A doctor who self-prescribed Tramadol, an opioid pain medication, has been found guilty of professional misconduct but has avoided being struck off.
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The Health Practitioners Disciplinary Tribunal heard the matter between the doctor and a Professional Conduct Committee over four days in August last year.
In 2019, the doctor, who has permanent name suppression, attended a medical course at the University of Otago in Dunedin when he prescribed the medication to himself to treat an ankle injury.
According to the summary of facts, the doctor visited a pharmacy and in front of the pharmacist, wrote a prescription for himself for antihistamine Loratadine, antibiotic Flucloxacillin, and painkiller Tramadol.
The pharmacist dispensed the Loratadine and Flucloxacillin but did not dispense the Tramadol, to which the doctor replied “that’s fine”.
Following this, the doctor had a consultation with another doctor, Doctor S, and was given a prescription. There was no discussion of any need for Tramadol.
The doctor went to a different pharmacy to present this prescription, but before handing it to the pharmacist he wrote on the same form a prescription for 50 tablets of Tramadol, 50mg.
The doctor was charged with professional misconduct for writing and presenting a prescription for his own use for Loratadine, Flucloxacillin, and Tramadol, altering a prescription to include Tramadol alongside the prescribed drug, and presenting that prescription to a pharmacist.
The doctor accepted some details of the charges but did not accept he knew or ought to have known that the second pharmacist would think Dr S wrote the Tramadol prescription.
The second pharmacist said she noticed the prescription for Tramadol was written in a different colour to the rest of the prescription and questioned the doctor on this to which he said both prescriptions were written by Dr S.
The pharmacist said she noticed “red flags” and told the doctor she would need to confirm this with Doctor S and would call him in the morning to rearrange collection, which resulted in alerting the Health Practitioners Disciplinary Tribunal.
The doctor said he was in pain, under stress and under pressure from the course he was attending which led him to make the “rash” decision to present the prescription in the way he did.
However, the doctor said he told the pharmacist he wrote the Tramadol prescription, not Doctor S.
The doctor’s lawyer, Matthew McClelland QC, said the charge related to moments in time, not a pattern of behaviour.
However, the tribunal found the doctor knew, or ought to have known, that by presenting the prescription to the second pharmacist, it was likely she would conclude the Tramadol prescription was written by Dr S.
The tribunal was satisfied this kind of conduct amounted to negligence and malpractice within the medical profession. He was found guilty and censured.
The doctor must engage with a mentor to ensure he has appropriate strategies when faced with personal issues and stressful situations and is required to advise all current and future employers of the tribunal’s decision and its orders.
The doctor’s prescribing to himself will be monitored by obtaining dispensing information from the Ministry of Health every six months and he is ordered to pay a fine of $2500 and a contribution of $36,000 for the total costs of the hearing.
* This story originally appeared in the New Zealand Herald.
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