Health Practitioners Disciplinary Tribunal decisions
The Health Practitioners Disciplinary Tribunal (The Tribunal) has asked us to publish a summary of its recent decisions. You can access the full decision on their website at the links provided.
Dr Joseph WILLIAMS – Med 16/371P
Charge
At a hearing held from 31 July to 10 August 2017, the Tribunal considered two charges laid by the Professional Conduct Committee (PCC) against Dr Joseph Williams, registered medical practitioner of Auckland. The Tribunal treated the two charges as one charge but with two categories.
Category 1 concerned prescribing a combination of a potent topical steroid and an antifungal cream in circumstances that amounted to professional misconduct in respect of 12 patients.
Category 2 concerned providing dietary advice in circumstances that departed from accepted medical practice or that resulted in actual harm to the patient.
Certain particulars of the charge also referred to issues concerning note-taking in the context of the prescribing of the medicines to the patient.
Findings
Category 1 of the charge was upheld. While Dr Williams may have used the mixture of the steroid and the antifungal cream with significant success, on the evidence before the Tribunal the use of the mixture for the individual cases was inappropriate and/or excessive.
The Tribunal was concerned that Dr Williams mixed the two medicines without himself having conducted any proper validated analysis of the consequences and without adequate formal research. A further major factor was that Dr Williams in many cases, prescribed the mixture in the face of concerns being expressed to him by other professionals whose views he should have respected and taken into account.
Category 2 of the Charge was also upheld. The dietary advice was inappropriate in the particular circumstances of the patient and brought harm to the patient.
The Tribunal also found Dr Williams’ note-taking to be inadequate.
Penalty
The Tribunal censured Dr Williams, fined him $10,000 and imposed conditions on his practice. The Tribunal ordered Dr Williams to pay a total contribution of $145,000 towards the costs of the Tribunal and the PCC.
The Tribunal directed publication of its decision and a summary.
Appeal
The Doctor appealed to the High Court against the Tribunal’s decision. The appeal was dismissed. Williams v PCC [2018] NZHC 2472.
The full decision of the Tribunal can be found here .
Dr H – Med17/378D
Charge
The Tribunal considered a charge of professional misconduct laid by the Director of Proceedings against Dr H, registered medical practitioner.
Particular 1 of the charge alleged that on four separate occasions when the patient who was over 50 years of age presented with dysphagia and or continuing weight loss, Dr H failed to refer the patient for an endoscopy and/or to a specialist. Particular 2 of the charge alleged that Dr H failed to communicate adequately with the patient to clarify his symptoms.
The medical practitioner accepted they had failed to properly refer the patient to a specialist or for an endoscopy. The medical practitioner believed they were blinkered by their initial diagnosis of gastritis. However, the medical practitioner accepted that by the third consultation, a referral for gastroscopy should have been done. There was no admission that this was professional misconduct, simply, that it was negligence at that point not to have made the referral.
Finding
The Tribunal found that Particular 1 of the charge was established as professional misconduct, warranting disciplinary sanction. It was satisfied that the failure to refer was negligent from the outset at the first consultation and remained so at each of the successive consultations.
The Tribunal found Particular 2 of the charge not established and that Dr H had not failed to communicate with the patient as charged.
Penalty
Dr H was censured, ordered to pay 30 percent of the costs of the Tribunal and the Director of Proceedings amounting to $21,636.
The Tribunal ordered permanent suppression of Dr H’s name and directed publication of its decision and a summary.
Dr H appealed the decision of the Tribunal to the High Court. The appeal was dismissed H v Director of Proceedings [2018] NZHC 2175
The full decision of the Tribunal can be found here .
Dr Martyn HOWELLS – Med 18/416P
Charge
On 17 July 2018 by video conference, the Tribunal considered a charge laid by the PCC against Dr Martyn Howells, medical practitioner of Dunedin.
The charge alleged that Dr Howells had between 2004 and 2010 altered the medical records of 12 patients resulting in a financial benefit of $3,929 to which his practice was not entitled.
Findings
The hearing proceeded on an agreed summary of facts basis. The Tribunal was satisfied that the charge was established and made out as misconduct. The Tribunal also noted that Dr Howells had repaid the $3,929 in December 2015.
Penalty
The Tribunal censured Dr Howells and imposed conditions on his practice for a period of 3 years. The Tribunal ordered him to pay a contribution of $20,000 towards the total costs of the PCC and $6,000 towards the costs of the Tribunal.
The Tribunal directed publication of its decision and a summary. The decision can be viewed on the Tribunal’s website here .
Dr Hirron FERNANDO – Med 16/352P
Charge
On 19 September 2016 the Health Practitioners Disciplinary Tribunal considered a charge laid by the Professional Conduct Committee against Dr Hirron Fernando, registered medical practitioner formerly of Hawkes Bay (the Doctor).
The charge alleged that the Doctor, registered in New Zealand but practising overseas, contacted New Zealand district health boards requesting health information and/or medical records for patients he falsely claimed he was treating in the United Kingdom. The Doctor then went on to use the information in a court in the United Kingdom for his own private purpose, without the consent of the patients.
The Doctor did not appear at the hearing, nor was he represented. The hearing proceeded on a formal proof basis.
Finding
The Tribunal was satisfied that the charges were made out as professional misconduct and were sufficiently serious to warrant disciplinary sanction.
The Tribunal noted that an unusual feature of this case was that during the period of time in which the Doctor conducted himself in this way, although a New Zealand registered doctor, he did not hold a current practising certificate and was living and working abroad.
Penalty
The Tribunal censured the Doctor and cancelled his registration. The Tribunal ordered costs of $30,428.77 towards the Tribunal’s costs and $26,480.40 towards the PCC’s costs.
The Doctor appealed the decision of the Tribunal to the High Court on the grounds the Tribunal had no jurisdiction to make the orders it made. The High Court dismissed the Doctor’s appeal.
The full decision of the Tribunal can be found at https://www.hpdt.org.nz/Charge-Details?file=Med16/352P
Dr Stephen JOHNS – Med 15/318D
Charge
On 07 – 11 March 2016 the Health Practitioners Disciplinary Tribunal considered a charge laid by the Director of Proceedings (DP) against Dr Stephen Johns, medical practitioner of Auckland (the doctor).
The charge alleged that Dr Johns failed to respond appropriately to an abnormal and progressively pathological foetal cardiotocograph indicating severe foetal compromise and failed to communicate with the patient and/or the patient’s husband.
Dr Johns denied the charge of professional misconduct but accepted that the failed to respond in a clinically appropriate manner as the situation unfolded and he failed to communicate effectively with the patient and her husband. The hearing proceeded by way of a defended hearing.
Finding
The Tribunal was satisfied that both charges were made out and professional misconduct had been established in this case that warranted disciplinary sanction.
Penalty
The Tribunal censured Dr Johns; imposed a fine of $7,000 and imposed conditions on his practice for a period of 3 years. Dr Jones was ordered to pay 30% of the total costs, as a contribution to costs of the Tribunal and PCC.
Dr Johns appealed the Tribunal’s findings that his conduct amounted to professional misconduct. The DP cross appealed against the doctor's permanent name suppression.
The High Court dismissed Dr John's appeal and allowed the appeal on name suppression.
The full decision of the Tribunal can found at https://www.hpdt.org.nz/Charge-Details?file=Med15/318D
Dr O – Med 16/375P
Charge
At a hearing held on 15 – 17 May 2017 the Health Practitioner’s Disciplinary Tribunal considered a charge laid by the Professional Conduct Committee (PCC) against Dr O,
(the Doctor) of Auckland.
The charge alleged that the Doctor used incorrect laser settings while treating his patient; recorded the incorrect settings in the patient notes; retrospectively altered the laser settings recorded in the clinical records and falsely advised or mislead the DHB, the Medical Council and the PCC of the laser settings. While suspended from his employment with the DHB, the Doctor breached conditions of his suspension by entering the DHB premises. It is further alleged that the Doctor misled or attempted to mislead the Chief Medical Officer of the DHB in the change of his supervisor.
The charges were defended by the Doctor.
Findings
The Tribunal found that by a “fairly fine margin” particular 1 of the charge was not established. Particular 2 and 3 were both not established by the PCC.
The Tribunal noted that this whole matter had its genesis in concerns with the DHB about the Doctor’s performance and competence and the Tribunal was is in no position to reach views about this. The Tribunal went on to say that this was not the appropriate forum for addressing such matters.