Two pharmacists faced claims at a fitness-to-practise inquiry relating to the supply of a double dose of a powerful drug to a young man who was a minor at the time.
Ana Eusebio and Patrick Staunton of Staunton’s Pharmacy Ltd, Link Pharmacy, on Hopkins Road, Castlebar, were the subject of the inquiry, which took place on Friday at the Pharmaceutical Society of Ireland’s headquarters in Dublin 2.
Ms Eusebio and Mr Staunton both face allegations of professional misconduct and poor professional performance.
Supervising pharmacist Ms Eusebio is accused of supplying twice the prescribed dose of Enbrel to the young man, referred to as Patient A, for a total of 12 times between 2011 and 2012.
Enbrel is a medication used to treat patients suffering from rheumatoid arthritis and other chronic autoimmune conditions, and is often taken in the form of an injection. It is managed on a patient-specific basis, and requires a high level of supervision, as it has a number of serious potential side effects.
Enbrel can leave patients at risk of serious infection and, in some cases, can also increase the risk of certain types of cancer.
Ms Eusebio supplied him with directions for 50mg of Enbrel to be taken twice weekly, when the prescriptions, from October 2011 and March 2012, were for a maximum of 25mg to be taken twice a week. Ms Eusebio is also accused of failing to take adequate steps after discovering the error on September 17, 2012.
She has admitted to the facts of these allegations, and that they amount to poor professional performance.
The accusations against superintendent pharmacist Patrick Staunton include failing to take adequate steps to ensure the health and wellbeing of Patient A after he found out about the matter on November 21, 2012.
Maria Dillon, legal representative for the pharmacists, fully defended Mr Staunton, saying that nothing in his actions could be considered grounds for poor professional performance, and that no evidence was given that proved professional misconduct.
During his evidence, Mr Staunton said he qualified as a pharmacist in 1982, and is now the superintendent pharmacist for his family pharmacies in Castlebar.
He said the parents of Patient A informed him of the supply error by a letter dated November 21, 2012, approximately nine weeks after the last supply error occurred.
“That sent alarm bells and shockwaves around the pharmacy,” said Mr Staunton.
He spoke with Ms Eusebio, and with Pfizer, which manufactures Enbrel. Mr Staunton then wrote a letter to the parents of Patient A, who is no longer a minor.
He added that while he had no further contact with the family, the incident concerned him greatly. “In more than 30 years, this was the first incident of this kind that had happened, and I was deeply concerned about it,” he said.
Mr Staunton insisted during cross-examination from Patrick Leonard, BL, representing the PSI, that he was ‘confident’ that Patient A’s family had spoken with their GP and consultant about the matter. However, he admitted that, in hindsight, he should have made further contact with the family.
Ms Eusebio chose to not give evidence to the inquiry, which first sat in November of last year. “This whole process has taken a toll on Ms Eusebio,” said Ms Dillon.
In her closing submissions, Ms Dillon said that both pharmacists are highly regarded by their colleagues, and that no evidence of harm to Patient A has been put before the inquiry.
She said that while a human error occurred, neither of the pharmacists poses a risk to patients.
Ms Dillon added that Patient A and his parents have initiated proceedings in the High Court.
She also noted that a separate case, which was heard before a PSI inquiry on November 24, 2016, also involved the drug Enbrel.
After evidence concluded, the chairman of the inquiry, in a somewhat unusual move, announced that findings in relation to the two pharmacists would not be announced on Friday but instead be submitted to the PSI council in written form at a future date.