Charges
On 14-16 March and 29-31 May 2017 the Health Practitioners Disciplinary Tribunal (the Tribunal) considered 7 charges of professional misconduct laid by a Professional Conduct Committee (PCC) against Dr N, medical practitioner (the Doctor).
Charge 1
The Doctor prescribed to Mr E inappropriate and/or excessive quantities of pethidine which is a drug of addiction. The Doctor did not give sufficient consideration to reducing the pethidine prescribed to Mr E and he failed to provide sufficient medical reasons in Mr E’s notes for the quantity of pethidine prescribed. In addition he informed the pharmacy Mr E could collect repeat prescriptions for pethidine early on at least 9 occasions.
Charge 2
The Doctor wrote prescriptions for pethidine, which is a controlled drug, on incorrect forms.
Charges 3 and 4
The doctor prescribed for employees and colleagues at two different places of work.
Charge 5
The doctor prescribed medications to his wife, his mother-in-law, his son and his daughter.
Charge 6
The doctor wrote a prescription in the name of one person when he knew it was going to be given to another patient. He did not record any details of the prescribing in the notes of the patient who received the medication. He prescribed Duromine when he should have known it was contraindicated for his patient.
Charge 7
The Doctor ordered excessive quantities of Diazepam and they were ordered for the purpose of diverting and/or misusing the medication.
Finding
The Tribunal found:
- charge 1 established and warranted disciplinary sanction;
- charge 2 established on the facts and made out as a breach of appropriate regulations and statements but it was not of sufficient severity to warrant disciplinary sanction;
- charge 3 established on the facts as a breach of appropriate standards and statements but was not of sufficient severity to warrant disciplinary sanction;
- charge 4 established and was a breach of applicable standards and statements but was not of sufficient severity to warrant disciplinary sanction;
- charge 5 established. The particular of the charge concerning the Doctor’s wife was separately found to be misconduct warranting disciplinary sanction. The particulars concerning the other three members of the family, while established as a breach of appropriate standards and statements, were cumulatively but not individually of sufficient severity to warrant disciplinary sanction;
- charge 6 was found to be contrary to standards and statements but did not require disciplinary sanction; and
- charge 7 established and warranted disciplinary sanction.
The Tribunal found in respect of all charges which were not found to be of sufficient severity to warrant disciplinary sanction were found to cumulatively warrant sanction.
Penalty
The Tribunal:
- suspended the Doctor from practising medicine for six months
- censured the Doctor;
- fined the Doctor $8000.00;
- imposed eight conditions on the Doctor’s practice for a period of three years; and
- ordered the Doctor pay costs of $122,000.00 which was approximately 40% of the total costs.
The Tribunal directed publication of the decision.
Substantive Appeal: A v PCC [2018] NZHC 1623
The Doctor appealed the Tribunal's decision to the High Court. The appeal was by way of rehearing and the High Court found the following charges proven:
- Charge 1: The Court found there was a lack of care and endeavour, and professional rigour, shown by the Doctor in his treatment of Mr E. The Court was concerned the Doctor prescribed Mr E with a large and risky quantity of an addictive controlled drug. His supervision of the patient was found to be significantly deficient in many aspects;
- Charge 5: The Court found the Doctor provided improper treatment of his wife (individually proved as a charge) and other members of his family (collectively proved as meriting sanction). The Tribunal assessment was unchanged; and
- Charge 7: The Court found the facts established but sought submissions on whether it merited sanction.
All the other charges were quashed.
High Court Penalty Decision: A v PCC [2018] NZHC 2158.
The Court found the conduct established under charge 7 did not amount to malpractice or conduct likely to bring the profession into disrepute and did not merit sanction.
The Court:
- did not consider a period of suspension was necessary so the Doctor was not suspended from practice;
- upheld the Tribunal’s decisions to censure the Doctor and fine him $8000.00;
- upheld the Tribunal’s decision to impose eight conditions on the Doctor’s practice but reduced the period that they will be in place down to two years; and
- reduced the costs to be paid by the Doctor to 25%.