, [Physician  
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A’s] evidence was that he did not make these changes. [Physician A] also testified that it  
is not his practice to prescribe non-psychiatric medications.  
The Panel found [Physician A’s] evidence to be credible and reliable. His evidence is  
supported by the Complainant, who testified that he did not receive certain prescriptions  
of Symbicort and Abilify, and by [Complaints Officer Y’s] purchase and sales analysis  
which found that the Pharmacy sold more Abilify and Symbicort than it had purchased.  
Although the Member first denied that she altered [Physician A’s] original prescription,  
she later conceded, after further questioning by College Counsel in cross-examination,  
that if the prescription was altered, it was because she “was scared at the time,” and she  
“didn’t mean to fraud.(sic)  
The Panel is satisfied that the evidence establishes that [Physician A’s] original  
prescription dated March 12, 2015, was altered by the Member. The Panel is of the view  
that by altering the date from March 12, 2015 to March 12, 2016, the Member created a  
new authorization to justify submitting claims for Abilify in 2016.  
The Panel is satisfied that the evidence also establishes that the Member created a false  
record of receiving a verbal authorization, to falsely indicate that she had received a  
verbal authorization for Symbicort from [Physician A] when she had not.  
iii) [Physician A’s] Original Prescription Dated October 16, 2015  
[Physician A] testified that he wrote a prescription dated October 16, 2015. His evidence  
was that his original prescription (Exhibit 15, p. 446), had been altered in two ways. First,  
the date had been changed from October 16, 2015 to May 16, 2016, and second, the  
words “Stop Abilify & Seroquel” had been removed and the words, “Rx Abilify 5mg  
Seroquel 25 mg” were inserted.  
The changes made to [Physician A’s] original prescription were set out in Exhibit 15, p.  
447, the prescription that the Member provided to the College. [Physician A] also  
testified that he had stopped prescribing Abilify for the Complainant between October  
2015 and August 9, 2017.  
The Panel found [Physician A’s] evidence about his original prescription dated October  
16, 2015, to be consistent and credible. [Physician A’s] evidence is supported by  
[Complaints Officer Y’s] purchase and sales analysis which found that the Pharmacy had  
sold more Abilify than it had purchased.  
[Physician A’s] evidence was in direct contrast to the Member’s evidence. The Member  
simply denied altering the prescription and offered no further explanation or information  
about the changes that had been made to [Physician A’s] original prescription.  
The Panel is satisfied that the evidence establishes that [Physician A’s] original  
prescription dated October 16, 2015 was altered by the Member. By altering the date on  
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the prescription, from October 16, 2015 to May 16, 2016, the Member was able to create  
a new authorization to justify submitting claims for Abilify in 2016.  
Prescription Hardcopies  
The College took the position that the Member falsified various prescription hardcopies  
to try and cover up her false billings. According to the College, the Member printed,  
signed and marked prescription hardcopies in response to the College’s investigation, to  
give the impression that the products had been dispensed and the markings on the  
prescription hardcopies had been made at the time of dispensing. The College argued that  
the Member took these steps without realizing the age of the patient would change. This  
is why 31 of the 40 prescription hardcopies that the Member provided to the College  
contained an incorrect age for the Complainant.  
[Complaints Officer Y’s] evidence was that for 31 of the 43 prescriptions, the  
Complainant’s age was incorrect on the prescription hardcopy; for 16 of the 43  
prescriptions, the Member provided duplicate prescription hardcopies that contained  
different written markings; and for 8 of the 43 prescriptions, the name of the prescriber  
on the hardcopy and/or authorization was incorrect. That is, the name of [Physician A] on  
the hardcopy and/or authorization was manually changed in pen to [Physician B]. The  
Panel accepts [Complaints Officer Y’s] evidence on these points as credible and reliable.  
The Panel received evidence from the Member regarding two prescription hardcopies  
relating to prescription #0990703 dated September 19, 2016 (Exhibit 10, p.127). In her  
evidence, the Member acknowledged that the two prescription hardcopies at issue contain  
different markings and different versions of her signature. The Member also  
acknowledged that the two prescription hardcopies contained the incorrect age for the  
Complainant; 49 instead of 48. The Member’s evidence was that the incorrect age was  
initially inputted in error, and was later corrected. The Member acknowledged that the  
two prescription hardcopies contained different prescribers. Again, her evidence was that  
the incorrect prescriber was initially inputted in error, and the error was later corrected by  
adding the correct prescriber’s name by hand. The Member denied that she printed the  
hardcopies and inputted the checkmarks after the College had requested her records.  
The Panel accepts the Member’s evidence and acknowledgement that the two  
prescription hardcopies at issue contain different markings and different versions of her  
signature.  
While the Member denied that she reprinted the prescription hardcopies at issue in  
response to the College’s investigation, the Panel finds the Member’s evidence on this  
point lacked credibility.  
The Panel is troubled by inconsistencies in the Member’s testimony. First, the Member  
acknowledged that in response to the College’s investigation, she printed the prescription  
hardcopies directly from the computer, added her comments, and then provided them to  
the College. Regarding the prescription hardcopies relating to prescription #0990703, she  
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later denied that she had reprinted the hardcopies and inputted checkmarks after the  
College had requested her records.  
The Panel is of the view that these inconsistencies are material to the determination of the  
facts at issue, and reduce the credibility of the Member’s testimony. These  
inconsistencies on material points, relating to the allegation that she falsified a record  
relating to her practice, demonstrates a certain carelessness with the truth. These  
inconsistencies undermine the Member’s credibility.  
Although the Member did not testify to the prescription hardcopy on p. 312, Exhibit 18,  
the Member provided the College with a third and different version of the prescription  
hardcopy which relates to prescription #0990703. In this version, the markings and the  
Member’s signature differ from the versions on p.127, Exhibit 10. Furthermore, the  
Complainant’s age recorded on this hardcopy is 48, not 49, which accurately reflects the  
Complainant’s age at the time of dispensing. The Panel is troubled by the existence of the  
different versions of the hardcopies that relate to the same prescription, all of which were  
provided to the College.  
The existence of three different versions of hardcopies relating to prescription #0990703,  
which were then provided to the College by the Member, detracts from the Member’s  
credibility. Her explanation that the hardcopies contained the Complainant’s incorrect  
age and the incorrect prescriber’s name due to an inputting error is not plausible.  
The Panel received evidence from [Fillware Technologies Owner], who testified that  
where the age of the patient on the hardcopy is older than the age of the patient would  
have been on the recorded date of dispensing, it is likely that the hardcopy was printed  
after the date the medication was dispensed. The Panel accepts [Fillware Technologies  
Owner’s] evidence on this issue as credible.  
The Panel accepts [Fillware Technologies Owner’s] evidence as a plausible explanation  
as to why, for two of the prescription hardcopies, the age of the Complainant was older,  
at 49, than the age the Complainant would have been on the recorded date of dispensing,  
which was 48.  
The Panel is of the view that the Member could not keep track of the prescription  
hardcopies that she provided to the College. The Member provided the College with three  
different prescription hardcopies that all related to the same prescription. Each hardcopy  
contained different markings, different signatures and incorrect or different ages for the  
Complainant.  
The Panel is satisfied that the evidence establishes that the Member, on more than one  
occasion, reprinted, signed and marked prescription hardcopies after the recorded date of  
dispensing, falsely indicating that the markings and the signature on the hardcopies were  
made at the time of dispensing.  
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The Panel accepts the College’s position that the Member falsified prescription  
hardcopies. She reprinted, signed and marked up several prescription hardcopies in  
response to the College’s investigation. The Member did so without realizing that the age  
on the prescription hardcopy would change. The Panel accepts that this is the reason why  
31 of the 40 prescription hardcopies provided to the College contained an incorrect age  
for the Complainant. The Panel accepts that the Member falsified prescription hardcopies  
after the fact to make it appear that she had dispensed the medications, when she had not.  
Unsubstantiated Claims  
As noted above, the Panel has made findings that the Member submitted approximately  
$38,000 in unsubstantiated claims.  
In the result, the Panel accepts the College’s position that the Member engaged in  
professional misconduct by submitting unsubstantiated claims amounting to  
approximately $38,000 for medications that were never dispensed, resulting in the  
creation of false records at the pharmacy, including prescription hardcopies and drug  
usage reports.  
Conclusion  
The Panel accepts the College’s position that the Member engaged in professional  
misconduct by falsifying records relating to her practice and/or a person’s health record  
with respect to one or more of the drugs or products listed in Appendix “A” and  
Appendix “B” in the Notice of Hearing.  
The Panel finds that the College established, on a balance of probabilities, that the  
Member engaged in professional misconduct when she falsified a number of records  
relating to her practice and/or a person’s health record on clear, cogent and convincing  
evidence.  
Therefore, the Panel concludes that the Member committed professional misconduct as  
set out in the allegations in paragraph 3 of the Notice of Hearing.  
Issue 3: Did the Member engage in professional misconduct by failing to keep  
records as required respecting her patients and/or practice?  
In this section, the Panel considers whether the Member failed to keep records as required  
respecting her patients and/or practice. This issue relates to the allegations set out in  
paragraph 2 in the Notice of Hearing. Much of the evidence that applied to Issues 1 and  
2, and was set out in detail in those sections, also applies to Issue 3. As such, that  
evidence will not be repeated here.  
The Evidence  
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[Complaints Officer Y’s] Evidence  
[Complaints Officer Y] testified that as part of the College’s investigation into the  
Member, the College requested Pharmacy records from the Member relating to the  
Complainant, including, among other things, records, original prescriptions and computer  
hardcopies for a number of prescriptions that the Complainant said he had not received.  
After reviewing the Pharmacy records provided by the Member, [Complaints Officer  
Y’s] evidence was:  
i) For 3 of the 43 prescriptions at issue, the Member did not provide a prescription  
hardcopy; and  
ii) For 2 of the 43 prescriptions, the Member did not provide a prescription.  
The Member’s Evidence  
The Member gave the following evidence regarding the pharmacy records requested by  
the College. She testified that she did not mean to not provide the College with  
prescription hardcopies that had been requested, for example, she mentioned prescription  
#0942786 dated October 26, 2015. The Member testified that she might have forgotten to  
send certain prescription hardcopies, but this was not done on purpose. She also noted  
that there were too many hardcopies being requested by the College.  
The Member testified that she did provide the College with the physician authorizations  
for the prescriptions that were requested. She testified that she had no reason not to  
provide them to the College. She added, that if she could not find an authorization, then  
this was the reason why it was not provided to the College.  
The College’s Position  
The College submitted that the regulatory provisions pursuant to s. 156 of the Drug and  
Pharmacies Regulation Act, and s. 40 (1) under of regulations made under the Drug and  
Pharmacies Regulation Act are relevant to the Member’s failure to keep records as she  
was required to do. These provisions state:  
Drug and Pharmacies Regulation Act  
Prescription information  
156 (1) Every person who dispenses a drug pursuant to a prescription shall ensure that the  
following information is recorded on the prescription,  
(a) the name and address of the person for whom the drug is prescribed;  
(b) the name, strength (where applicable) and quantity of the prescribed drug;  
(c) the directions for use, as prescribed;  
(d) the name and address of the prescriber;  
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(e) the identity of the manufacturer of the drug dispensed;  
(f) an identification number or other designation;  
(g) the signature of the person dispensing the drug and, where different, also the  
signature of the person receiving a verbal prescription;  
(h) the date on which the drug is dispensed;  
(i) the price charged. R.S.O. 1990, c. H.4, s. 156 (1).  
Ontario Regulation 58/11 made under the Drug and Pharmacies Regulation Act  
40. (1) A drug shall not be dispensed in a pharmacy pursuant to a prescription unless the  
prescription has been authorized by a prescriber. O. Reg. 58/11, s. 40 (1);  
O. Reg. 301/12, s. 2 (1).  
(2) Subject to subsections (3) and (4), the authorization required by subsection (1)  
may be given verbally or by signature. O. Reg. 58/11, s. 40 (2).  
(3) A drug shall not be dispensed in a pharmacy pursuant to a prescription given  
verbally unless all of the following conditions have been met:  
1. The drug is not a narcotic drug. (This does not prevent the dispensing of a  
verbal prescription narcotic.)  
2. The verbal direction was received by a member who was practising at the  
pharmacy.  
3. The member receiving the verbal direction recorded,  
i. the date the verbal direction was received,  
ii. the number of refills authorized by the verbal direction, and  
iii. the name of the member who received the verbal direction.  
4. The prescription was recorded and signed by the member receiving the  
verbal direction.  
The College argued that the Member failed to keep records as required by the Drug and  
Pharmacies Regulation Act and the regulations made under the Drug and Pharmacies  
Regulation Act. According to the College, the Member falsified various records at the  
Pharmacy, including:  
i) Altering [Physician A’s] written prescriptions more specifically by changing the  
date and adding additional medication to try justify the overbilling;  
ii) Creating fraudulent records of verbal authorizations received from [Physician A]  
and [Physician B] when no verbal authorization was given;  
iii) Submitting claims for prescriptions that were never dispensed, creating a variety  
of false records such as prescription hardcopies and drug usage reports, which  
falsely indicated that medication had been dispensed when it was not;  
iv) Signing and marking hardcopies to indicate that a prescription was dispensed  
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when the medication was never dispensed; and  
v) Printing, signing, and marking hardcopies months or years after the date the  
medication was purportedly dispensed, and falsely indicating that those markings  
were made at the time of dispensing.  
The College argued that the Member also failed to keep records as required by failing to  
maintain certain records. According to the College, the Member was required to maintain  
records for all of the 43 prescriptions at issue, but she was unable to provide prescription  
hardcopies or physician authorizations for all 43 prescriptions when she was requested to  
do so as part of the College’s investigation.  
The College argued, further, that many of the records provided by the Member were  
inaccurate. For instance, the College pointed out that 31 of the 40 prescription hardcopies  
provided by the Member contained an incorrect age for the Complainant, and that 8 of the  
hardcopies/authorizations provided contained an incorrect physician name.  
The College also argued that the Member’s records of the purported verbal authorizations  
were not properly documented. Even though the College took the position that the  
records are falsified, the College submitted that virtually none of the verbal authorization  
records provided to the College investigator contained the Member’s name or her  
signature, in contravention of s. 40 (1) of Ontario Regulation 58/11. The College  
submitted that the regulation requires a record of a verbal authorization and must include,  
among other things, the name of the member who received the verbal authorization and  
the signature of the member who receives the verbal authorization.  
The Member’s Position  
The Member denied engaging in professional misconduct as alleged in the Notice of  
Hearing. The Member did not make any specific submissions regarding this particular  
issue.  
Analysis  
As mentioned earlier in this decision, the Panel has made findings that the Member:  
i) Altered [Physician A’s] written prescriptions;  
ii) Created fraudulent records of verbal authorizations received from [Physician A]  
and [Physician B] when no verbal authorizations were given;  
iii) Submitted claims for prescriptions that were never dispensed;  
iv) Created false records indicating that medication had been dispensed to the  
Complainant when it was not;  
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v) Printed, signed, and marked hardcopies months or years after the date of recorded  
dispensing, and falsely indicated that the signature and those markings were made  
at the time that they were to have been dispensed.  
The Panel finds that the evidence establishes that the Member failed to keep and maintain  
certain records relating to her practice as she was required to do and that should have  
been provided to the College’s investigator.  
In the result the Panel accepts the College’s position that the Member engaged in  
professional misconduct by failing to keep certain records as required.