Psychiatrist Dr Paul Fox resigned from Waikato DHB in early 2014 but a patient says he complained about Fox's treatment and raised concerns over his medical licence in April 2013. Photo / File
A former patient of a notorious American psychiatrist claims he alerted hospital staff to the doctor's de-registration in the United States eight months before it came to light.
Dr Paul Fox was employed by Waikato District Health Board in 2012, the same year he surrendered his psychiatry licence in New York and Connecticut amid controversy over an affair with a teenage patient.
After the Herald revealed in January 2014 that Fox was not registered in his home country and had left under a cloud, he resigned and his New Zealand provisional registration was cancelled by the Medical Council.
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But Waikato DHB says it acted on the information the patient gave staff about Fox's registration and began an investigation in 2013.
Fox, who treated Sandy Hook shooter Adam Lanza five years before he went on to kill 26 staff and pupils at his former school, eventually returned to America, where he was last year jailed for the sexual assault of the 18-year-old woman.
But before his past was publicly exposed, a patient at the Henry Rongomau Bennett Centre at Waikato Hospital where Fox worked, lodged several complaints about the psychiatrist.
Phil Brooks also warned hospital staff that Fox had surrendered his licence in America, showing them an affidavit signed by a Hamilton Justice of the Peace in July 2012, referencing the voluntary surrender.
Now 64, Brooks was admitted to the mental health facility in April 2013 after he tried to take his own life.
The next day Fox conducted an assessment that Brooks describes as disturbing.
"After the first consultation with Paul Fox I knew that there was something very wrong with that man and that was the catalyst for investigating him on Google."
Brooks, a polytech lecturer who had suffered depression for a decade, said Fox referred to his suicide attempt as "self-murder", which he found confrontational.
"He was extremely provocative and aggressive in his manner. He actually admitted that he liked provoking people."
Compared to other mental health providers, Brooks found Fox's bedside manner dangerously ill-equipped to assist his recovery.
"You don't provoke and attack somebody who is mentally ill. You're going to increase their levels of stress and distress and make them more desperate."
He made a handwritten complaint on the form available in the ward and at the same time says he showed staff the surrender documents.
When Brooks questioned Fox about his behaviour, the psychiatrist refused to be his doctor.
A week later Brooks was discharged, and on May 13, 2013 he wrote a formal complaint to Fox accusing the psychiatrist of trying to destabilise him, being culturally insensitive, and inflammatory.
He said Fox insulted and humiliated him in front of the assessment panel and wrote him off as mentally disordered.
It was the same day the New York State Board of Professional Misconduct made a charge of professional misconduct against Fox, a document searchable online.
In September that year, Brooks wrote to Waikato DHB reiterating his concerns, which had also been expressed in a phone call to the DHB.
He wrote that Fox had breached his right to be treated with respect, to be fully informed and to services of an appropriate standard.
Brooks asked that his complaints about Fox be investigated, that Fox's competence and fitness to practice be assessed, that any diagnosis the psychiatrist made of Brooks be removed from his file, and that any other complaints about Fox be investigated.
Brooks relocated to Australia in March 2014, and was not aware until recently that Fox's past had been made public or that the doctor had returned to the US and was now in jail.
In June last year, when Fox pleaded guilty to sexual assault, Waikato DHB executive director of Mental Health and Addiction Services Vicki Aitken told the Herald the DHB had become aware of the specific details of that complaint against Fox in January 2014.
"We commissioned an independent external review by a senior psychiatrist into Dr Fox's practice at the DHB. This found no issues, therefore we have no need to relook at his patients."
But Brooks, now fully recovered, retired and back in New Zealand, said he does not recall being contacted about his complaints against Fox by the senior psychiatrist.
"They knew from April 11 or shortly thereafter that there were problems with Paul Fox and my treatment," he said.
"I raised these issues, which they never really addressed properly, so I don't see how a review can say there were no issues because quite clearly there were significant issues."
Waikato DHB hospital and community services executive director Leena Singh said the DHB did investigate Brooks' complaints and responded to his requests.
"The complaints and subsequent investigations did not identify any issues or concerns with clinical competence."
Singh said the DHB investigated the information Brooks supplied about Fox's surrendered licence and that it did this before Fox was exposed on January 1, 2014.
However, it is not clear what, if any, action was taken by the DHB over the surrendered licence.
It was only when media reported the situation some eight months later, that Fox resigned.
"Given the unusual nature of Dr Fox's surrender it would have been prudent to contact the US and conduct a thorough review," Brooks said.
He accused the DHB of being negligent by allowing Fox to continue treating seriously ill patients, and believed the matter should be re-investigated.
Fox worked at the DHB for 19 months, initially as a locum and then under supervision.
In May 2016, RNZ reported Fox had told the DHB around the time he was recruited that there had been a complaint laid against him in Connecticut, but he gave no details and further inquiries by the DHB revealed nothing of concern.
Singh said the date any investigation of Fox began was not available.
The Herald put a series of extra questions to the DHB including what action was taken once the DHB became aware of Fox's deregistration, but the DHB said it would treat the questions as an Official Information Act [OIA] request, which gives it 20 working days to respond.
The Herald has twice requested the senior psychiatrist's independent review from the DHB under the OIA, but the DHB withheld it, stating that as an employer it must protect the privacy of former employees.
In a response to those OIAs last year, Aitken said concerns were identified in relation to "professional conduct issues overseas and prior to Dr Fox's employment with Waikato DHB, which were not disclosed as part of the initial recruitment process for Dr Fox".
"As a result, Waikato DHB undertook a series of actions relating to Dr Fox, including
detailed communication with the Medical Council of New Zealand.
"Dr Fox subsequently resigned from his position at Waikato DHB and we have had no further contact with, or about him since 2014."
In another response Aitken said: "... there were and remain no clinical concerns relating to Dr Fox's practice identified at any time during, or subsequent to his employment with Waikato DHB".
However, Jane Stevens, the mother of Nicky Stevens, who took his own life while in Waikato DHB care in March 2015, said she was "absolutely disgusted" when it was discovered Fox was working in New Zealand after surrendering his licence over "boundary violations".
"I was really concerned about obviously the fact that he was treating our son and basically had access to vulnerable people, including our son. You don't know what went on."
Stevens called Brooks' case a prime example of serious concerns being raised but nothing coming of it until Fox was exposed publicly.
"Dr Fox was the person who put Nicky on the drug regime that he was on right up until he died, and that has huge concerns for me.
"There's big questions now around Adam Lanza's drug regime, and nobody's ever addressed that.
"This needs to be re-visited and there needs to be some accountability and transparency."
According to American court documents, police detectives investigating the December 2012 Sandy Hook Elementary School massacre discovered a female patient had told another doctor in March 2012 of her year-long affair with Fox, sparking the de-registration.
The then 18-year-old university student, identified as Jane Doe in court records, had begun seeing Fox in 2011 for treatment of depression and an eating disorder, and at some point he began having sex with her.
The woman told investigators about the sexual relationship, saying she was "drugged up and out of my mind" on a cocktail of prescription drugs that Fox had prescribed.
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