Case Study 2: A Part 2 Poison Sold by an Unlisted Assistant
On a weekday lunchtime, the registered pharmacist at a community pharmacy in Sha Tin goes to the bank, leaving a 19-year-old pharmacy assistant alone for 25 minutes. The assistant has worked there for 8 months but is not on the List of Listed Sellers of Poisons. A 16-year-old student asks for a 120 mL bottle of a liquid cough preparation labelled 'P2' and containing a Part 2 poison. The label says 'Sold only by a listed seller or registered pharmacist'. The student has a dry cough and no other symptoms. The assistant knows the student's mother and wants to help. The pharmacy's certificate of registration is displayed. The assistant rings the pharmacist, who says 'just sell it, it's only P2'. The pharmacist is 10 minutes away. The student is waiting and has HK$50. The bottle costs HK$48.
1. Was it lawful for the assistant to sell the P2 product? What if the pharmacist had authorised it by phone?
Read the worked answer
No, the sale by this assistant would not be lawful.
- Part 2 poisons may be sold by retail by a registered pharmacist or by a listed seller of poisons from the relevant premises.
- The assistant is not a listed seller. The fact that the product is 'only P2' does not make it freely saleable by any staff member.
- A pharmacist's telephone authorisation does not cure the problem. The sale must be made by a person with the required legal status. If the pharmacist is not physically present and the assistant is not a listed seller, the assistant cannot lawfully complete the sale.
- If the assistant were a listed seller, the position could differ: a listed seller may sell Part 2 poisons without a prescription, but must still comply with labelling, premises and record requirements. The key issue here is the assistant's status, not merely the product's P2 classification.
2. What should the pharmacist do on return?
Read the worked answer
The pharmacist should first establish whether the sale has already occurred.
- If the sale has not occurred: stop it immediately, explain to the student, and either make the sale personally as the registered pharmacist or decline and advise on symptomatic care and when to see a doctor.
- If the sale has occurred: do not create a false record or backdate anything. Record what happened, who sold the product, the time, product and price, and what advice was given.
- Review staffing so that a registered pharmacist or listed seller is present whenever P2 poisons are sold. Retrain the assistant on the legal categories.
- Consider informing the pharmacy owner and seeking advice on whether the incident needs to be reported to the Pharmacy and Poisons Board. The professional duty is not to conceal a possible offence.
- Check whether the student had any contraindication or reason for referral, and document the advice given.
3. What are the key differences between Part 1 and Part 2 poisons in retail sale?
Read the worked answer
| Issue | Part 1 poison | Part 2 poison |
|---|---|---|
| Prescription | Generally requires a valid prescription from a registered medical practitioner | May be sold without a prescription |
| Seller | Registered pharmacist in a registered pharmacy | Registered pharmacist or listed seller of poisons |
| Supervision | Sale must be by the registered pharmacist | Sale may be by a listed seller; pharmacist presence is not required for every sale if the seller is properly listed |
| Records | Poisons record and prescription retention requirements apply | Records may be required, but the prescription regime does not apply in the same way |
| Labelling | Strict poison labelling and warning requirements | Strict poison labelling and warning requirements still apply |
The practical lesson is that P2 status reduces prescribing control, but it does not remove the need for an authorised seller, correct labelling and professional advice.