Script for disaster: Prescription fraud shocks
Prescription fraud that’s stunned the medical community sees 37 pharmacies under investigation after a mum-of-six claimed she was a cancer patient and photocopied her script dozens of times to feed her addiction to opioid painkillers. Tony Wall reports.
Thirty-seven pharmacists have been investigated by their regulator after dispensing a dangerous drug – in some cases multiple times – to an addict using a dodgy script.
It’s understood that regulators are stunned the woman was able to use a single prescription over and over to obtain the opioid painkiller tramadol from 21 pharmacies in Auckland and Waikato before the whistle was blown.
In most cases, the prescription wasn’t signed or dated. The revelation comes after a Stuff and Sundy Star-Times series showed rates of opioid prescribing have skyrocketed, with tramadol and codeine use rising by 277 per cent and 91 per cent respectively. The woman, Ramona Aroha Deane, 41, would take her children into pharmacies and while they ran wild around the shop, she would spin a yarn about how she was dying of cancer.
Deane said she is now clean and regrets her actions, but couldn’t believe how easily she obtained the tramadol. ‘‘They should have known – I was going there quite a bit, they should have clicked on, but they didn’t.’’
Senior pharmacists were shocked by the case. ‘‘When we heard there were 60 dispensings of a single prescription by 37 pharmacists at 21 pharmacies – and 600 tramadol obtained – I just about swallowed by tonsils,’’ one said.
‘‘It’s a bit of an indication of a systemic failure when that can happen with a single document.’’
When the Pharmacy Council, the body that regulates the industry, was notified it set up a professional conduct committee to investigate the pharmacists, council chief executive Michael Pead said.
After that process, four pharmacists were referred to the Health Practitioners Disciplinary Tribunal, Pead said.
The others were asked to undergo training and ‘‘professional development’’.
The HPDT is yet to hear the cases.
It’s understood one pharmacist dispensed on the script eight times.
Pead said no-one in the industry could remember a case of such magnitude.
‘‘It did surprise us. It’s the most significant fraudulent prescription we’ve seen in recent times. We were most definitely concerned about it.’’ The case was first reported by Pharmacy Today. According to court documents, Deane was issued a single prescription for 10 tramadol tablets and 13 tablets of the antibiotic Flagyl by Guardian Dental Care in Manukau City on March 10, 2017.
A few weeks later she rang the dentist to say she’d lost her prescription and was emailed another copy, which wasn’t signed.
Guardian dental owner Shivam Verma said he couldn’t comment on whether that was against protocol because the matter was still being investigated.
Deane made multiple copies of the prescription and between May and July of 2017 used it at various pharmacies.
According to the court documents, medicine was dispensed six times at Takanini Pharmacy, five times at Pahurehure Pharmacy and once at Papakura Pharmacy. It’s understood none of these pharmacies are before the HPDT in relation to the case.
On July 27, Deane tried to use the script at Papakura Pharmacy again but the pharmacist challenged her and she left without receiving the medicine.
Deane pleaded guilty to a charge of dishonest use of a document and was sentenced in the Tokoroa District Court to 120 hours’ community work and 12 months of supervision.
It’s unclear how health authorities and police first became aware of the issue.
Deane says she turned herself into police in Putaruru, South Waikato because she wanted to get help.
Unichem Papakura pharmacist Melanie Baker says they alerted police after Deane’s second attempt to gain the drugs.
Another source says a DHB staff member noticed unusual prescribing trends and alerted authorities.
Baker said she refused to let Deane have the drugs the second time and kept the prescription.
‘‘I stamped it and said ‘you’re not having the script back because I don’t believe you’re genuine’.
‘‘The Pharmacy Council comes down hard on pharmacists but they don’t realise this lady does a whole performance . . . she’s crying and saying she’s dying and all that.’’
A source familiar with the case says most of the
pharmacists involved said Deane was a ‘‘good actor’’ but that was no excuse as the script wasn’t signed.
One pharmacist whose staff dealt with Deane numerous times said she was convincing.
‘‘People would instantly sympathise with her because she would come in with kids, she looked very tired . . . and the kids would be running around the shop while she was telling her story of how she has cancer.’’
But Pead said part of a pharmacist’s job was to look at the legitimacy of prescriptions.
‘‘That’s what we’re concerned about – has the pharmacist done their job as expected?’’
Richard Townley, chief executive of the Pharmaceutical Society, said fake prescriptions were a growing problem.
The Deane case had come as a ‘‘bit of a surprise’’ and the society was working to improve quality standards and training.
‘‘We’re pretty concerned when these things slip through because pharmacists’ professional reputation gets called into question.’’
It’s understood that pharmacists are frustrated that GPs haven’t taken up electronic prescribing in greater numbers. Under the NZ ePrescription Service, a barcode is attached to a script meaning it can’t be used again.
While 69 per cent of pharmacies are set up to scan prescriptions, only 14 per cent of GPs are using the system.
Richard Medlicott, medical director for the Royal NZ College of General Practitioners, said doctors had been slow to take up the service because of initial concerns about cost and additional work.
The Deane case was another reason why GPs should use it, Medlicott said.
‘‘It’s pretty much foolproof – once the barcode is scanned it can’t be scanned again.
‘‘I’m really keen that the message gets out to GPs that there’s a risk of fraudulent use of your name and there are ways of avoiding that and the main one is the ePrescription service.’’
Pharmacists in Auckland also have access to a clinical information-sharing service called TestSafe but sources say some pharmacists are reluctant to use it because it’s cumbersome and ‘‘clunky’’.
‘‘There is a total disconnect between the health professions on IT,’’ a source said.
‘‘When we heard there were 60 dispensings of a single prescription by 37 pharmacists at 21 pharmacies – and 600 tramadol obtained – I just about swallowed by tonsils.’’
– Senior pharmacist