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Reporting and preventing use of unlawful document - s228 MPMR

Section 228 of the Medicines and Poisons (Medicines) Regulation 2021 (MPMR) requires a person who is authorised to deal with a medicine to give notice to the chief executive in the approved form as soon as practicable if they are given a document for a diversion-risk medicine that they reasonably believe has been unlawfully obtained or made.

This form must be used by the authorised person to give notice to the chief executive.

Section 229 of the MPMR details the requirements for keeping and marking non-compliant paper prescriptions if the medicine is not dispensed.

By way of note, if a supplier becomes aware of an incident after providing a diversion-risk medicine, they must complete the Reporting supply on false prescriptions or purchase orders for diversion-risk medicine pursuant to section 230 of the MPMR.

An "incident" means any of the following:

  1. false information, material to the prescription or purchase order, was given to the person who prescribed the medicine or gave the purchase order;
  2. the prescription or purchase order was changed by a person other than—
    1. for a prescription—the prescriber of the prescription or the dispenser of the medicine for the prescription; or
    2. for a purchase order—the person who gave the purchase order;
  3. the prescription or purchase order was false in any material particular.

You may be contacted by an inspector appointed under the Medicines and Poisons Act 2019 or an authorised delegate of the chief executive to require further information and/or for auditing/inspection purposes relevant to this notice.

If, at this stage, you are not able to provide all the information in this notice, under section 228 of the MPMR you must give as much information as possible and you can provide any additional information or a follow-up notice at a later date.

Contact information

This notice is managed by Medicines Compliance.
Should you require assistance in completing this form, please email MedicinesCompliance@health.qld.gov.au

Privacy notice

Personal information collected by Queensland Health is handled in accordance with the Information Privacy Act 2009. Queensland Health is collecting your personal information on this approved form under authority of section 228 of the MPMR. All personal information will be securely stored and only accessible by Queensland Health staff. Your personal information will not be disclosed to other third parties without consent, unless the disclosure is authorised or required by under law. Failure to provide information may render the form incomplete, which may constitute an offence under the Medicines and Poisons Act 2019. For information about how Queensland Health protects your personal information, or to learn about your right to access your own personal information, please see our website at http://www.health.qld.gov.au/global/privacy

Required fields are marked with an asterisk (*).
Please indicate if this is the initial notice or follow-up notice *
Please email additional information to MedicinesCompliance@health.qld.gov.au and include the initial notice Submission ID in the email title.
Was the diversion-risk medicine dispensed/supplied? *
Do not complete this notice. Complete the Reporting supply on false prescription or purchase order for diversion-risk medicines pursuant to section 230 of the MPMR.
Please provide details of authorised person giving the notice
Business / organisation details of authorised person giving the notice
e.g. substance authority number (Queensland licensees), licence or authority number (interstate licensees and Commonwealth licensees) or a pharmacy business number
Is the contact number different to the one you provided earlier? *
Is the email address different to the one you provided earlier? *
What type of unlawful document is this notice for? *
Please include details of the diversion-risk medicine/s that were on the purchase order?

Note: Schedule 2, Part 3 of the MPMR provides a list of diversion-risk medicines

Information: Diversion-risk medicine/s should be listed using only the terms used in the Australian Standard of Uniform Scheduling of Medicines and Poisons (SUSMP/Poisons Standard). These terms do not include brand names of products, they only refer to active ingredients. If a substance is not listed in the SUSMP/Poisons Standard but is a derivative of one that is listed in the SUSMP, then select the substance that is listed.

Diversion-risk Medicine
Unit description
Strength
Strength unit
Total number of units

I am giving notice under section 228 of the MPMR that I reasonably believe that
If a purchase order has been unlawfully obtained
A purchase order has been unlawfully made
If reasonably believe the entire purchase order was fraudulent
If reasonably believe a genuine purchase order was altered
Can you provide a copy of the purchase order?
Was the person presenting the purchase order, the person for whom the purchase order was written?
Can you provide the name and physical address details of the person who gave the purchase order?
Section 228(2)(a) of the MPMR states that you must record the name and physical address of the person who gave the document. You are required to comply with this section only to the extent that it is safe for you to comply.
Please provide details of the purchaser or buyer?
How was the unlawful document discovered?
Please include details of the diversion-risk medicine/s that were on the prescription?

Note: Schedule 2, Part 3 of the MPMR provides a list of diversion-risk medicines

Information: Diversion-risk medicine/s should be listed using only the terms used in the Australian Standard of Uniform Scheduling of Medicines and Poisons (SUSMP/Poisons Standard). These terms do not include brand names of products, they only refer to active ingredients. If a substance is not listed in the SUSMP/Poisons Standard but is a derivative of one that is listed in the SUSMP, then select the substance that is listed.

Diversion-risk Medicine
Unit description
Strength
Strength unit
Total number of units

I am giving notice under section 228 of the MPMR that I reasonably believe that
If a prescription has been unlawfully obtained
If a prescription has been unlawfully made
If reasonably believe the entire prescription was fraudulent
If reasonably believe a genuine prescription was altered
Can you provide a copy of the prescription?
Was the person presenting the prescription, the person for whom the prescription was written?
Can you provide the name and physical address details of the person who gave the prescription?
Section 228(2)(a) of the MPMR states that you must record the name and physical address of the person who gave the document. You are required to comply with this section only to the extent that it is safe for you to comply.
Please provide details of the prescriber?
How was the unlawful document discovered?
Has this incident been reported to the Queensland Police Service (QPS)? *
Do you have a QPS reference number for the report made?
Is there any evidence available to confirm that the document has been unlawfully obtained or made?
If yes, please ensure a copy of all supporting evidence is saved and available upon request if required
Is there any further information that you are able to provide that may be relevant to this notice?
Certification *
MPMR-228, Version 1

Last updated: 20 October 2021