An investigation into how thousands of lubricated probe covers were distributed as condoms by a sexual health organisation has found a number of failings in their procurement process.
In August, Sexual Health and Family Planning ACT (SHFPACT) issued a recall for products that were distributed as condoms to school students and at community events since January.
It turned out many of these products were not condoms but lubricated probe covers that are used during trans-vaginal ultrasounds to maintain hygiene.
The products look similar to condoms but do not offer the same level of protection against pregnancy and sexually transmitted infections.
A total of 4200 probe covers may have been distributed to the community, including to students at five public colleges and some public high school students, before the problem was identified.
An investigation by PKF Integrity Services into how the mishap occurred found the organisation did not have a formalised or documented procurement and purchasing procedure.
SHFPACT also did not have a way to verify the orders when they had been sent to the supplier or once they had been delivered.
It didn't have a central matrix or register to keep track of products in stock. This could have been used to re-order items as needed and ensure consistency in products that were purchased.
Another factor that contributed to the bungle was that the probe covers were listed under the category of condoms on the supplier's website.
"The probe covers were accepted by SHFPACT as being condoms upon delivery and no additional validation or verification was undertaken to ensure that the product was appropriate for the intended purpose," the investigators found.
"Regular inventory counts or stocktakes for items that were not sold (condoms) to the public by SHFPACT were not undertaken. Stocktake control measures may have identified probe covers were added to the condom inventory."
PKF made some recommendations to improve the organisation's procurement and inventory controls.
It said there should be an ordering catalogue or central matrix to keep track of products using their product number.
Staff should only order products using their number rather than having to search for key words such as "condoms", "lube" and "needles".
The orders for high-risk items that would be given out to the public should be checked and approved by the chief executive or her delegate.
"Implementing a comprehensive ordering catalogue will standardise item selection and mitigate the risk of errors," PKF said.
"Further, regular stocktakes of particular items, such as condoms, will enhance inventory accuracy and act as a safeguard against future discrepancies."
Staff should also get training on procurement and there should be a specific person to oversee the procurement part of the organisation.
SHFPACT chief executive Tracey Hall said they were committed to implementing these recommendations and had formed a working group to start improving their procurement process.
"We remain committed to providing sexual and reproductive health education and clinical services to the Canberra community, and these enhanced processes will support our ability to continue to distribute condoms to prevent sexually transmissible infections and as a contraceptive method to prevent pregnancy as part of our approach," Ms Hall said.
Ms Hall apologised deeply to the community when the recall was issued in August.
Students were warned not to use the "condoms" they had received as part of a sexual health program and to seek medical advice if they had already used the products.
