Ladhams v Medical Board of Australia (No 2)

This case concerns an application by Dr Andrew Ladhams, a medical practitioner, to review a decision of the Medical Board of Australia to take immediate action in respect of his registration as a medical practitioner. The Board had imposed conditions upon the registration of Dr Ladhams, which were later varied, and which this Tribunal is asked to review. The Board's decision to take immediate action was based on a reasonable belief that Dr Ladhams' conduct, or performance, posed a serious risk to the public and that it was necessary to take that immediate action to protect public health and safety. The conditions imposed on Dr Ladhams' registration prohibited him from treating Lyme Disease in any patient without first obtaining an opinion from an infectious disease specialist and from inserting peripherally inserted central catheters or other forms of central venous catheters in any patient. The Tribunal removed those conditions and imposed others in their place.

The issues which the Tribunal was required to determine were whether Dr Ladhams posed a serious risk to the public and, if so, what conditions should be imposed on his registration in order to address the identified risk. The Tribunal considered that there was a real and serious risk that Dr Ladhams was misdiagnosing Lyme Disease in his patients. The methodology which he applied in making those diagnoses was, in the Tribunal's view, biased towards a diagnosis of Lyme Disease. The Tribunal found that the risk of misdiagnosis gave rise to a real and serious risk that some other condition from which the patient suffers would remain undiagnosed and untreated. This is particularly so when there appeared to be a predisposition or bias towards the diagnosis of Lyme Disease. The Tribunal also found that it was necessary to impose conditions on Dr Ladhams' registration in order to protect the public from the identified risks. The Tribunal did not believe that the conditions imposed by the Board, or those now proposed by it, were appropriate to manage the identified risks. The Tribunal considered that the conditions imposed should address the relevant risks specifically, and otherwise be the least onerous possible. The Tribunal imposed new conditions on Dr Ladhams' registration, which required him not to diagnose or treat Lyme Disease without obtaining a positive diagnosis of Lyme Disease from a laboratory accredited by the National Association of Testing Authorities (NATA) using Centres for Disease Control (CDC) criteria. The Tribunal also required him not to treat any patient for Lyme Disease with intravenous antibiotics without having referred the patient to an Infectious Diseases Specialist for the development of a written medical treatment plan. He must obtain the approval of the Medical Board of Australia to refer patients to that specialist for that purpose. He must only treat any patient referred to an Infectious Diseases Specialist pursuant to the condition in accordance with the written medical treatment plan developed by the Specialist.