Edmonton pharmacist suspended for deliberately giving wrong drug to patient

Shivangi Patel had only been a licensed Alberta pharmacist for 43 days when she deliberately gave a customer the wrong drug. Now she has been suspended for 18 months.

Alberta College of Pharmacy calls the subterfuge ‘very serious and completely unacceptable’

Suboxone is a drug used to help people struggling with opioid addictions to taper off drug use, by curbing cravings and offsetting withdrawal symptoms. (Sally Pitt/CBC)

An Edmonton pharmacist has been suspended for 18 months and fined $10,000 for deliberately giving a customer the wrong drug.

After she is reinstated, Shivangi Patel won't be allowed to own or run a pharmacy. She must also cover the costs of the investigation and hearing, estimated to be $27,000.

On May 25, 2019, Patel had only been licensed to practice for 43 days when she worked at Saturday night shift at Namao Centre Shopper's Drug Mart.

It was almost midnight and Patel was working alone when a customer came in to get a prescribed dose of Suboxone for his opioid addiction. 

Patel had already closed the safe that held narcotics and was unable to open it.

"The patient said he didn't want to wait," the Alberta College of Pharmacy said in a 27-page decision. "Ms. Patel stated that she was getting very stressed to the point where she couldn't think." 

Patel said the customer told her he needed his medication and threatened to call the police. 

Instead of phoning the manager, Patel took some Apo-Prednisone pills into the back and crushed them. 

"Both medications are similar in colour and when crushed they are similar in appearance," the college decision said. 

A pharmacy technician counting pills to fill a prescription. (Laura Meader/CBC)

Patel gave the crushed pills to the patient. He said the powder felt different and tasted bitter. She assured him he had just taken Suboxone. 

The man left the store, but returned a few minutes later and asked to speak to someone about a suspected drug error. He talked to the front store staff and a security guard. Patel was called to the front of the store. 

Once again, she assured him that no mistake had been made.

When the pharmacy owner later asked another pharmacist to investigate, Patel lied and told him she had given the customer Suboxone. 

The investigator reviewed surveillance tape. It showed Patel unsuccessfully trying to get into the safe, then crushing up Apo-Prednisone pills and giving the powder to the customer. 

The pharmacy owner spoke to Patel by phone on May 29 and told her about the videotape evidence. At that point, Patel admitted what she had done, but asked the owner not to make a formal complaint to the college.

'She felt panicked' 

The pharmacy owner reported the incident to the college. During an interview with the college complaints director, Patel said she didn't have "bad intentions" when she gave the customer the wrong drug. 

She admitted she had never administered Suboxone before and said she had never received any information from the pharmacy about how to unlock the safe.

"Ms. Patel felt that Patient Y's behaviour was aggressive and verbally hostile towards her, and so she felt she had to take some form of action that would satisfy Patient Y and have him leave the store" the hearing tribunal wrote. 

At the January hearing, Patel's lawyer called the incident a lapse in judgment and insisted her inexperience was the reason for her actions that night. 

The complaints director said in his 12 years on the job, it was the first time he had seen a pharmacist intentionally give a patient the wrong medication.

"There is no question that this amounts to serious unprofessional conduct," the tribunal wrote. "The honest dispensing of drugs to a patient, particularly a vulnerable patient, is critical to the safety of the public. Ms. Patel, through her actions, posed a significant risk for patient safety." 

The tribunal was told the patient did not suffer any harm.

Patel was fired shortly after the incident, but continued to practice at a different pharmacy. 

The college suspended her license for 18 months and ordered her to take courses at her own expense. 

When her suspension ends, she'll have to be directly supervised for at least six months, and for five years must show any future employers the tribunal's written decision.


Janice Johnston

Court and crime reporter

Janice Johnston is an investigative journalist with CBC Edmonton who has covered Alberta courts and crime for more than three decades. She won a national Radio Television Digital News Association award in 2016 for her coverage of the trial of a 13-year-old Alberta boy who was acquitted of killing his abusive father. You can reach her at janice.johnston@cbc.ca.