Can a Clinical Pharmacist Be Debarred for Fabricating Therapeutic Drug Monitoring (TDM) Serum Concentration Logs?

A university or teaching hospital clinical training board will summarily expel an undergraduate Doctor of Pharmacy (Pharm.D.) student or rusticate an intern clinical pharmacist, cancel all clinical pharmacokinetics credits, and report the practitioner to the Pharmacy Council of Nigeria (PCN) for permanent professional debarment and strike-off from the register of pharmacists for fabricating Therapeutic Drug Monitoring (TDM) patient serum drug concentration logs, falsifying pharmacokinetic clearance and elimination half-life ($t_{1/2}$) calculations for narrow therapeutic index drugs (such as aminoglycosides, vancomycin, digoxin, or phenytoin), or forging clinical pharmacokinetics consultant attestation signatures. In accredited clinical pharmacy curricula, therapeutic drug monitoring represents a life-critical clinical competency; fabricating serum concentration measurements subverts patient dosage individualization, risks catastrophic patient drug toxicity (such as nephrotoxicity, ototoxicity, or fatal cardiac arrhythmias), conceals sub-therapeutic failure, and constitutes criminal forgery and gross clinical malpractice.

Clinical pharmacy examination boards and teaching hospital pharmacokinetics consultants enforce strict electronic laboratory audits to detect fabricated therapeutic drug monitoring submissions.

1. The clinical pharmacokinetics coordinator audits submitted TDM case portfolio dockets and detects identical steady-state peak and trough concentrations that contradict the patient’s recorded renal clearance (estimated GFR).
2. The chief hospital laboratory technologist cross-references cited patient hospital numbers and blood sampling timestamps against the central clinical chemistry laboratory analyzer electronic database.
3. The audit reveals that no blood serum samples were analyzed under the cited patient accession numbers, or that no fluorescence polarization immunoassay (FPIA) or HPLC runs were performed at the recorded timestamps.
4. The supervising clinical pharmacy consultant whose signature appears on the dosing consultation sheet inspects the document and formally submits a written affidavit attesting to signature forgery.
5. The College of Health Sciences issues an immediate suspension from clinical hospital wards and compiles a formal Clinical Malpractice Docket.
6. The Provost transmits the investigation dossier to the University Central Student Disciplinary Committee (SDC).
7. The student or intern appears before the disciplinary panel to defend their clinical submissions in accordance with constitutional fair hearing.
8. The University Senate ratifies an order of summary expulsion, and the PCN Disciplinary Tribunal is formally notified to revoke provisional registration and bar the practitioner from pharmacy practice nationwide.

Acquiring hands-on competency in therapeutic drug monitoring is essential for clinical pharmacists who will optimize individual dosage regimens and prevent toxic adverse drug reactions in hospitalized patients.

• Official College of Pharmacy Clinical Pharmacokinetics and TDM Consultation Logbook.
• Certified copies of teaching hospital central clinical chemistry daily automated immunoassay analyzer logs.
• Forensic signature verification report and written disclaimers from supervising consultant clinical pharmacists.
• Original patient medication charts and raw pharmacokinetic dosing calculation worksheets impounded during the audit.

Pharmacy students must respect the sacred duty of patient care and document actual analytical measurements honestly rather than manufacturing idealized pharmacokinetic numbers.

Under PCN professional regulations and national healthcare legislation, falsifying clinical therapeutic drug monitoring records is classified as gross professional misconduct and life-endangering fraud, carrying mandatory debarment and permanent revocation of professional licensure.

Maintaining uncompromising clinical truthfulness ensures that graduating pharmacists possess the genuine technical acumen required to safeguard human lives in clinical therapy.