July • August 2003 - Ontario College of Pharmacists

REPORT
CORONER’S REPORT
CORONER’S REPORT
The College regularly receives reports from the Ontario
Coroner’s Office. Following is a summary of the findings of a
recent case along with recommendations that have an impact
on pharmacists and pharmacy practice.
CASE
KIMBERLY ANN ROGERS
On August 9, 2001, Kimberly Ann
Rogers, a 40 year-old woman who was
eight months pregnant, was found
dead in the apartment in which she
was confined by terms of a sentence
imposed for welfare fraud. Ms. Rogers
had a history of depression with panic
attacks, migraines and a disabling knee
injury. As a result of her conviction, Ms
Rogers had been temporarily ineligible
for welfare benefits under the
province’s “zero-tolerance” policy.
There were many stresses in Ms
Roger’s life including financial, legal,
medical and occupational issues.
While the coroner’s jury made
several recommendations, the
following summary only lists the relevant
medical aspects of this case as
information and education for pharmacists.
A full report of the coroner’s jury
can be obtained by contacting the
Office of the Chief Coroner at 416-
326-5010.
Recommendation #5 to the
Government of Ontario—
Minister of Health and the
College of Physicians and
Surgeons
“Physicians should be educated on the
potential risks of tri-cyclic anti-depressants
in the treatment of depression, and
should be encouraged to use the safer
class of anti-depressants such as SSRI’s
as a first line drug therapy. Wherever
appropriate, physicians should
encourage patients to access supportive
counselling services in the community.”
Rationale: To encourage the use of
extreme caution in the prescribing of
medications, by encouraging the
prescribing of a less dangerous or lethal
drug.
Pharmacists should also bear this
information in mind and are encouraged
to collaborate with physicians,
patients and community services agencies
to ensure optimal drug therapy.
(The report also noted that this patient
was pregnant and therapy was chosen
with that consideration in mind.) Each
refill of a prescription for antidepressants
is an opportunity for the
pharmacist to dialogue with the
patient, to monitor any changes in drug
therapy or the patient’s condition, and
to determine whether the patient is
accessing counselling services.
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Pharmacy Connection July • August 2003