Med19/455P and Med19/466P – Dr T

Charge

On 2 and 3 March 2020, the Health Doctors Disciplinary Tribunal (the Tribunal) considered two separate charges laid by a Professional Conduct Committee against Dr T, medical Doctor (the Doctor).

The charges against the Doctor are summarised as:

Charge 1 alleged that the Doctor breached his conditions on scope of practice; failed to comply with imposed conditions requiring urine testing to prove abstinence from cannabis; breached a voluntary undertaking not to practice medicine until results of a urine test were consistent with remaining abstinence from cannabis; and inappropriately prescribed medications for patients when they were not intended for the patient.

Charge 2 alleged that the Doctor acted inappropriately and/or dishonestly in creating a false patient profile in the practice management system at his practice. It is alleged that the Doctor used this to submit his own urine samples to subvert the conditions imposed upon him.

A full account of the charges can be found at the end of the Tribunal’s decision.

Background: Charge 1

The Doctor is a registered medical practitioner. At all material times, he worked as a general practitioner.

In February 2015, the Doctor applied to the Medical Council of New Zealand (the Council) to renew his annual practising certificate. The Doctor disclosed that over the previous three years, he had developed a dependency on cannabis which he was using to treat a condition.

The Doctor was referred to the Health Committee of the Council.

The Health Committee determined that the Doctor should undergo random urine screening to monitor the decreasing presence of cannabinoid in his urine. On 17 May 2015, the Doctor signed an agreement, including an undertaking that he would be abstinent from cannabis and comply with a random drug testing programme.

From May 2015 to 20 July 2017 the Doctor provided multiple urine samples which tested positive for Carboxy-THC, indicating cannabis use.  This breached the undertaking the Doctor had with the Health Committee and the condition on his scope of practice which required his test results to show levels consistent with abstinence.  The Doctor also failed to provide his urine tests in accordance with the Health Committee’s protocol.

On 19 April 2017, the Doctor prescribed Fluorometholone and Chloramphenicol eyedrops in Ms R’s name intended for his own use. On 30 June 2017, the Doctor also prescribed Tenoxicam tablets in Ms R’s name.  The Doctor also prescribed hypertension medication for a patient who was not the intended recipient.

Background: Charge 2

In or around 2001, the Doctor created a patient profile in his practice management system using the pseudonym, ‘Mr Y.’ This was for use by patients who required sensitive tests and did not want this information known by hospital and laboratory staff.

The Doctor was subject to the conditions imposed on his scope of practice during 2016 and 2017 as referred to above in relation to Charge 1 above. He was expected to submit his urine tests to the Health Committee. To protect his privacy, the Health Committee assigned the Doctor the pseudonym ‘L Amant’ for testing his urine samples.

Between July and October 2017, the Doctor submitted his own urine samples for drug testing under the Mr Y profile. The results were positive for Carboxy-THC, with Carboxy THC:Creatinine ratios ranging between 4 and 26ug/mmol. These test results were not provided to the Health Committee.

On 17 November 2017, the Doctor was suspended on an interim basis, as a result of his failure to provide urine samples. He has not practised since that date.

Finding

Charge 1

The hearing proceeded on an agreed summary of facts. The Doctor admitted particulars 1,2 and 7 of charge 1.

The Tribunal found that charge 1 was established on particulars 1,2,3,7 and 8. The Doctor was found to have breached conditions on the scope of practice under the Health Practitioners Competence Assurance Act (particulars 1 and 2).

The Tribunal also established that the Doctor failed to comply with the drug testing programme (particular 3) and inappropriate prescribing in the name of an unknown overseas patient (particulars 7 and 8), established as professional misconduct under the Health Practitioners Competence Assurance Act 2003.

The Tribunal did not establish particulars 4,5 and 6 as professional misconduct.

Charge 2

The Doctor denied Charge 2 on the basis that his conduct was not for the purposes of subverting the conditions of his scope of practice. He therefore denied that the conduct amounted to professional misconduct.

Charge 2 was not established by the Tribunal as professional misconduct.

Penalty

The Tribunal:

• Censured the Doctor;
• Suspended the Doctor for a period of 2 months;
• Imposed conditions for the Doctor upon recommencing practice, that he;
• Ordered the Doctor to pay 25% of the costs which amounted to $31,528.00;

The Tribunal directed publication of its decision and a summary.

The full decision relating to this case can be found on the Tribunal website at www.hpdt.org.nz reference no: Med19/466P.