Dr Patel (the respondent) surrendered his registration with the Australian Health Practitioner Regulatory Authority (AHPRA) after he had failed to correctly and diligently diagnose and treat a patient experiencing symptoms of heart failure.

Background facts

The respondent was the subject of three complaints made to Health Care Complaints Commission (HCCC) that concerned unsatisfactory professional conduct.

Relevant circumstances

The first complaint concerned the treatment of a patient, which the respondent conceded amounted to unsatisfactory professional conduct. While waiting in the waiting room, the patient collapsed in the respondent's presence before the consultation. During the consultation, the patient reported a dizzy feeling over the previous three days and faint feeling that day. The respondent failed to ask the patient whether they had previously collapsed despite indications of a cardiovascular problem and as any competent practitioner would enquire about. The respondent also failed to take the patient's temperature, pulse rate, perform a cardiac auscultation, adequately use a stethoscope to listen to breath sounds or sufficiently investigate the patient's blood pressure.

The patient was diagnosed with a viral illness and dehydration without any sufficient clinical findings, ultimately failing to demonstrate appropriate judgement. The respondent did not give any adequate consideration to a differential diagnosis of heart failure, which the symptoms indicated.

The respondent recommended a treatment plan of Nurofen and increased fluid intake. It was said that, had the diagnosis of dehydration been correct, it would need to be significant dehydration to cause a collapse, which an increase in fluid intake would not sufficiently treat.

The respondent also spoke to the patient's father over the phone on the same day of the consultation. The father advised the respondent that the patient had vomited and was sleeping. The respondent should have realised the clinical signs that the patient was deteriorating and should have directed the patient to a hospital.

The patient is now deceased. In August 2017, the Coroner found that it is more likely than not that the patient would have survived had he been properly diagnosed and treated on the day of the consultation with the respondent.

The second complaint related to the respondent also failing to keep proper medical records for the patient in accordance with clauses 7(1) and Schedule 2(1) and (2) of the Health Practitioner Regulation (New South Wales) Regulation 2010 (repealed).

The third complaint was that the conduct alleged in first and second complaints amounted to professional misconduct. The respondent admitted to each of the three complaints and their particulars.

The respondent surrendered his registration by way of writing to the AHPRA in April 2019, with effect in May 2019. The respondent also provided a statutory declaration outlining that he has "no intention of ever re-applying for registration as a medical practitioner". Due to the respondent admitting to the subject-matter of the complaints in writing to the Tribunal, an inquiry did not need to be conducted pursuant to s165 of Health Practitioner Regulation National Law (NSW) (the National Law).

Schedule 5D of the National Law also provides that a Committee or the Tribunal may decide to not conduct an inquiry, or alternatively to terminate an inquiry or appeal if the complaint before the Committee or Tribunal is withdrawn.

HCCC wrote to the Tribunal in June 2019 requesting that the complaint be withdrawn. Although the Tribunal does not have express power to dismiss proceedings, it was understood by clause 12 of Schedule 5D and section 165H that the power is intended in specified circumstances.

The Tribunal referred to Boland ADCJ in Health Care Complaints Commission v Khan [2014] NSWCATOD 83 at [29], "The better view may be that if the HCCC and/or the parties seek a complaint should be withdrawn in the circumstances outlined in cl 12 of Schedule 5D [of the National Law], that s 55 (1)(a) should be utilised in conjunction with that clause, and as part of the Tribunal's practice and procedure powers, to dismiss the complaint. This is a practical outcome as any complaint is now filed in the Tribunal as an annexure to an application."

In conjunction with clause 12 of Schedule 5D of the National Law, the Tribunal was satisfied that section 55(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW) may be used to dismiss the complaint.

Sanction

The Tribunal was satisfied that in consideration of:

  1. the respondent's expression of deep regret;
  2. the surrendering of his registration;
  3. the sworn undertaking to never practice medicine again; and
  4. his age, being 78 years old, that the respondent no longer poses a threat to the public and protective orders would not be necessary.

The Tribunal was also satisfied that it would not be of public interest to continue the inquiry. The matter was therefore terminated pursuant to clause 12(1) of Schedule 5D of the National Law, the complaints were dismissed and there were no orders as to costs.