Charge

On 10 - 13 August 2021, the Health Practitioners Disciplinary Tribunal (the Tribunal) considered a charge laid by a Professional Conduct Committee against Dr E registered medical practitioner (the Doctor).

The Charge alleged that the Doctor: 

1.    wrote and/or presented a prescription at a Pharmacy for Loratadine, Flucloxacillin and Tramadol in his own name and/or for his own use:
2.    Altered a prescription written by another doctor by adding a prescription for Tramadol for his own use and/or
3.    (a)    Presented the altered prescription to a pharmacist at a second Pharmacy and/or
       (b)    knew or ought to have known that in presenting the altered prescription, the pharmacist was likely to conclude that the prescribing doctor had prescribed Tramadol to the Doctor.

The acts alleged amounted to malpractice or negligence and brought or is likely to bring discredit to the profession.

Background 

The Doctor was attending an onsite surgical anatomy course away from his hometown.  The Doctor said he was suffering pain from an ankle injury.  On the first occasion he wrote a script out in front of a pharmacist for Loratadine, Flucloxacillin and Tramadol.  The pharmacist dispensed the medication but declined to dispense the Tramadol.  The Doctor accepted that and left the pharmacy.

On the second occasion, after visiting another doctor on an unrelated matter, a prescription was issued.  At this consultation they did not discuss prescribing Tramadol. After receiving the prescription, the Doctor altered it by adding a prescription for 50 tablets of Tramadol 50mg. The Doctor presented the altered script to a pharmacist at a second pharmacy.  The pharmacist was suspicious and contacted the prescribing practitioner to verify the script.

The Doctor accepted the charge in relation to the first and second particulars and for the most part, the third particular but debated what occurred at the second pharmacy and the communication between the Doctor and the pharmacist at this pharmacy.

Finding

The Tribunal found the charge fully established.  

Tramadol has the risk of addiction and is a psychotropic medication.  It is therefore never appropriate to self-prescribe. The Tribunal accepted that the doctor was either naïve or was unaware of the requirements to avoid self-prescribing.  While ignorance is not an excuse the Tribunal found that on its own, particular 1 was not a serious departure from expected standards on this occasion.

The Tribunal found particular 2 did amount to malpractice and conduct likely to bring discredit to the medical profession.

In relation to particular 3, the Tribunal considered that on the balance of probabilities when the Doctor presented the altered prescription to the pharmacist at the second pharmacy, he knew or ought to have known that the pharmacist would likely conclude the prescribing practitioner had prescribed Tramadol.  

The Tribunal considered the Doctor’s conduct set out in Particular 3 was his most serious breach of professional standards and amounted to professional misconduct under s 100(1)(a) and (b) of the Act.

The Doctor’s conduct was considered a serious departure from professional standards and warranted disciplinary sanction

Penalty 

The Tribunal:
•    Censured the doctor.
•    Placed conditions on the doctor’s practice for 18 months
•    Fined the doctor $2,500.
•    Ordered the doctor to pay 35% of the costs of and incidental to the hearing.

The Tribunal directed publication of the decision and a summary.