On 29 March 2019 the New South Wales Civil and Administrative Tribunal (the Tribunal) found that the respondent, a registered medical practitioner, was guilty of unsatisfactory professional conduct and professional misconduct.

The Tribunal cancelled the Respondent's registration as a medical professional, ordered that an application for review of the cancellation order cannot be made until after 14 November 2022 and ordered the respondent to pay $16,000 to the Health Care Complaints Commission for its costs.

Background Facts

The Health Care Complaints Commission made eight complaints related to the respondent's conduct as a medical practitioner. The conduct related to two specific patients (Patient A and Patient B) and occurred between August 2015 to September 2016. The complaints alleged the respondent engaged in the following conduct (complaints one to eight):

  1. An inappropriate friendship with each of Patient A and Patient B, each featuring explicit text messaging, offers of financial assistance and home visits outside the therapeutic relationship (unsatisfactory professional conduct).
  2. Knowingly giving false and misleading evidence to the Medical Council of New South Wales (improper and unethical conduct).
  3. Failing to perform adequate assessments, obtain adequate histories and exercise clinical judgement prior to prescribing benzodiazepines (unsatisfactory professional conduct).
  4. Failing to record relevant clinical information during consultations, contrary to the Regulations (unsatisfactory professional conduct).
  5. Breaching professional boundaries during the treatment period with Patient B, including making sexual advances and providing alcohol (unsatisfactory professional conduct).
  6. Failing to obtain the necessary authorities to prescribe Schedule 2 drugs, and prescribing schedule 2 drugs without performing the appropriate assessments (unsatisfactory professional conduct).
  7. Failing to document interactions with Patient B that occurred outside the therapeutic context in contravention of the Health Practitioner Regulation (NSW) (repealed)(unsatisfactory professional conduct).
  8. Professional misconduct, by virtue of paragraphs 1, 2, 3 and 5 above.

The Tribunal heard expert evidence from Dr Nespolon, engaged by the Health Care Complaints Commission to give an opinion as to whether the respondent engaged in unsatisfactory professional conduct.

Dr Nespolon's report made the following key observations:

  1. Each of the patients targeted by the Respondent were particularly vulnerable and experiencing mental health issues.
  2. The respondent's clinical judgement was poor and he showed little insight into the nature and seriousness of his conduct.
  3. In some instances, the respondent prescribed inappropriate quantities of particular drugs, which were requested by the patient and prescribed without appropriate regard for the patient's needs.
  4. The respondent failed to show adequate care for his patient's care, including failing to consider care plans of other practitioners and allied health professionals.
  5. In many circumstances, significant and unusual events occurred, yet the respondent failed to adequately record those events. The respondent showed little to no understanding of the obligations of a medical practitioner to take accurate patient histories and notes.

Issues

The Tribunal was required to assess each of the complaints to determine whether, in each circumstance, the respondent had engaged in unsatisfactory professional conduct, or in relation to complaint eight, professional misconduct.

Findings

In relation to each of the complaints, the Tribunal's findings were as follows:

  1. The nature of the relationship and communications between Patient A and the respondent was sexualised behaviour, as defined by the Medical Board of Australia. The communications were excessive and showed little regard for Patient A's psychological and substance abuse issues. The conduct was part of a course of conduct designed to seduce Patient A. The conduct was significant below that expected a practitioner of an equivalent level of training or experience and was unsatisfactory professional conduct.
  2. The evidence established that the respondent had knowing given false denials of the conduct described in complaint one. This was deemed to be improper and unethical conduct, and unsatisfactory professional conduct.
  3. The respondent's clinical judgement was lacking and he failed to appreciate the need for routine assessments and enquiries. These failures put the conduct as a level significantly below that expected a practitioner of an equivalent level of training or experience and amounted to unsatisfactory professional conduct. The respondent prescribed drugs to Patient A in inappropriate doses, which put his patients at risk and showed little regard for the care plans of other practitioners, which he was aware of. The respondent prescribed these drugs without the required authorities. This conduct was significantly below that expected a practitioner of an equivalent level of training or experience and was unsatisfactory professional conduct.
  4. The respondent's record keeping was so poor that it failed to meet the requirements of the Health Practitioner Regulation National Law Regulation 2010. This conduct was below that expected a practitioner of an equivalent level of training or experience and was unsatisfactory professional conduct.
  5. The respondent's relationship with Patient B contravened the Sexual Boundaries Guidelines published by the Medical Board of Australia. The conduct attracted strong criticism and was unsatisfactory professional conduct.
  6. The respondent failed to perform appropriate assessments of Patient B, which resulted in a contravention of the Poisons and Therapeutic Goods Act. This conduct was unsatisfactory professional conduct.
  7. The patient records made for Patient B were incomplete and omitted significant instances of contact. This conduct fell below that expected a practitioner of an equivalent level of training or experience and was unsatisfactory professional conduct.
  8. Together, the instances of unsatisfactory professional conduct described above amounted to professional misconduct.

Orders

The Tribunal found that the seriousness and extent of the unsatisfactory professional conduct and professional misconduct warranted an order cancelling the respondent's registration and ordering that the respondent be prohibited from applying for a review of the cancellation of his registration. The Tribunal stated the purpose of this order was protection of the public and the reputation of the medical profession.

The respondent was required to pay the Health Complaints Commission's fair and reasonable costs.