According to an agreed summary of facts, Dr I was the general practitioner and medical director at an Auckland clinic where Dr A worked part-time from 2018 to 2019.
In August 2018, she became a casual patient at Dr I’s clinic while she was still working there - despite having her own GP.
Records showed Dr I saw her for consultations 28 times until 2020, dispensing 127 medications to her including codeine, tramadol, zopiclone, lorazepam, and clonazepam.
Codeine and tramadol were potentially addictive drugs, while lorazepam and clonazepam were Class C controlled drugs.
Dr I accepted he issued 61 of the prescription items, but claimed the rest were falsified by Dr A who allegedly manipulated security flaws in the clinic’s computer system.
At the same time, Dr A’s own GP was also prescribing zopiclone and lorazepam for her.
“[Dr I] entrusted [Dr A] with the role of co-ordinating her care between himself and [her GP], but he did not put in place any systems to co-ordinate her care over and above that,” said Robert Stewart, counsel for the Professional Conduct Committee (PCC), which brought the charges against Dr I.
In 2019, the Medical Council’s Health Committee notified Dr I of a disciplinary decision against Dr A, where she was found to have a substance use disorder as well as disordered personality traits that affected her ability to practise medicine.
Dr I received the email but did not pay sufficient attention.
“I didn’t read the attachments on the email, it was my fault,” he told the tribunal on Monday afternoon.
The PCC said Dr I would have had an early warning of medication overuse had he kept accurate records of the actual amounts of opioids, benzodiazepines, and sedatives prescribed to Dr A.
“Instead, he treated acute migraine and acute anxiety well outside New Zealand guidelines, thus enabling drug misuse and dependence,” Stewart said, reading from the agreed summary.
Dr I’s clinical notes also did not sufficiently explain the “high quantities of medications with the potential for misuse”.
The PCC charged him with treating and prescribing inappropriate amounts of drugs to someone he was close to, doing so without properly assessing her medical history or taking proper notes, and even after being notified of her substance use disorder.
Dr I accepted he was at fault and accepted the charges on Monday - his treatment of Dr A was inappropriate because it “blurred boundaries” and potentially affected his clinical objectivity, he told the tribunal in writing.
Doctors are bound by a professional code not to treat themselves or people who are close to them except in exceptional circumstances.
A Medical Council statement also specified that doctors must not prescribe controlled drugs or drugs that pose a risk of addiction or misuse to people close to them.
The tribunal found Dr I guilty of negligence amounting to professional misconduct likely to bring discredit to the medical profession, and this warranted disciplinary sanction.
Tribunal chair Alison Douglass reserved the decision on whether Dr I’s conduct amounted to malpractice.
The hearing continues tomorrow on penalties.
