Charge
From 15 to 17 October 2019, the Health Practitioners Disciplinary Tribunal (the Tribunal) considered a charge laid by a Professional Conduct Committee against Dr R, medical practitioner (the Doctor).
The Charge had essentially three categories:
- First, in respect of each of two patients the Doctor was alleged to have inappropriately or excessively prescribed pethidine to those patients.
- Secondly, the Doctor failed accurately or adequately to document the prescribing of pethidine in the patient records of the two patients.
- Thirdly, the Doctor failed to maintain a Controlled Drugs Register (CDR) as required by the Misuse of Drugs Regulations 1977 in respect of the pethidine prescribed for each of the two patients and/or the correct dosage of pethidine prescribed for each patient.
Background
The Doctor defended the Charge. He said he had inherited the two patients and their management plans and gone to considerable efforts in trying to find effective alternative management plans for them both, which he eventually achieved. The disciplinary process had been a huge learning experience, He had reflected on his actions and practice and made considerable changes to his prescribing and the way in which he managed his patients.
Finding
The Tribunal found the first category of the charge was not established. The Doctor had made attempts to find alternatives and solutions for the two patients. The Tribunal commended the Doctor for finding ways in which their conditions could be addressed without the use of pethidine.
The Tribunal found the second category of the charge was established. The Doctor’s note taking for each of the patients was not up to standard. The Tribunal found the Doctor’s conduct to be negligent and it warranted disciplinary sanction.
The Tribunal found the third category of the charge was also established. It amounted to negligence, both in terms of the failure to complete all required details in the CDR and failure to record the correct dosage of pethidine prescribed for the two patients in the CDR and in the patients’ notes. The Tribunal found that this failure warranted disciplinary sanction.
Penalty
The Tribunal:
- censured the Doctor;
- fined the Doctor $2,000;
- ordered the Doctor pay 30% of the costs which amounted to $22,110; and
- directed publication of the decision.
No conditions were imposed but the Tribunal strongly recommended the Doctor work towards vocational registration as a general practitioner and consider undertaking the General Practitioner Vocational Training Programme.
Other Orders
The Tribunal ordered permanent suppression of:
- names and identifying details of the two patients referred to in the charge;
- names and identifying details of the Doctor and his wife; and
- the name of the Doctor’s practice.