Health Ombudsman v White

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QUEENSLAND CIVIL AND
ADMINISTRATIVE TRIBUNAL


CITATION:

Health Ombudsman v White  [2019] QCAT 36

PARTIES:

HEALTH OMBUDSMAN
(applicant)

v

HAYDEN THOMAS WESLEY WHITE

(respondent)

APPLICATION NO/S:

OCR298-17

MATTER TYPE:

Occupational regulation matters

DELIVERED ON:

7 March 2019 and 1 May 2019

HEARING DATE:

19 July 2018

HEARD AT:

Brisbane

DECISION OF:

Judge Sheridan

Assisted by:
Dr G Powell
Dr D Evans
Mr M Halliday

ORDERS:

1. Pursuant to s 107(2) of the Health Ombudsman Act 2013 (Qld), the respondent has behaved in a way that constitutes professional misconduct.

2. Pursuant to s 107(3) of the Health Ombudsman Act 2013 (Qld), the respondent be reprimanded.

3. Pursuant to s 107(3) of the Health Ombudsman Act 2013 (Qld), the respondent is fined an amount of $5,000 to be paid to the Health Ombudsman in five equal instalments payable by the end of each month with the first payment due by 31 March 2019.

4.   Each party bear their own costs.

CATCHWORDS:

PROFESSIONS AND TRADES – HEALTH CARE PROFESSIONALS – MEDICAL PRACTITIONERS – DISCIPLINARY PROCEEDINGS – PROFESSIONAL MISCONDUCT AND UNPROFESSIONAL CONDUCT – DEPARTURES FROM ACCEPTED STANDARDS – where the practitioner admitted to unlawfully misappropriating and self-administering Schedule 8 controlled drugs over a six month period – where, at the time of the conduct, the practitioner had an impairment – where the practitioner admitted to professional misconduct – whether the practitioner should be subject to a reprimand and/or a period of suspension or fine

Health Ombudsman Act 2013 (Qld), s 103, s 104, s 107
Health Practitioner Regulation National Law(Queensland), s 5
Public Service Act 2008 (Qld), s 188

Medical Board of Australia v Andrew [2015] QCAT 94, distinguished.
Medical Board of Australia v Dr “C” [2012] SAHPT 4, distinguished.
Medical Board of Australia v Henning [2014] SAHPT 15, distinguished.
Medical Board of Australia v Stephens [2018] WASAT 13, distinguished.

APPEARANCES & REPRESENTATION:

Applicant:

M T Hickey, instructed by the Office of the Health Ombudsman

Respondent:

G W Diehm QC, instructed by Ashurst Australia

REASONS FOR DECISION

  1. On 20 December 2017, the Health Ombudsman referred to the Tribunal a health service complaint against the respondent pursuant to s 103(1)(a) and s 104 of the Health Ombudsman Act 2013 (Qld) (HO Act).  The matters alleged in the disciplinary referral arose from a self-disclosure notification made by the respondent.

  2. There are three charges the subject of the referral, which relate to the respondent’s conduct whilst working as the director of the intensive care unit at a metropolitan hospital (the ICU).  In summary, by the charges it is alleged that between May 2013 and mid-November 2013:

    (a)Charge 1 – the respondent misappropriated a Schedule 8 drug, Fentanyl, from his employer, in that he diverted Fentanyl intended to be discarded in the intensive care unit for the purposes of self-administration;

    (b)Charge 2 – the respondent unlawfully possessed a Schedule 8 drug, Fentanyl, in that he took possession of the drug in the manner outlined in charge 1 for the…

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Details
Case
[2019] QCAT 36
Decision Date

CaseChat Overview and Summary

Health Ombudsman v White was a disciplinary proceeding brought against a medical practitioner in Queensland. The respondent, a director of intensive care medicine, admitted to professional misconduct by misappropriating and self-administering Schedule 8 controlled drugs over a six-month period. The respondent had a history of anxiety and depression, which had worsened due to stress, leading him to misuse Fentanyl to manage his symptoms. Both the Health Ombudsman and the respondent filed submissions on the appropriate sanction for the misconduct. The Ombudsman argued for a six-month suspension or, alternatively, a reprimand and a $25,000 fine, while the respondent argued for a reprimand without suspension or fine.

The court considered the severity of the misconduct and the respondent's personal circumstances, including his mental health issues and lack of intent to harm patients. The court found that while the respondent's actions were serious, his cooperation and remorse, along with his mental health condition, warranted a less severe penalty than proposed by the Ombudsman. The court concluded that a reprimand and a fine of $5,000 were appropriate sanctions, with the fine to be paid in five equal instalments. Each party was ordered to bear their own costs.

In summary, the court reprimanded the respondent and imposed a fine of $5,000 for his professional misconduct, taking into account his mitigating factors and the lack of harm to patients.

Orders

Orders of the court

1. Pursuant to s 107(2) of the Health Ombudsman Act 2013 (Qld), the respondent has behaved in a way that constitutes professional misconduct.

2. Pursuant to s 107(3) of the Health Ombudsman Act 2013 (Qld), the respondent be reprimanded.

3. Pursuant to s 107(3) of the Health Ombudsman Act 2013 (Qld), the respondent is fined an amount of $5,000 to be paid to the Health Ombudsman in five equal instalments payable by the end of each month with the first payment due by 31 March 2019.

4. Each party bear their own costs.

Background

Background to the litigation

The parties did not reach agreement as to sanction and each party filed separate submissions. The Health Ombudsman submits that the appropriate sanction is that the respondent be suspended from practice for six months, or, in the alternative that the respondent be reprimanded and fined $25,000. The respondent submits that a reprimand is the most appropriate sanction, and that neither a suspension nor a fine is necessary. Factual backgroundProfessional background In 1990, the respondent completed a bachelor of medicine and a bachelor of surgery overseas. After working and studying overseas, the respondent moved to Brisbane in 2002, where he completed an intensive care fellowship at two metropolitan hospitals in Brisbane. In 2006, after working in anaesthetics at a Brisbane metropolitan hospital, the respondent was appointed Director of the ICU. Subsequently, he completed a graduate certificate in health economics and a fellowship in respiratory medicine, and then completed his fellowships with the College of Intensive Care Medicine of Australia and New Zealand and the Royal Australasian College of Physicians, Adult Medicine Division. The respondent has currently stepped aside as the director in order to have greater time for research.Personal circumstances The respondent was first diagnosed with an anxiety disorder in his early 20s after moving overseas to study and being separated from his family and a familiar environment. This has at times developed into significant episodes of depression. The respondent had taken antidepressants at times, namely, Prozac, as well as Lexotan sporadically in order to treat his anxiety. His condition did not interfere with his daily life or work. From in or about 2002, after coming to Australia it seems that the respondent did not experience any significant problems with his mental health. However, the respondent’s health began to deteriorate in 2011 due to a number of stressors. The respondent’s underlying anxiety condition worsened, and in 2012 he began again taking Prozac for his anxiety, as well as Lexotan occasionally. Unfortunately, by May 2013, he was feeling increasingly overwhelmed. Misconduct The respondent began to self-administer Fentanyl by way of injection in the bathroom of the Hospital in an effort to manage his considerable situational stress. He found that the Fentanyl took “the edge off” his anxiety. Initially, the respondent administered around 20 mg between one or two times a week. The dose steadily increased to 50 mg and then to 70 mg. The respondent’s use increased to such an extent that eventually he was taking Fentanyl twice daily up to five or six times a week. The respondent would obtain the Fentanyl from discarded Fentanyl leftover from patients. Within the ICU at that time, no record was kept of discarded Fentanyl. This system enabled the respondent to systematically misappropriate small amounts without detection. It is not alleged that the respondent diverted any Fentanyl which had been intended for the direct use of patients.

Evidence

Evidence Before The Court

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Decision

Reasons for decision

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Ratio Decidendi

Legal Principle Established

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