Health Practitioners Disciplinary Tribunal decisions

Dr Bainbridge – Med20/490P

Auckland psychiatrist Dr Simon Bainbridge’s registration was cancelled after he had an intimate relationship with a vulnerable patient.

Dr Bainbridge was working as a consultant psychiatrist with the Counties Manukau District Health Board when he started treating Ms E for depression in 2011. Ms E also suffered from mobility difficulties. The relationship commenced after Ms E invited Dr Bainbridge for coffee after a treatment session in 2011 and continued until 2018. The relationship only came to light when Ms E’s personal trainer saw sexually explicit images of Dr Bainbridge on Ms E’s phone. The personal trainer became concerned about the nature of the relationship and subsequently contacted the Medical Council. Dr Bainbridge denied any sexual involvement with Ms E, stating that she had developed an unhealthy infatuation with him. A three-day tribunal hearing was held in Auckland in April 2021 to determine the charge.

Findings

Having heard evidence from Ms E, her personal trainer, Dr Bainbridge, and four other witnesses, the Tribunal was satisfied that Dr Bainbridge entered into and maintained a sexual relationship with Ms E during the period of 2011 – 2018. The Tribunal did not accept Dr Bainbridge’s account that Ms E was infatuated with him, or his explanation that at one point he threatened to call the Police if she did not cease contacting him. The Tribunal noted that Dr Bainbridge was not credible and could not corroborate supposedly raising Ms E’s inappropriate advances towards him with his peer group. Ultimately, the Tribunal considered Dr Bainbridge’s actions of maintaining a relationship with Ms E was a serious breach of professional boundaries bringing discredit to the profession, and that this amounted to professional misconduct.

Penalty

In cancelling Dr Bainbridge’s registration, the Tribunal noted Dr Bainbridge’s conduct was a serious departure from expected professional and ethical standards. The Tribunal considered that Dr Bainbridge was in a position of trust, and that there was a firmly entrenched power imbalance underpinning the relationship. The Tribunal cancelled Dr Bainbridge’s registration and prohibited him from re-applying for a period of two years and eight months. It ordered that Dr Bainbridge could not re-apply for registration for at least two years and eight months, and that before he could re-apply he had to undertake a Sexual Misconduct Assessment.

The full decision can be found here .

High Court appeal [2022] NZHC 3289

Dr Bainbridge appealed the Tribunal’s findings to the High Court, saying the Tribunal erred by favouring Ms E’s evidence. Dr Bainbridge also said the Tribunal’s hearing was unfair because he represented himself as no one stressed the importance of having a lawyer. Finally, Dr Bainbridge disagreed that his registration should be cancelled.

In dismissing Dr Bainbridge’s appeal, the High Court agreed with the Tribunal’s findings. Justice Gordon agreed that cancellation was appropriate given previous authorities, the psycho-therapeutic nature of the treatment provided, and the patient’s vulnerability. Her Honour also noted Dr Bainbridge appeared to be determined to represent himself throughout the proceedings (following regular reminders that he may wish to obtain a lawyer). Her Honour emphasised that Dr Bainbridge had a lawyer but following a disagreement with his lawyer he elected to represent himself.

Dr M – Med20/482P

In a decision released on 16 December 2021, the Health Practitioners Disciplinary Tribunal found a charge of professional misconduct against Dr M established for prescribing medications in family members’ names for his own use.

Dr M had been prescribing medications including tramadol and omeprazole in family members’ names for personal use over a four-year period between 2013 and 2017. At the time, Dr M was subject to a voluntary agreement with the Medical Council’s Health Committee to abstain from taking medications not prescribed to him. Dr M also attempted to hide his self-prescribing by misleading the Medical Council, saying the drugs were for his family members after concerns were raised. Dr M had also written 147 prescriptions for his wife over a nine-year period. The prescriptions included psychotropic medications, controlled drugs, and drugs with a potential for addiction and misuse.

Findings

The Tribunal considered the particulars of the charge established, noting that each (separately and cumulatively) amounted to a serious departure from acceptable standards and professional guidelines. The Tribunal characterised Dr M’s conduct as improper and unethical, noting that his practise of prescribing drugs with a risk of addiction / misuse to his wife was haphazard and lacked any objective assessment. Ultimately, the Tribunal was satisfied that Dr M’s conduct amounted to both malpractice and negligence which brought or was likely to bring discredit to the medical profession.

Penalty

The Tribunal considered Dr M’s conduct was persistent and occurred over an extended period. It was significantly aggravating that Dr M prescribed a large quantity of prescriptions (169 in total) for a wide range of medications, including medications with a risk of abuse and dependency such as tramadol, lorazepam, and zopiclone. Dr M’s actions in misleading the Medical Council were described as dishonest.

Dr M attributed his conduct to his and his wife’s health issues, noting that his actions were not driven by any recreational or improper purposes. The Tribunal acknowledged that Dr M was remorseful and had led an exemplary career by making significant contributions to the health services in his region.

The Tribunal did not consider it necessary to cancel or suspend Dr M’s registration, as he had already ceased practising. The Tribunal ordered:

• a censure;
• a fine of $7,500;
• a contribution towards costs; and
• conditions on Dr M’s scope of practice should he choose to return.

The full decision can be accessed on the Tribunal’s website: https://www.hpdt.org.nz/Charge-Details?file=Med20/482P

High Court appeal – Admissibility of Dr M’s interview with the Professional Conduct Committee :2021: NZHC 2249

Dr M met with the Professional Conduct Committee at the conclusion of the PCC’s investigation. At the meeting Dr M made various admissions about his own conduct. The PCC later tried to rely on these admissions to prove the professional misconduct charge. At a pre-trial hearing the Tribunal ruled the PCC could not rely on Dr M’s admissions as evidence.

The PCC appealed the Tribunal’s decision to the High Court. In a decision released in August 2021, the High Court held that Dr M’s statements to the PCC during the meeting were not privileged and could be used as evidence before the Tribunal. In allowing the appeal, the High Court stated, “ the Tribunal’s interpretation would allow a practitioner to appear before the PCC and admit to misconduct in ways the PCC might not be able to prove through other evidence, which the Tribunal would be unable to consider or take into account when dealing with a charge of professional misconduct against that practitioner.”

Dr A - Med21/528P

In a decision released in June 2023, the Health Practitioners Disciplinary Tribunal cancelled a paediatrician’s registration, following two convictions for indecent assault towards female extended family members in their late teens.

The conduct took place over four months, while the two family members were living with Dr A, and he had previously been sentenced to five months’ home detention by the District Court. The Tribunal found the two convictions reflected adversely on Dr A’s fitness to practise and that Dr A’s conduct had brought and / or was likely to bring discredit to the medical profession. 

In coming to this decision, the Tribunal noted the nature and prolonged duration of Dr A’s conduct, Dr A’s scope of practice as a paediatrician and the gross breach of trust involved with the offending. Against this, the Tribunal noted Dr A’s guilty pleas, his lack of previous disciplinary history and engagement with rehabilitation. The Tribunal particularly noted Dr A “did not seem truly remorseful for his actions”. In addition, the Tribunal said it was difficult to imagine any conviction for indecent assault that did not reflect adversely on a practitioner’s fitness to practise.

The Tribunal cancelled Dr A’s registration and prohibited him from reapplying for a minimum of three years. The Tribunal also censured him and imposed conditions on his return to practice. This included that he must undertake a Sexual Misconduct Assessment test (and comply with any conditions arising), to comply with any chaperone conditions imposed, and that he must advise any future employers and supervisors of the Tribunal’s decision and its orders.

Dr Naylin (Nalendra) Appanna - Med21/518P

Dr Appanna was found guilty of professional misconduct for blurring boundaries between his personal life and professional practice by providing medical services to Ms Y, who he was in a sexual relationship with.

Facts

Dr Appanna met Ms Y through an online dating app. When they first met, Dr Appanna drove past his medical clinic and told Ms Y that he worked there. Ms Y therefore knew that Dr Appanna was a doctor. They discussed entering a sexual relationship over drinks, and Dr Appanna explained that he required anyone he was in a sexual relationship with to have a sexually transmitted infection (STI) test. Dr Appanna drove Ms Y back to his medical clinic and performed the STI test on her. While performing this test, Dr Appanna “fingered” Ms Y. He also commented on an abnormality on her cervix (and told her he could arrange to remove the abnormality). They then had sexual contact that evening.

Over the course of their two-month relationship, Dr Appanna and Ms Y engaged in sexual activity multiple times at his clinic. In addition to the STI test on the first evening, he provided her with medical advice and offered to refer her to a pain clinic for a chronic health issue. He also obtained her medical records. On one occasion he provided her with the Class-C controlled drug midazolam (a sedative) as she was in pain. He also sent her a photograph of an unidentifiable patient in an operating theatre.

Following the end of their relationship, and while Dr Appanna was under investigation by the Professional Conduct Committee, he spoke to a journalist and provided him with Ms Y’s personal information including her name and phone number, and details of medical services he provided her.

Findings

The Tribunal found that the repeated blurring of boundaries between his personal and professional life through his relationship with Ms Y was a breach of professional standards, including the Medical Council’s statement on Providing care to yourself and those close to you. The Tribunal also found Dr Appanna breached Ms Y’s privacy by providing her health information to a journalist. Overall, the Tribunal found Dr Appanna’s actions amounted to professional misconduct, by way of malpractice and negligence and that his conduct also bought discredit to the profession.

Penalty

The Tribunal suspended Dr Appanna for three months. In ordering this suspension the Tribunal noted that his conduct would have warranted a suspension for 12 months, if not for the delays to the hearing caused by COVID-19, and the fact that Dr Appanna had been practising subject to a requirement to have a chaperone in that time.

Conditions were imposed upon his return to practice requiring a supervisor review his prescribing, and review his understanding of boundaries and his position of power as a medical practitioner. He will also have to inform any employer, practice partner, or health care provider he contracts with of the Tribunal’s decision. Dr Appanna was ordered to pay 45% of the costs of the investigation and Tribunal proceedings.

Dr A - Med 18/431P

Charge

On 29 May 2019, the Health Practitioners Disciplinary Tribunal (the Tribunal) considered a charge of professional misconduct laid by a Professional Conduct Committee against Dr A, a registered medical practitioner  (the Doctor).

The charge alleged the Doctor breached her ethical obligations when she prescribed prescription medicines and controlled drugs including the drugs tramadol hydrochloride, zopiclone, codeine phosphate, citalopram hydrobromide, lorazepam, mirtazapine, and triazolam for her own use.  She prescribed these drugs in her own name and in the name of family members knowing that she was the intended recipient of the medication.

It was also alleged that she consumed the drugs and mislead or attempted to mislead her employer and the Medical Council by advising them she had not picked up a prescription dispensed to her. In addition she misled or attempted to mislead a pharmacist by incorrectly leading him to believe the drugs prescribed by her were for patients rather than for her own use.

The alleged misconduct occurred over the period of 8 May 2011 to 19 May 2017.

Background

The Doctor signed  an Agreed Statement of Facts in which she admitted the truth and accuracy of most of the Charge. She denied the allegations which related to misleading or attempting to mislead the pharmacist.

The Doctor accepted that her conduct amounted to professional misconduct.

Finding

The Tribunal found all the particulars established except for the particular which related to the allegation about the Doctor misleading or attempting to mislead the pharmacist.

The Tribunal found all the particulars established, and severally and cumulatively, they amounted to  professional misconduct.

Penalty

The Tribunal ordered:

• the Doctor be censured;
• the Doctor pay a fine of $5,000;
• five conditions be placed on her practising certificate which will apply for three years from when the Doctor resumes or continues practice; and
• the Doctor pay costs of $30,000 which was approximately 35% of the total costs.

The Tribunal recommended to the Health Committee of the Medical Council that it obtain dispensing information from the Ministry of Health regularly to monitor the Doctor’s compliance with the Medical Council statement on Good Prescribing Practice and other relevant Codes.

The full decision relating to the case can be found on the Tribunal website at:

https://www.hpdt.org.nz/Charge-Details?file=Med18/431P

Dr Paul BENNETT - Med20/488P

Facts

The High Court recently upheld the Health Practitioners Disciplinary Tribunal (Tribunal) decision to cancel Dr Paul Bennett’s registration for professional misconduct.

Dr Bennett had treated a patient (Ms E) on a regular basis for eight years when he also began paying her for casual work. Over the following year they developed a friendship, sometimes going to events together. After discussing the nature of their relationship and whether Ms E should change doctors, she decided she should and did so in March 2016 when Dr Bennett informally registered her with another doctor at the same practice.

Dr Bennett and Ms E’s relationship became sexual shortly after this. Despite the supposed transfer, due to the other doctor’s limited hours Ms E would still see Dr Bennett when the other doctor was unavailable. Ms E consulted with Dr Bennett on nine occasions over the next two years in addition to his providing repeat prescriptions to Ms E from time to time.  The Tribunal described this transfer process as “flawed” and considered the evidence established that Dr Bennett continued to maintain responsibility for Ms E’s care despite their sexual relationship.

Findings

The Tribunal found all of the particulars of the charge, which Dr Bennett also admitted, established:

• Entering into and continuing a sexual relationship with a recent patient.
• Providing medical care to [Ms E] while in a close personal relationship.
• Making misleading statements to the Medical Council about the nature of the relationship.

The Tribunal was satisfied that, “regardless of the exact timing of Dr Bennett commencing a sexual relationship with Ms E, there was an ongoing intimate and inappropriate relationship with her.” It found, “Dr Bennett’s actions clearly breach the standards set out in the Medical Council’s statement Sexual Boundaries in the Doctor-Patient Relationship, and the zero-tolerance position on doctors who breach sexual boundaries with a current patient.”

Other factors of concern were the effect on Ms E and her medical care – as she was having to keep their relationship secret, there were occasions when Ms E was not honest to the other doctor treating her about being sexually active, and the stress resulted in a decline in Ms E’s health. In addition, after the Council was notified of the relationship, Dr Bennett initially denied there having been a sexual relationship, although he later retracted that denial.

Penalty

In determining the appropriate penalty, the Tribunal focussed on the proximity of the therapeutic relationship and personal relationship, finding Dr Bennett had, “initiated the sexual relationship and continued it in the knowledge that he was not complying with the professional standards expected of him.” As well as failing to take steps to adequately end the doctor/patient relationship. The Tribunal considered a penalty of cancellation was necessary, ordering:

• a censure;
• cancellation of Dr Bennett’s registration;
• conditions on future re-registration; 
• payment of $30,000 in costs; and
• publication of the Tribunal’s decision (excepting notifier’s name and identifying details).

The Tribunal’s decision will shortly be available on its website, https://www.hpdt.org.nz .

Dr Ben-Dom - Med19/445P

Facts

The PCC filed a charge relating to eight patients Dr Ran Ben-Dom (a general practitioner) saw between 2011 and 2017.

The PCC primarily alleged that Dr Ben-Dom raised the topic of breast health, had discussions with patients about breast health and in some cases undertook breast examinations, in circumstances where it was not clinically justified and was not the patient’s presenting concern. In relation to the final patient, the PCC alleged Dr Ben-Dom breached an undertaking to “utterly avoid” raising the issue of breast cancer prevention unless it was brought up by the patient. The PCC also alleged that Dr Ben-Dom raised inappropriate matters with one patient and offered to perform a cervical smear on a patient in a manner that was inappropriate.

The PCC referred to expert evidence and submitted that there was no sound body of medical opinion supporting the practice by Dr Ben-Dom of regularly and repeatedly raising breast examination issues (whether clinical or self-breast examinations), when this was not the patient’s presenting concern.

Dr Ben-Dom denied the specific allegations in relation to the individual consultations. He considered there was no undue pressure placed on patients to have examinations and they were all undertaken professionally, with a chaperone routinely offered. He also denied making inappropriate comments about patients’ breasts. Dr Ben-Dom submitted that his behaviour was influenced by his training and practice in Israel and that he took a proactive approach to the prevention of disease. Dr Ben-Dom relied on the ‘theory of medicine’ defence, which is discussed further below.

Findings

Absence of clinical justification

The PCC submitted that based on Council guidelines, expert evidence, and the evidence of Dr Ben-Dom’s professional peers, his approach was inconsistent with sound medical opinion. The Tribunal confined its findings to the particular circumstances at issue (as opposed to issuing a more general statement concerning breast self-examination and clinical breast examination). It emphasised that the New Zealand standard generally required that other than in circumstances where specific concerns were identified or a family history supported it, the topics of breast self-examination or clinical breast examination should be initiated by the patient rather than the doctor.

Theory of medicine defence

Dr Ben-Dom considered he had adopted and was practising a theory of medicine, and that he acted honestly and in good faith towards the respective patients. Accordingly, Dr Ben-Dom submitted that he could not be found guilty of the disciplinary charge. The Tribunal found that the defence did not apply in this case. It noted Dr Ben-Dom’s articulation of his approach to medicine did not constitute a theory. Instead, Dr Ben-Dom was described as having taken “initiative to introduce the topic”.

The Tribunal found that in each case raising the topic and carrying out the examinations was not clinically justified. This was a significant breach of standards and amounted to malpractice on Dr Ben-Dom’s and brought discredit to the profession.

Penalty

The Tribunal censured Dr Ben-Dom and fined him $5000. It imposed conditions on his practice including that he complete an educational programme, have a female chaperone present when seeing patients for breast examinations, notify patients of the chaperone conditions, and that he submit to audits of these conditions. Dr Ben-Dom was ordered to pay a 50% contribution towards costs (his contribution being $160,000).  

The Tribunal expressed serious concerns that Dr Ben-Dom continued to hold views on ethics contrary to those promoted by the Council. The Tribunal also noted the fact that Dr Ben-Dom continued with his approach to breast self-examination and clinical breast examination despite multiple complaints over several years. The Tribunal stated that the case ‘’called for suspension’’ but this was mitigated by the 11 months Dr Ben-Dom was unable to practice due to interim conditions imposed by the Council.

Dr Ben-Dom challenged the Tribunal’s factual findings along with its finding of professional misconduct, the penalty imposed, and the decision to decline his application for permanent suppression (Ben-Dom v Professional Conduct Committee [2020] NZHC 3094 ). The appeal was dismissed apart from the Court agreeing to amend a condition requiring Dr Ben-Dom to personally meet the costs of the audit of his compliance with conditions.

The High Court dismissed the PCC’s appeal of the Tribunal’s decision not to impose a period of suspension.

The Tribunal's full decision can be viewed on their website at:
https://www.hpdt.org.nz/portals/0/1078Med19445P.pdf

Dr Rakesh Kumar Chawdhry - Med 19/452P

Charge

At a hearing held in Wellington on 09 September 2019 the Health Practitioner’s Disciplinary
Tribunal (the Tribunal) considered a charge laid by the Professional Conduct Committee
appointed by the Medical Council of New Zealand against Doctor Rakesh Chawdhry (the
Doctor) of Christchurch.

The charge alleged that the Doctor’s conduct reflected adversely on his fitness to practise.
The charge showed that the Doctor had been convicted in the District Court in Christchurch
of 13 counts of indecent assault and one count of sexual violation by unlawful sexual
connection. All the victims were the Doctor’s patients.

Following a Judge alone trial the Doctor was found guilty. He was subsequently sentenced to
4 years 4 months imprisonment and ordered to make emotional harm payments of $22,000 to
10 of the complainants.

Background

The hearing proceeded on the basis of an agreed summary of facts. Neither the Doctor nor
his counsel attended the hearing, however they did make written submissions to the Tribunal.

Finding

The Tribunal found that the charge was made out and the Doctor’s conduct undoubtedly
reflected on his fitness to practise. The Tribunal noted that the offences were gross breaches
of trust and were repeated over a sustained period of time. The Tribunal agreed that
disciplinary sanction should follow.

Penalty

The Tribunal censured the Doctor and cancelled his registration. A condition was also
imposed on the Doctor to be satisfied before applying for re-registration should the Doctor
choose to do so. The Tribunal ordered the Doctor to pay a total contribution of 30% towards
the costs of the Tribunal and the PCC. This amounted to $10,556.33.

The full decision can be found on the website at the following link:

https://www.hpdt.org.nz/Charge-Details?file=Med19/452P

Dr D - 1222/Med21/516P

Facts

Dr D was convicted of two charges of assault on a person in a family relationship under section 194A of the Crimes Act 1961. This related to offending in September 2019 where Dr D assaulted his partner.  Dr D also pleaded guilty to one charge of threatening behaviour under the Summary Offences Act 1981. The PCC considered these convictions amounted to professional misconduct in that they had brought discredit to the profession reflected adversely on Dr D’s fitness to practise.

Findings

Dr D accepted his conduct amounted to professional misconduct under section 100(1)(b) of the Act but disagreed his convictions reflected adversely on his fitness to practise. The Tribunal found that, when considering family violence convictions in a 21st century context, they had to reflect adversely on a doctor’s fitness to practise. The Tribunal was also satisfied that a reasonable member of the public would consider the reputation of the medical profession lowered by Dr D’s conduct. The Tribunal found the charge to be made out.

Penalty

Aggravating factors considered by the Tribunal included the seriousness of the offending, the impact on the victim and Dr D’s previous disciplinary history (including a previous PCC investigation into convictions for drink-driving in 2003, 2015 and 2017). Mitigating factors included Dr D’s acceptance of responsibility, his remorse over the offending and his rehabilitation efforts. Dr D was censured and had conditions imposed including that he advise future employers of the Tribunal’s decision and that he continue to engage with the Council’s Health Committee. Dr D was ordered to contribute 30% towards the costs of the proceedings.

Link to full Tribunal decision

See the HPDT website for full details of the charge, additional orders, and decision.

Dr Deane Diesel Drew - Med19/441P

Charge

On 25June and 26 June 2019, the Health Practitioners Disciplinary Tribunal (the Tribunal) considered a charge laid by a Professional Conduct Committee against Dr Deane Diesel Drew, medical practitioner of Wellington (the Doctor)

The charge alleged the Doctor was guilty of professional misconduct in relation to four women patients with whom he had an inappropriate sexual relationship. The women were patients of his at the time of commencing the relationship.  All of these patients were vulnerable through their mental health issues. The charge further alleged the Doctor prescribed drugs of dependence and psychotropic medications to three of these patients contrary to accepted professional standards. 

The conduct was alleged to have occurred over a lengthy period of time from approximately 1991 until October 2016 when the allegations came to a head. 

Background

The hearing proceeded on the basis of an agreed summary of facts. The Doctor admitted each of the particulars and underlying facts to the charge.

Finding

The Tribunal found all the particulars of the charge were established and the charge of professional misconduct was made out.

The Tribunal considered the charge against the Doctor involved prolonged breaches of trust against highly vulnerable patients.  His conduct was found to constitute malpractice and/or negligence and has brought or was likely to bring discredit to his profession.

Penalty

The Tribunal ordered that the Doctor’s registration be cancelled and conditions were imposed that he needed to meet before he could apply for re-registration.  The Tribunal also recommended to the Medical Council, three further conditions that should be placed on his practice if the Doctor was re-registered in the future.

The Doctor was censured, fined $3000.00, and ordered to pay 35% of the total costs ($28,966.27).

The full decision of the Tribunal can be found here .

Dr E - Med19/457P

Facts

Prescribing to Patient A

Patient A was a regular patient of Dr E’s practice. During a consultation in 2018 Patient A told Dr E she was concerned she was pregnant. Dr E ordered blood tests to establish whether she was pregnant. At a later consultation, Patient A, having previously received a positive result from a home pregnancy test, requested a medical abortion. Dr E offered to refer her to Family Planning, but Patient A declined, and Dr E agreed to prescribe her medication instead. During the consultation Dr E used the Medsafe website to look up the required medications for a medical abortion. Dr E subsequently prescribed misoprostol and/or mifepristone to patient A. The purpose of those prescriptions was agreed to be to procure a medical abortion. This prescribing was contrary to both requirements of the Contraception, Sterilisation and Abortion Act 1977 (CSA Act) and guidelines for medical abortions in New Zealand issued by the Abortion Supervisory Committee in that Dr E did not:

• Establish the gestation of Patient A’s pregnancy;
• Exclude the possibility of an ectopic pregnancy;
• Document what support Patient A had in place;
• Document Patient A’s consent for the off-licence use of misoprostol.

Prescribing to Patient B

Dr E saw Patient B in 2017 and during the consultation she requested an abortion. Patient B had not had a consultation with Dr E previously. Dr E discussed the option of a referral to Family Planning, but Patient A explained that she had been unable to confirm an appointment. They also discussed a referral to a private provider specialising in the termination of pregnancies. Dr E then wrote a prescription for misoprostol and Primolut. Dr E did not discuss how or when to take the medication or the potential side effects with patient B. Subsequently, Dr E failed to keep clear and complete records when he changed his consultation notes.

Tribunal Findings

The Tribunal found the charge against Dr E made out as malpractice and negligence and likely to bring discredit to the profession. No findings were made on particulars 4 and 9 (as they specified the Council statements breached). The Tribunal found that every other particular was established.

Penalty

The Tribunal censured Dr E, fined him $7,500 and imposed conditions on his practice. These conditions included participation in an educational course on the CSA Act and the provision of records. Aggravating factors considered by the Tribunal were the clear breaches of professional standards, the potential harm to patients, and failures to undertake clinical examinations or stand up to patient pressure to prescribe. Mitigating factors considered by the Tribunal were the practitioner’s admission of wrongdoing and the absence of patient harm.

The full decision of the tribunal can be found at:
https://www.hpdt.org.nz/portals/0/1079Med19457P.pdf

Dr E - Med20/503P

Dr E was charged with writing and presenting prescriptions for tramadol for himself on two occasions. On one of those occasions, he presented a prescription for tramadol in a way that suggested it was written by another doctor. Dr E largely accepted the facts but denied presenting a prescription in a misleading way.

The Tribunal accepted the pharmacist’s recollection that Dr E wrote on a prescription and presented it in a way that the pharmacist would conclude the other doctor wrote the prescription.

The Tribunal found Dr E guilty of professional misconduct and noted Dr E’s clear breach of professional standards, the repeated conduct and his lack of insight. The Tribunal also noted Dr E’s lack of previous disciplinary history, his position as a young doctor and a lack of evidence of drug seeking behaviour. The Tribunal noted that in comparison to other self-prescribing cases, there was no prescribing in the name of another. Dr E was censured, fined $2500 and had conditions imposed.

The full decision relating to the case can be found on the Tribunal website at:
https://www.hpdt.org.nz/Charge-Details?file=Med20/503P

Dr Mitchell Feller - Med 19/442P

Charge

At a hearing held in Wellington on 22 – 23 July 2019 the Health Practitioner’s Disciplinary
Tribunal considered a charge laid by the Professional Conduct Committee appointed by the
Medical Council of New Zealand against Doctor Mitchell Feller (the Doctor) formerly of
Hawera.

The charge alleged that the Doctor developed and/or conducted a clinical study and/or
clinical trial undertaken in circumstances where he had failed to seek or obtain the necessary
approvals and failed to adequately follow or comply with relevant ethical guidelines for
clinical research studies.

The Doctor was charged with supplying or assisting to supply or encourage the use of his
preparation named Te Kiri Gold (TKG), by his patients. Failing to obtain his patient’s
informed consent and failing to disclose his financial interest in the product. He also used a
patient group which included vulnerable or terminally ill patients.

Background

The charge was heard by way of formal proof as the practitioner did not attend the hearing or
participate in the hearing process in any way.

Findings

The Tribunal found that the charge was made out in all its particulars as misconduct,
malpractice and negligence and the conduct brings discredit to the profession. Vulnerable
patients were put at risk, they were misled and their consent was not properly informed. The
Tribunal agreed that disciplinary sanction should follow.

Penalty

The Tribunal censured the Doctor and cancelled his registration in NZ. The Doctor was
ordered to pay a fine of $5,000 and pay a total contribution of $56,100 towards the costs of
the Tribunal and the PCC. The tribunal also requested a copy of its decision be sent to the
appropriate authorities in South Carolina and the Federation of State Medical Boards in the
USA.

The full decision can be found on the website at the following link:

https://www.hpdt.org.nz/Charge-Details?file=Med19/442P

Dr Hirron FERNANDO – Med 16/352P

Dr Judith Gill Med19/458P

Facts

Between 2003 and 2011, Dr Gill was working as sole director of Auckland Metro Doctors. During this period she was responsible for submitting incorrect information to her Primary Health Organisation (PHO), which meant that she received an additional $420,652.31 funding for patients who were not eligible or entitled. The overpayment was the subject of a criminal prosecution by the Ministry of Health which was withdrawn when Dr Gill repaid a substantial amount.

Findings

The Tribunal did not consider Dr Gill’s conduct was deliberate but considered that she ought to have known of the requirements for submitting correct information to the PHO to obtain capitation funding. Despite this, the Tribunal found that Dr Gill’s conduct fell well below the standard expected of a doctor. Accordingly, it found the conduct amounted to professional misconduct in that it was malpractice and was likely to bring discredit to the medical profession.

Penalty

The Tribunal agreed that the extensive time period, amount of money overpaid, and Dr Gill’s lack of insight or cooperation with the Professional Conduct Committee investigation (and subsequent prosecution) were aggravating factors. The Tribunal considered this case was one of the most serious cases of wrongly-claimed funds the Tribunal has had to deal with. This finding reiterated the seriousness attached to misuse of public health funds by health professionals.

The Tribunal ordered Dr Gill be censured and cancelled and noted it could not consider a lesser rehabilitative penalty given Dr Gill’s lack of engagement with the proceedings. Dr Gill was also ordered to pay a 75% contribution towards costs. The full decision can be found here .

Dr H – Med17/378D

Dr H - Med19/448P

Facts

Dr H was charged with professional misconduct in that he behaved in an unprofessional manner towards colleagues, and was unavailable/failed to respond within a reasonable timeframe when on call.

The instances of unprofessional behaviour took place in telephone calls where Dr H was alleged to have been rude and verbally abusive to Dr Y and/or brusque towards Dr B. Both Dr Y and Dr B were colleagues of Dr H and had, on separate occasions, sought his assistance as the on-call doctor in his particular specialty.  

The PCC also charged Dr H in relation to numerous instances of failing to be available while on call. One of these instances related to an occasion where Dr H had been contacted to urgently see a patient as the rostered on-call specialist. Dr H had confirmed to his colleague that he would attend, but did not do so within a reasonable time frame.

Finding

The Tribunal found three of the seven particulars made out – these related to the one instance of unprofessional behaviour towards Dr Y and two instances of failing to be available while on-call. The Tribunal considered these instances amounted to professional misconduct. The Tribunal found that the remaining particulars, including brusqueness towards Dr B, were not established.

The Tribunal noted that communication was a factor in several instances, and that while Dr H was under stress at the time due to being an on-call specialist, this did not excuse his manner of communication.

Penalty

The Tribunal ordered that Dr H be censured and pay a 60% contribution towards costs. In reaching its decision the Tribunal considered the stress put on Dr H as an on-call specialist. However, the Tribunal noted this was a result of commitments he had undertaken and did not excuse his behaviour to his colleagues. The Tribunal also considered the matter reflected inadequate processes surrounding communication and the practitioner’s employment. The Tribunal did not consider it necessary to impose conditions as the practitioner was not currently employed and had undertaken a course on communication.

The full decision of the Tribunal can be found on their website at: https://www.hpdt.org.nz/portals/0/1105Med19448P.pdf

Dr Martyn HOWELLS – Med 18/416P

Dr J - Med19/443P

Facts

In 2018, Dr J disabled an Alcohol Interlock Device so he could drive his vehicle while intoxicated. He then drove at erratic speeds, swerved across all lanes of a motorway, and collided with left and right barriers. Two members of the public blocked Dr J from driving any further and forced him to stop. Dr J’s vehicle did not collide with any other vehicles. Dr J refused to give his details to Police and attempted to walk away before he was detained. His breath contained 1376 micrograms of alcohol per litre of breath. Dr J was convicted of dangerous driving and driving with excess breath alcohol. Dr J was also convicted of disabling an Alcohol Interlock Device. He was sentenced to 12 months’ supervision and disqualified from driving for seven months. He was also ordered to have a zero-alcohol licence.

Tribunal findings

The Tribunal was satisfied that the Charge was established and that the 2018 convictions reflected adversely on Dr J’s fitness to practice. In making its finding the Tribunal noted that the offending occurred in the context of a history of alcohol-related offending and was the result of an alcohol addiction. The Tribunal also accepted that there was no evidence that Dr J’s patients had ever been directly at risk as a result of his alcohol issues.

Penalty

The Tribunal found that the circumstances surrounding Dr J’s offending were very serious and the result of deliberate actions. Aggravating factors considered by the Tribunal included the nature and seriousness of the conduct, Dr J’s history of alcohol-related offending and the risk to the public as a result of his driving. Mitigating factors considered by the Tribunal included the practitioner’s admission of wrongdoing and remorse, his personal circumstances and that there was no evidence Dr J’s patients had ever been directly at risk as a result of his problems with alcohol. Dr J was censured, suspended for six months, and ordered to pay a 30% contribution towards costs. The Tribunal also imposed conditions including that Dr J not practice in a sole-charge or unsupervised role, that he advise employers of the Tribunal’s decision, that he remain abstinent and meet conditions imposed by the Health Committee and that he work under supervision.

The full decision of the tribunal can be viewed on their website at:
https://www.hpdt.org.nz/portals/0/1038Med19443P.pdf

Dr Stephen JOHNS – Med 15/318D

Dr Carl Knox Med21/515P

Facts

In July 2018 Dr Knox was involved in an alcohol-related assault on two people. Dr Knox was convicted of injuring with reckless disregard and assault with intent to injure. He was sentenced to four months’ community detention and ordered to pay reparation.  

In November 2018 Dr Knox was stopped at a Police checkpoint. When tested, his breath contained 476 micrograms of alcohol per litre of breath. Dr Knox was convicted of driving with excess breath alcohol and driving while disqualified, and received a further disqualification.

In January 2020, Dr Knox entered into an Agreement with the Health Committee for his return to practice. Amongst other conditions, Dr Knox agreed to abstain from illicit substances and non-prescribed substances. As part of the Health Committee’s monitoring of his commitment, he agreed to provide three-monthly hair samples to be tested. One of the three-monthly hair samples taken on 9 June 2020 (covering the preceding three months) tested positive for MDMA, in contravention of his agreement with the Health Committee. The PCC considered this amounted to professional misconduct.

Findings

The Tribunal was satisfied that all four convictions reflected adversely on Dr Knox’s fitness to practise. The Tribunal was not satisfied that Particulars 1 – 4 also merited a separate finding that his conduct brought discredit to the profession under s 100(1)(b). This was because Dr Knox’s offending occurred outside of the workplace and did not involve his medical practice. Further, the Tribunal did not find Particular 5 established as it was not satisfied that Dr Knox’s non-compliance with the Health Committee Agreement was conduct that had brought or was likely to bring discredit to the medical profession.

Penalty

The Tribunal considered the aggravating factors of Dr Knox’s conduct were the seriousness of the assault, his multiple driving related offences and his contravention of the health agreement. Mitigating factors included Dr Knox’s acceptance of responsibility, his remorse and the time passed since the convictions. The Tribunal censured Dr Knox and imposed conditions on his practice, including that he advise current and future employers of the Tribunal’s decision, that he continue to engage and meet conditions set by the Health Committee, and that he work under supervision. Dr Knox was ordered to pay a 50% contribution towards costs.

Link to Tribunal website

See the Tribunal website for further details around the charge and decision.

Dr L - Med20/489P

Facts

Dr L began treating Ms N in 2013 and subsequently treated her former husband and children. Over this time Dr L treated Ms N for significant mental and physical health concerns. In 2017, Dr L contacted Ms N about participation in a practice CPR scenario. When Ms N indicated she did not want to participate, Dr L offered her a $50 voucher for a local beautician as he had already purchased it (this was supposed to be a reward for participating in the CPR scenario). Around the same time Dr L messaged Ms N after a consultation (where exercise had been discussed). They subsequently agreed to go for a walk together. During this walk Dr L told Ms N that they could not be friends as he was her doctor.

In or around late 2017/early 2018, after a consultation with Ms N, Dr L phoned Ms N and informed her that he had romantic feelings for her. He subsequently requested that she see other GPs at the practice but did not note this on her medical record. Dr L continued to treat Ms N’s former husband and children. Subsequently, Dr L and Ms N met on two occasions over two months, and on these occasions the relationship became physically intimate. The following month Dr L contacted Ms N five to six times. At the final meeting Ms N told Dr L that he should not contact her further.

Tribunal finding

The Tribunal found both particulars established. The key facts were agreed and the practitioner admitted the charge. The Tribunal found that the practitioner’s conduct represented a serious breach of the Medical Council’s expectations in regard to professional and sexual boundaries in the doctor-patient relationship. Further, the Tribunal was satisfied that Dr L’s expression of romantic feelings to Ms N, and the subsequent relationship, amounted to malpractice. The Tribunal also concluded that a reasonable member of the public would find Dr L’s behaviour lowered the reputation of the medical profession. The Tribunal made particular reference to the fact that Dr L continued to provide treatment to Ms N during the period of their close personal relationship, which included undertaking a gynaecological examination and prescribing antidepressants to her. 

Penalty

As aggravating features, the Tribunal noted the nature of the consultations, the length of the relationship and the treatment of Ms N’s family members. Mitigating factors included Dr L’s self-reporting, his acceptance of responsibility and his ongoing personal and professional development. The Tribunal censured Dr L and suspended him from practice for three months. The Tribunal also imposed conditions on Dr L’s return to practice. These included that Dr L participate in an educational programme, that Dr L have a chaperone for consultations with female patients, professional supervision and mentorship and that Dr L notify prospective employers of the Tribunal’s decision.

The full decision can be viewed on the Tribunal's website at:
https://www.hpdt.org.nz/Charge-Details?file=Med20/489P&keyword=dr%20L

Dr N - Med20/501P

Facts

Dr N’s former friend notified Dr N’s employer of concerns Dr N had inappropriately disclosed information to them including sensitive health information about patients. The DHB then undertook an audit and discovered Dr N had inappropriately accessed medical records of 35 patients on a number of occasions over approximately 11 months. The PCC considered this amounted to professional misconduct in that it was malpractice/negligence as well as bringing discredit to the profession.

Findings

The Tribunal found the charge established. Dr N admitted providing their former friend with health information including two mental health risk assessments on Dr N’s employer’s letterhead. Dr N denied providing some of the information described in the complaint but acknowledged the friend may have accessed this information through Dr N’s personal belongings. Dr N also accepted accessing the DHB’s electronic records to review patient records without any legitimate reason to do this. Dr N accessed some of the records for personal reasons relating to their personal circumstances. The Tribunal was satisfied that Dr N’s conduct was a gross breach of medical practitioners’ ethical obligations relating to personal information.  

Penalty

Given the seriousness of Dr N’s conduct, the Tribunal considered a suspension of at least four months was appropriate. However, the Tribunal made no order for suspension as Dr N had been out of practice for a year as a result of the original complaint and was then subject to practice restrictions. The Tribunal censured Dr N, placed conditions on their practice, and ordered a 30% contribution towards costs. These included compliance with requirements of the Medical Council’s Health Committee, undertaking an educational programme on medical ethics, privacy, confidentiality and professional boundaries, supervision from a vocationally registered peer, regular audits of Dr N’s access to patient records, and that for a period of three years Dr N advise current and future employers of the Tribunal’s decision and orders. In reaching its decision the Tribunal considered the role of Dr N’s difficult personal circumstances in driving their conduct and noted Dr N’s behaviour compromised the trust members of the public should have in the health system’s management of their personal information.

Link to Tribunal website

See the Tribunal website for further details around the charge, additional orders, and decision.

Mr N - Med19/454P

Facts

In [ ] Mr N developed an alcohol and drug addiction which he initially addressed by attending a clinic but later stopped attending. Mr N was discharged from his employment at [private hospital] and continued informal contact with a colleague, Dr R, who was to monitor him. Between 2006 and 2017 Mr N prescribed medicines for his own use on 76 occasions. He also prescribed for various family members between 2010 and 2017. None of the prescribing over this period was documented.

In Mr N’s applications for his Annual Practicing Certificate in 2008 and 2014 he answered ‘’no’’ to questions concerning mental and physical conditions. Mr N also admitted to misleading the Medical Council investigation in regard to submissions given about the extent of his addiction issues. Finally, as part of its inquiry the PCC contacted Mr N’s own general practitioner, Dr R, to request medical records. Subsequently, Mr N contacted Dr R to request he remove the name and contact details of his treating doctor at [private hospital].

Tribunal Findings

Self-prescribing

The Tribunal found that particulars 1 and 2 were clearly established as malpractice and conduct bringing discredit to the profession. The Tribunal also accepted the PCCs submissions on the severity of the prescribing.

Prescribing to family

The Tribunal found all the particulars relating to Mr N’s prescribing to family to be made out. Further, every particular excluding 5 and 9 warranted separate disciplinary action.

Failure to Document treatment

The Tribunal found there has been a breach of standards by Mr N in relation to his obligation to keep contemporaneous, accurate and legible records of treatment provided and medications prescribed.

Failure to disclose health issue(s)/addiction(s)

The Tribunal found that all the particulars relating to Mr N’s failure to disclose relevant health and addiction information to Council were made out. The Tribunal highlighted the need for honesty and accuracy from practitioners to enable Council and PCCs to be properly informed.

Penalty

The Tribunal made orders that Mr N be censured, fined $2000 and have conditions imposed on his practice. In reaching its decision the Tribunal took account of the stress and complications within Mr N’s family. However, the Tribunal also noted that this did not excuse the prescribing of drugs of dependence or the failure to keep records. Further, while it was not part of the charge, the Tribunal noted that advice Mr N was given around disclosing medical or mental issues on his APC had not worked in his best interests.

The Tribunal's full decision can be viewed on their website at:
https://www.hpdt.org.nz/portals/0/1089Med19454P.pdf

Dr Nelson Nagoor - 1298/Med22/554D

Dr Nelson Nagoor was found guilty by the Health Practitioners Disciplinary Tribunal of professional misconduct for significantly departing from the accepted standards of care by failing to inform a patient of their cancer diagnosis and failing to act on recommendations from a report.

In 2019, Dr Nagoor was working as a GP at a community practice in Invercargill. In April 2019, Mr Linder attended to the practice to get a suspicious mole checked. Dr Nagoor removed the mole by excising the lesion. The subsequent histology report provided a diagnosis of a primary melanoma, invasive, with a sub-type of superficial spreading melanoma. The report recommended that a wider excision be completed. Later that month, Mr Linder attended the clinic for a follow-up. He asked Dr Nagoor if he had cancer, and Dr Nagoor said no. Six months later, Mr Linder was diagnosed with Stage IV melanoma at Southland Hospital. He sadly died in June 2022.

A complaint was made to the Health and Disability Commissioner about Mr Linder’s care. An investigation found that Dr Nagoor had breached Rights 4(1) and 6(1) of the Code of Health and Disability Services Consumers’ Rights. Following a referral from the Deputy Commissioner, the Director of Proceedings then laid charges in the Tribunal.

The Tribunal found that there were two important omissions in Mr Linder’s care: firstly, Dr Nagoor’s failure to communicate the diagnosis of melanoma, and secondly, to act on the recommendations for further excision and referral for specialist care. Furthermore, the Tribunal noted that the frequency of follow-up reviews was inconsistent with reasonable and accepted practice set out Australasian Guidelines for the Management of Skin Cancer. Consequently, the Tribunal found that an opportunity for earlier intervention was missed and his actions fell well below an appropriate and reasonable standard of care.

The Tribunal concluded Dr Nagoor was guilty of professional misconduct by way of clinical negligence and acts or omissions that brought were likely to bring discredit to the profession. The Tribunal found that he repeatedly, and to a significant degree, departed from the accepted standards of care expected of a medical practitioner working in general practice.

The Tribunal considered that the appropriate penalty was a suspension of three months. Suspension was favoured over cancellation as it would be out of step with comparable cases, and it would not be effective given Dr Nagoor’s intention to retire. The Tribunal also ordered:

• censure;
• conditions on future re-registration, including that he does not practise as sole practitioner for three years;
• a fine of $5000;
• payment of $26,000 costs to the Director of Proceedings and Tribunal; and
• publication of the Tribunal’s decision (excepting name and identifying details of two of the Director’s witnesses).

Furthermore, the Tribunal recommended that the Medical Council advise the Health Professions Council of South Africa of its decision and orders, given that is understood that Dr Nagoor has subsequently returned to live in South Africa.

The Tribunal’s decision is available on its website at: https://www.hpdt.org.nz/Charge-Details?file=Med22/554D .

Dr O – Med 16/375P

Dr O Med21/534P

The Health Practitioners Disciplinary Tribunal has censured a General Practitioner who entered into a close personal relationship with a man while his wife and children were her patients.  The doctor also breached the wife’s privacy by disclosing health information to her husband. 

Allegations

The PCC alleged Dr O entered into and continued a close personal and/or sexual relationship with a male patient (while the patient’s wife and children were also Dr O’s patients). The PCC also alleged Dr O ended her doctor-patient relationship with the male patient for the purposes of furthering a personal relationship with him. The charge captured a close personal and/or sexual relationship with him as a former patient. Finally, the PCC alleged Dr O breached the wife’s by disclosing to him details of upcoming appointments.

Findings

The Tribunal found parts of the charge established. The Tribunal did not consider Dr O entered into a close personal/sexual relationship with the male patient while he was her registered patient, nor that she had transferred his care for the purposes of furthering a close personal/sexual relationship. The Tribunal accepted Dr O entered into and continued a close personal/sexual relationship with the man when he was a former patient, but did not consider this reached the threshold for professional misconduct as he did not have any vulnerabilities – Dr O only saw him for three consultations and there was no evidence of his reliance on her.

The Tribunal accepted Dr O entered and continued a close personal relationship with the former patient while his wife and children were her patients, which the Tribunal considered met the threshold for misconduct. The Tribunal also found Dr O’s disclosure of his wife’s appointment amounted to misconduct when combined with the other conduct. The Tribunal considered Dr O’s conduct was likely to bring discredit to the profession.

Penalty

The Tribunal ordered censure, conditions and costs. This included that, for a period of three years, Dr O engage with a supervisor recommended by Council.  This was aimed at helping Dr O self-reflect and monitor her doctor patient relationships.

The full decision can be found on the Tribunal's website:

https://www.hpdt.org.nz/Charge-Details?file=Med21/534P

Dr Paltridge - Med20/502P

Dr Paltridge was found guilty of professional misconduct for clear breaches of professional standards by importing, prescribing, and dispensing drugs of potential abuse over a six-year period. In doing so, he also failed to adequately maintain clinical records and assess patients in accordance with accepted standards of medical practice.

Facts and Findings

For over fifteen years, Dr Paltridge was involved in the New Zealand Men’s Clinic as a director and medical practitioner. Between 2012-2017, Dr Paltridge prescribed, imported and dispensed performing and image enhancing drugs (PIEDs) such as testosterone, anabolic steroids, and human growth hormone (HGH) to patients at the Clinic. The prescribing of these drugs departed from the accepted standards of medical practice. These medicines were often prescribed without clinical indication for their use. Dr Paltridge also failed to keep medical records for these patients, complete adequate clinical investigations, or provide follow-up care.

One of these patients, Mr X, was particularly vulnerable having a previous history of drug abuse. Dr Paltridge prescribed PIEDs in excessive quantities to Mr X. He did so without properly assessing Mr X’s condition, obtaining a sufficient medical history, or determining whether there was a clinical indication for their use. Even after being informed of Mr X’s history from his GP, Dr Paltridge continued to prescribe to Mr X. The Tribunal also found that Dr Paltridge had failed to maintain/record notes from these consultations with Mr X.

In addition to his conduct relating to treating patients, Dr Paltridge wrote prescriptions for individuals who were not under his care and did not receive the medications to stock his clinic. He did this by providing Medsafe with inaccurate patient prescription lists to meet its requirements for releasing the consignments to him.

Penalty

Dr Paltridge was suspended for six months. In coming to this conclusion, the Tribunal accepted that there were numerous aggravating factors pointing to cancellation including:

• The Tribunal’s previous finding of professional misconduct in 2011 for similar conduct;
• The lengthy duration and excessive nature of the prescribing;
• His risk to vulnerable patients;
• Knowledge of Patient X’s prior drug abuse;
• The importation of unregistered drugs and drugs not approved for human use.

However, the Tribunal also acknowledged Dr Paltridge’s cooperation in the process and his “very good” prospects of rehabilitation in his new role as a GP. It held that the need for rehabilitation was a strong reason not to cancel his registration.

The Tribunal also censured Dr Paltridge, fined him $5000, and imposed conditions on his practice for a period of three years after recommencing practice. These conditions included limiting his ability to practise to only a Council-approved group practice, requiring him to inform employers of the Tribunal’s decision, and prohibiting him from prescribing, importing, and dispensing drugs of concern such as testosterone and anabolic steroids. He was ordered to pay 54% of the PCC’s and Tribunal’s costs.

In addition to the penalty, the Tribunal recommended that the Medical Council undertake an audit within twelve months of his return to practice of his prescribing and documentation practices, and inpractice participation or speciality college equivalent. 

The Tribunal’s decision is available on its website: Dr Paltridge Charge Details

Dr Rairi Med22/547P

In a decision released August 2023, the Health Practitioners Disciplinary Tribunal censured and imposed conditions on Auckland General Practitioner Dr Poanere Rairi for prescribing addictive medicines to his employee, who was another doctor at the practice, in breach of the Council’s statement on Providing care to yourself and those close to you. This continued even after Dr Rairi was made aware of the employee’s pre-existing substance use disorder.

Dr Rairi was the sole GP at an Auckland medical centre. The practice was also staffed by contractors, including Dr A. Dr A also enrolled at the medical centre as a casual patient but continued to see their usual GP. Over a 17-month period, Dr Rairi prescribed various medicines to Dr A including tramadol, codeine, and benzodiazepines. During this time, the Medical Council’s Health Committee had notified Dr Rairi of Dr A’s substance use disorder and the conditions imposed on their practice requiring them to be supervised by a vocationally trained GP. Dr Rairi terminated Dr A’s employment shortly after as the practice could not comply with this condition. However, Dr Rairi continued to prescribe to Dr A after the notification from the Committee.

The Tribunal censured Dr Rairi and imposed conditions on his practice for a period of two years. The Tribunal also ordered Dr Rairi to pay a contribution of the PCC and Tribunal’s costs. The full decision can be found at the link below:

https://www.hpdt.org.nz/Charge-Details?file=Med22/547P

Dr S - Med 18/417P

Charge

On 26 October 2018 the Health Practitioners Disciplinary Tribunal considered a charge laid by a Professional Conduct Committee (PCC) against Dr S, medical practitioner (the Doctor).

The charge contained four particulars. The first three particulars alleged that the Doctor prescribed medications for herself or in the names of family members for those family members or for herself. The PCC alleged that each of these particulars either separately or cumulatively amounted to professional misconduct,

The fourth particular alleged that the Doctor was convicted on a charge of driving with excess alcohol and a further charge of failing to stop when required to do so by a law enforcement officer and that this conduct reflected adversely on the practitioner’s fitness to practise.

The hearing proceeded on the basis of an Agreed Summary of Facts. 

Finding

The Tribunal found the facts established and that the charges were made out except for the particular of the conviction charge relating to failing to stop.  This particular did not qualify for consideration under section 100(2) of the HPCA Act as the maximum penalty for the conviction was below the requirement of imprisonment of a term of three months or longer.

The charge was serious.  Prescribing any drugs to family members, particularly drugs of dependence, is of concern because of the lack of objectivity on the part of the medical practitioner which in turn could lead to serious consequences for the family member.

Penalty

The Tribunal censured the Doctor and fined her $5,000.  Conditions were imposed for a period of three years.  The Tribunal also recommended the Medical Council’s Health Committee carry out a comprehensive assessment of the Doctor’s health needs and a comprehensive review of the Doctor’s current health management programme.

Costs of $17,000 were awarded against the Doctor and an order of permanent name suppression of the name of the Doctor and any identifying features including her health issues was made. 

The Tribunal exempted from the name suppression order publication by the Medical Council referring to the Tribunal decision on the Doctor’s formal record and the Doctor herself from informing any prospective employer of the Tribunal’s decision. The Medical Council was also able to refer to the decision when responding to any legitimate enquiry by or on behalf of a party considering employing the Doctor.

The Tribunal further directed publication of its decision and a summary. The full decision can be found on the website at the following link:

https://www.hpdt.org.nz/Charge-Details?file=Med18/417P

Dr S - Med22/560P

In 2018, Dr S was found guilty of professional misconduct. Her conduct included prescribing to herself, and prescribing in family members’ names for her own use. Conditions were imposed on her practice prohibiting her prescribing to herself, her family, or any partner.

In June 2019, Dr S entered a personal relationship with her patient, Mr D, which later became a sexual relationship. While they were in a relationship, Mr D signed a lease to live at Dr S’s home.  Dr S continued to provide GP services to Mr D, which included prescribing medications, completing medical certificates and ACC claims, providing advice on an injury and making referrals to other treatment providers. Dr S remained Mr D’s main treatment provider until after she was informed that the Council had received a notification about her relationship with Mr D.

Dr S altered and retrospectively created consultation records for the care she provided to Mr D. On other occasions there were no records for her prescribing for Mr D.

The Tribunal was satisfied that it was inappropriate for Dr S to enter a relationship with a patient, or have a patient live at her property. It found that her amendments to Mr D’s records were a deliberate attempt to conceal her conduct, and that her prescribing for him was a breach of the Tribunal’s own conditions on her practice. The Tribunal found that some of the prescribing was more than the therapeutic dose for one person, and that some of the medication Dr S prescribed to Mr D was for her own use.

Dr S’s registration was cancelled with a minimum period of 12 months before she could apply for re-registration. In ordering cancellation, the Tribunal noted the totality of her conduct, and that previous attempts to rehabilitate had been unsuccessful. It imposed conditions requiring her to demonstrate her fitness to practise and complete education before any future application for re-registration. Dr S was ordered to contribute to the costs of the PCC and Tribunal.

The full decision can be viewed on the Tribunal’s website .

Dr Singh - 1226/Med 21/520P

Facts

Dr Singh was convicted of one charge of sexual violation by unlawful sexual connection under sections 128 and 128B of the Crimes Act 1961. This related to a consultation with a patient in December 2017. The PCC considered Dr Singh’s conviction had brought discredit to the profession and reflected adversely on his fitness to practise. The disciplinary charge also alleged that in response to an HDC complaint and investigation, Dr Singh also retrospectively amended the patient’s clinical notes in response to a related Health and Disability Commissioner complaint and investigation.

Findings

Dr Singh argued there was no nefarious sexual motivation and so his offending could not be described as a “serious sexual offence”. The Tribunal rejected this. The Tribunal acknowledged the time he had already been suspended but noted that this was primarily due to the appeals of his criminal conviction. The Tribunal was satisfied that both separately and cumulatively Dr Singh’s conduct amounted to professional misconduct (because it brought discredit to the profession) and that the conviction reflected adversely on his fitness to practise.

Penalty

The Tribunal noted key aggravating factors including the breach of trust, highly sensitive nature of the procedure performed, the ‘’fundamentally dishonest’’ nature of Dr Singh’s alteration to his notes, and his ‘’lack of any genuine remorse or insight’’. The Tribunal highlighted that Dr Singh’s attempts to minimise his offending “did not serve him well” before the Tribunal. It was suggested that if he accepted his conduct then this, combined with the time he was suspended, might have made suspension available as an ultimate penalty.

Dr Singh was censured and his registration was cancelled (with a condition that he could not reapply for re-registration for 12 months). Conditions were imposed on his return to practice including that he undertake a Sexual Misconduct Assessment Test at his own cost. Dr Singh was also ordered to contribute around 30% to the overall costs of the proceedings.

Link to Tribunal website

See the Tribunal website for further details around the charge, additional orders, and decision.  

Dr T - Med19/455P

Charge 1 - facts

Drug testing programme

In February 2015, Dr T disclosed to the Council that he had developed a cannabis dependency. This was referred to the Council’s Health Committee. A psychiatrist engaged by the Council’s Health Committee informed the Committee that Dr T was dependent on cannabis and used it on a daily basis, including while he was on call. The Committee determined Dr T should undertake fortnightly random urine screening for six weeks and then random monthly testing for 12 months. Dr T later signed an agreement to abstain from all drugs of abuse and to comply with testing. From May 2015 until May 2016, samples submitted by Dr T tested positive for cannabis.

Voluntary undertaking and conditions on scope of practice

In October 2016, Dr T breached a voluntary undertaking to the Council by practising despite returning positive cannabis tests. As a result, in November 2016 the Council imposed conditions on Dr T’s scope of practice. These included that Dr T would undergo regular urine testing (to show continued abstinence). Between December 2016 and February 2017, Dr T submitted several urine samples in a manner inconsistent with Health Committee testing protocols. These samples tested negative for cannabis. Between March and July 2017, Dr T submitted multiple urine samples for testing, some of which tested positive for cannabis. Dr T did not provide any urine samples after 24 August 2017. Dr T accepted that the positive test results and his failure to comply with fortnightly testing after 24 August 2017 was in breach of the conditions on his scope of practice.

Inappropriate prescribing

On 19 April 2017, Dr T prescribed eye drops in Ms R’s name. Ms R was the receptionist of Dr T’s medical practice at the time. Dr T presented both prescriptions at the pharmacy and was dispensed both medicines. On 30 June 2017, Dr T prescribed Tenoxicam (a non-steroidal anti-inflammatory) in Ms R’s name. Ms R denied ever receiving the medications. On 17 July 2017, Dr T prescribed medication for a patient’s brother who lived in Iran, despite the brother not being Dr T’s patient and Dr T not having assessed him.

Charge 2 – facts

In around 2001, Dr T created a patient profile in his practice management system using a pseudonym. He said this was for use by patients who required sensitive tests and did not want this information known by hospital or laboratory staff. On four occasions in 2017, Dr T submitted urine samples to laboratories under this pseudonym. All these samples tested positive for cannabis. Dr T did not provide the results of these tests to the Health Committee.

Tribunal decision – Charge 1

The Tribunal found breaches of Dr T’s conditions on his scope of practice, non-compliance with the Health Committee’s drug testing programme, and prescribing to an unknown patient in Iran amounted to professional misconduct. The remaining particulars were not established. 

Tribunal decision – Charge 2

The Tribunal did not consider Charge 2 amounted to professional misconduct. The Tribunal accepted Dr T created the fake profile prior to the events set out above and used it for other patients. The Tribunal noted that this was an accepted way of protecting patient identities and that the Council condoned practitioners creating fictitious names as part of its own urine testing protocol. Further, the Tribunal was not satisfied there was a sufficient link between Dr T’s cannabis conditions, and the tests submitted under a false name, and noted a breach of conditions had already been captured by Charge 1.

Penalty

The Tribunal was satisfied that censure, two months’ suspension and conditions on Dr T’s practice was an appropriate and proportionate penalty. Dr T was also ordered to contribute to 25% of the overall costs. In reaching this decision, the Tribunal noted the absence of patient harm and the interest in Dr T’s rehabilitation. The Tribunal specified that the suspension ordered in this case was not punitive but rather to ensure Dr T had time to attend to his rehabilitation. The Tribunal granted Dr T permanent name suppression on the grounds that the presumption of open justice was displaced by Dr T’s interests, in particular the risk that publication would have a detrimental effect on his rehabilitation.

The full decision of the Tribunal can be found on their website at:
https://www.hpdt.org.nz/portals/0/1097Med19455P.pdf

Dr Tovaranonte - Med21/531P

The Health Practitioners Disciplinary Tribunal has censured a Christchurch medical practitioner, Dr Preechapon Tovaranonte, for making anonymous, disparaging comments online about colleagues and medical practices.  Dr Tovaranonte also submitted an anonymous, vexatious complaint to the Health and Disability Commissioner (HDC) about a medical practice.  He also misrepresented his qualifications in online publications. 

Facts

Dr Tovaranonte used an alias to make posts on social media and other online fora.  Following the termination of his contract with a medical centre, he left a false and malicious Google review of the medical centre using his alias.  He also left disparaging comments on the medical centre’s Facebook page.  Following the termination of his contract with another medical practice several years later, he left similar, disparaging comments about the practice on a community Facebook page.  He also advertised an alternative online health provider, under his alias – without disclosing the fact that he worked for that provider.

Dr Tovaranonte also submitted a false and vexatious complaint to the HDC about the second medical practice.  The complaint was presented using an alias and as coming from a patient of the practice when Dr Tovaranonte had never been patient.

Dr Tovaranonte also misstated his qualifications on website advertisements and a LinkedIn profile.  He claimed to have law and business degrees when he did not. 

Findings

The Tribunal found all four particulars established.  It held that Dr Tovaranonte’s conduct amounted to professional misconduct and was conduct likely to bring discredit to the profession.

The Tribunal was satisfied that the comments about medical centres were disparaging and unprofessional.  The complaint to the HDC was considered unprofessional and significant departure from professional standards.  The misleading LinkedIn profile website advertisement was considered to be a serious departure from professional standards.  The website advertisement was found to be misleading, but not, by itself, conduct which would bring discredit to the profession. 

Dr Julian White - Med22/547P

Following a hearing on 16 February 2023, the Health Practitioners Disciplinary Tribunal found Dr Julian White guilty of professional misconduct for convictions that brought or were likely to bring discredit to the medical profession and reflected adversely on Dr White’s fitness to practise. Dr White was also found guilty in relation to his failure to declare relevant information on a Practising Certificate (PC) application.

Dr White was a vocationally registered GP. He had previously worked in New Zealand, however had been working as a doctor in Australia since 2018. On 1 July 2021, Dr White was convicted in New Zealand of a charge of male assaults female, four charges of using a forged document, six charges of obtaining by deception, and a charge of using a document for pecuniary advantage. The first charge related to an incident where Dr White punched a family member’s face. The forged document charges arose from Dr White having used a forged document to obtain a loan, obtaining a false valuation, and signing a finance agreement in someone else’s name. The other fraud charges related to a fraudulent insurance claim. Dr White was sentenced to four months’ home detention and ordered to pay reparations.

In August 2018, Dr White made an application for a PC. Dr White did not disclose that the Police had charged him with fraud and the Australian Health Practitioner Regulation Authority (AHPRA) was investigating concerns about his competence. In 2019, Dr White again failed to disclose the AHPRA investigation and further charges.

In relation to the convictions, the Tribunal found Dr White guilty of professional misconduct under ss 100(1)(b) and (c). The Tribunal recognised that in other cases, charges had been previously established under both ss 100(1)(b) and (c). Although these cases involved work-related offending, the Tribunal stated that it was not a requirement that the alleged conduct be connected to a workplace, an aspect of medical practice and/or that there is a risk to the health and safety of patients. The Tribunal noted registration carries with it an obligation to behave in a way which is ethical, honest and in accordance with the law. It was, therefore, clear that the offending adversely reflected on Dr White’s fitness to practise and that a reasonable member of the public could conclude that the reputation and good standing of the profession had been lowered by his behaviour.

In relation to the failure to disclose information on an APC, the Tribunal was satisfied that the conduct was a sufficiently serious departure from accepted standards to warrant disciplinary sanction given the nature and number of omissions. The Tribunal noted that Dr White’s omissions had a bearing on both his fitness and competency to practise. It was on Dr White to properly turn his mind to the application and provide the appropriate information. Dr White’s conduct, therefore, amounted to professional misconduct under s 100(1)(b).

The Tribunal ordered cancellation of Dr White’s registration. It also ordered that Dr White be censured, have conditions imposed on his return to practice including a course of education focusing on professional ethics, and that he pay 30 per cent of the PCC’s and Tribunal’s costs.

Dr Joseph WILLIAMS – Med 16/371P

Dr Y Med20/473P

Charge and findings

The PCC charged Dr Y with professional misconduct in relation to allegations he performed inappropriate physical and visual examinations of rectal / perianal areas of police recruits when they were being assessed for fitness to join the police between 1998 and 2006. Following a hearing in November 2020, the Health Practitioners Disciplinary Tribunal found Dr Y found guilty of professional misconduct, although did not accept Dr Y’s conduct warranted disciplinary sanction.

Subsequent appeal and cross-appeal

In a decision released in June 2022, Dr Y successfully appealed against the Tribunal's finding of professional misconduct and the refusal to grant permanent name suppression. The PCC unsuccessfully cross-appealed the Tribunals decision not to impose a disciplinary sanction on the Doctor – XY v A Professional Conduct Committee [2022] NZHC 1498.

Further information can be found here .

Dr Teimur Youssefi 1297/Med21/537P

In a decision released in January 2024, the Health Practitioners Disciplinary Tribunal found Dr Teimur Youssefi guilty of professional misconduct following a conviction for knowingly using a forged document to obtain registration in New Zealand and for subsequent unprofessional behaviour.

In 2015 Dr Youssefi applied for provisional general registration with the Medical Council of New Zealand. He provided a falsified certificate of good standing in support of this application, and incorrectly stated that he had not been the subject of disciplinary proceedings (when he was the subject of a disciplinary charge in another jurisdiction). His registration was subsequently cancelled by the Medical Council and he was charged with knowingly using a forged document. Following a series of appeals, Dr Youssefi was ultimately convicted and discharged for this offence. In July 2022, the Tribunal found Dr Youssefi’s conviction reflected adversely on his fitness to practise.

In the intervening period, Dr Youssefi was re-registered (in the provisional scope) and employed as a House Officer. During this time, Dr Youssefi behaved unprofessionally in that he:

• Was unpleasant towards his supervisors during a meeting to check on his wellbeing;
• Alleged colleagues who raised concerns about his wellbeing were bullying him;
• Incorrectly claimed a nurse was so impressed with his performance that she had praised him to the head of department (when this had not occurred);
• Said a former supervisor, who had given him negative feedback, was “crazy” in the context of this supervisor’s mental health, and that this supervisors comments were invalid as a result.
• Said that his supervisor was unfit to be a supervisor, and that his supervisor’s concerns about him were “flagrant lies” and “initial paranoid suspicion”.

While the Tribunal noted Dr Youssefi’s registration had been cancelled before, it remained concerned about Dr Youssefi’s continued dishonesty and his lack of insight about the seriousness of his conduct. Dr Youssefi was censured and had imposed conditions on his practice. These conditions included requirements to engage with a mentor and undertake further education in professional interactions and communication.