Medical Radiation Technologists Board of Queensland v Sanderson
[2012] QCAT 107
•13 March 2012
| CITATION: | Medical Radiation Technologists Board of Queensland v Sanderson [2012] QCAT 107 | |
| PARTIES: | Medical Radiation Technologists Board of Queensland (Applicant) | |
| v | ||
| Laura Jane Sanderson (Respondent) | ||
| APPLICATION NUMBER: | OCR175-11 |
| MATTER TYPE: | Occupational regulation matters |
| HEARING DATE: | On the papers |
| HEARD AT: | Brisbane |
| DECISION OF: | Judge Fleur Kingham, Deputy President Assessors Martin Buckley Greg Rattray Jennifer Felton |
| DELIVERED ON: | 13 March 2012 |
| DELIVERED AT: | Brisbane |
ORDERS MADE: | 1. Ms Sanderson is reprimanded. 2. Ms Sanderson is prohibited from applying for registration until the following conditions have been satisfied: a. A period of nine months has elapsed from the date of these orders; b. Ms Sanderson must undergo treatment for her alcohol dependence with a psychiatrist specialising in addiction medicine. The psychiatrist must be nominated by Ms Sanderson and approved in writing by the Board. Ms Sanderson must provide the psychiatrist with a copy of these orders, the Tribunal’s reasons and the report of Dr David Storor dated 28 March 2011. The treatment must be at the frequency and for the duration as determined by the psychiatrist. Ms Sanderson must be fully compliant with this treatment, including all directions and taking any medications prescribed by the psychiatrist, for a period of not less than six months immediately prior to lodging the application with the Board (‘the 6 month period’); c. Ms Sanderson must undergo monthly haematological testing (Carbohydrate Deficient Transferrin (CDT), Liver Function (LF) and Mean Corpuscular Volume (MCV)) to demonstrate total abstinence from alcohol consumption during the six month period, or such longer period as determined by the psychiatrist; d. Ms Sanderson has provided to the Board a report of the psychiatrist advising that Ms Sanderson is fit to return to practise. 3. The following conditions must be imposed upon any future registration of Ms Sanderson for a period of not less than 12 months: a. Ms Sanderson must remain totally abstinent from alcohol. b. Ms Sanderson must continue treatment with the psychiatrist at the frequency and for the duration as determined by the psychiatrist. Ms Sanderson must be fully compliant with this treatment, including all directions and taking any medications prescribed by the psychiatrist. Ms Sanderson will authorise the psychiatrist to report to the Board as to Ms Sanderson’s health status as the psychiatrist sees fit, or as requested by the Board. c. Ms Sanderson must undergo alcohol breath testing in accordance with the Board’s protocol. d. Ms Sanderson must undergo haematological testing (CDT, LT and MCV) in accordance with the Board’s protocol. Attendance for such testing shall occur within seven days of this condition becoming effective, unless otherwise directed by the Board. e. Ms Sanderson must not work in sole practice. f. Ms Sanderson must work only in a supervised position as nominated by Ms Sanderson and approved in writing by the Board. Ms Sanderson must recruit a radiographer colleague of not less than five years experience (to be nominated by Ms Sanderson and approved in writing by the Board) to act as a workplace supervisor. g. Ms Sanderson must provide a copy of these orders and the Tribunal’s reasons to both the supervisor and her employer. Ms Sanderson must authorise, in writing, both the supervisor and her employer to report to the Board as to Ms Sanderson’s competence and fitness to practice: i. If the supervisor or employer have a concern about Ms Sanderson’s competence and fitness to practice; ii. As requested by the Board; and iii. In any event, at three monthly intervals. h. Ms Sanderson will notify the psychiatrist and the Board immediately upon becoming aware of any material change in her health. i. Ms Sanderson will authorise the Board, in writing, to advise both the supervisor and her employer if notified by the psychiatrist (pursuant to paragraph 3(b) of these orders) or Ms Sanderson (pursuant to paragraph 3(g) of these orders) of any concerns in respect of Ms Sanderson’s health status. 4. Ms Sanderson must bear all costs of and associated with compliance with paragraphs 2 and 3 of these orders. 5. Ms Sanderson must pay the Board’s costs of and incidental to these proceedings on the standard basis on the District Court scale as agreed, or failing agreement as assessed by QICS, within one month of the Tribunal fixing those costs (or such further time as the Board may allow). 6. Publication of the medical records pertaining to Ms Sanderson filed in these proceedings, other than the report of Dr Storor, is prohibited. |
| CATCHWORDS: | HEALTH PRACTITIONER – GROUND FOR DISCIPLINARY ACTION – where the registrant could not be located during a shift – where the registrant was intoxicated while on shift – where the registrant did not cause harm to a patient or colleague – where conduct constituted unsatisfactory professional conduct HEALTH PRACTITIONER – GROUND FOR DISCIPLINARY ACTION – IMPARMENT – where registrant suffers from alcohol dependency HEALTH PRACTITIONER – CONDITIONS OF APPLICATION FOR REGISTRATION – where joint submissions were made – where the registrant is no longer registered to practice – where registrant no longer resides in the jurisdiction – where the registrant has sought treatment for alcohol dependency HEALTH PRACTITIONER – DISCIPLINARY ACTION – COSTS – where the registrant has assisted the Tribunal HEALTH PRACTITIONER – DISCIPLINARY ACTION – NON PUBLICATION – where the registrant’s medical records form part of the proceedings – where registrant’s medical records contain confidential information Queensland Civil and Administrative Tribunal Act 2009, s 66(2)(d) Health Practitioners (Professional Standards) Act1999, ss 9, 124(1)(a), 142(2), 243 Health Practitioner Regulation National Law, ss 140, 142 |
APPEARANCES and REPRESENTATION (if any):
This matter was heard on the papers in accordance with section 32 of the Queensland Civil and Administrative Act 2009.
REASONS FOR DECISION
Background
Ms Sanderson was a registered medical radiation technologist from 18 July 2007 until 30 June 2011 when she let her registration lapse. The Board commenced these disciplinary proceedings after a workplace incident on 26 August 2010, when Ms Sanderson was found to be heavily intoxicated. She was then working as a radiographer at the Princess Alexandra Hospital. She entered a rehabilitation facility as an in-patient. Shortly after her discharge, she joined her husband who was then working in the United States, where they currently reside.
The Board alleges two grounds for taking disciplinary action against Ms Sanderson:
(a) That she has behaved in a way that constitutes unsatisfactory professional conduct[1]; and
(b) That she suffers from an impairment[2].
[1]Health Practitioners (Professional Standards) Act1999, s 124(1)(a); Schedule definition of unsatisfactory professional conduct.
[2]Health Practitioners (Professional Standards) Act1999, s 142(2); Schedule definition of impairment.
Ms Sanderson concedes both grounds. Although she is no longer registered, the Tribunal retains jurisdiction because she was registered at the time of the incident and when she suffered from an impairment[3].
[3]Health Practitioners (Professional Standards) Act 1999, ss 9 and 243.
The conduct
There is no dispute the agreed facts establish grounds to take disciplinary action. On the day in question, Ms Sanderson had consumed a one litre cask of wine at work, with unsurprising consequences. She went missing for three hours during her shift before she was located. Whilst there was no harm caused to any patient or colleague, the potential for harm was real. The Tribunal is satisfied Ms Sanderson’s conduct was of a lesser standard than might reasonably be expected of her by the public or her peers.[4] Her conduct also demonstrated a lack of judgement or care in the practise of her profession.[5]
[4]Health Practitioners (Professional Standards) Act1999, Schedule definition of unsatisfactory professional conduct paragraph a.
[5]Health Practitioners (Professional Standards) Act1999, Schedule definition of unsatisfactory professional conduct paragraph b.
The Tribunal has a report prepared by Dr Storor who treated Ms Sanderson on a number of occasions. Whilst not offering a specific diagnosis, he reported that he treated Ms Sanderson for her problems with managing alcohol. The Tribunal is satisfied that her capacity to fulfil her professional responsibilities was impaired by her dependence upon and abuse of alcohol.
Ms Sanderson, now in her early 30s, says she has been dependant on alcohol throughout her adult life. In the months leading up to the incident, she was drinking on a daily basis, including in the mornings before and during work. She was suffering from some personal stressors at the time.
As might be expected with such a long-standing condition, Ms Sanderson has made previous attempts to deal with her dependence. In November 2008, she underwent treatment at a rehabilitation facility. Between that period of treatment and August 2010, she had two periods during which she relapsed into alcohol abuse.
Ms Sanderson reports she is continuing with her rehabilitation whilst in the United States. The Tribunal does not have any current assessment of her heath status. However, Ms Sanderson has not sought to persuade the Tribunal that she is currently fit to practise as a radiographer. That is a matter best determined if, and when, Ms Sanderson applies for registration.
The sanction
The parties have made a joint submission to the Tribunal for orders that would preclude Ms Sanderson from seeking registration for a further nine months. Having let her registration lapse in August 2010, she will not have practised for more than two years, a significant period out of the profession.
The orders will also preclude her from applying for registration until she can demonstrate that she has undergone six months of treatment for alcohol dependence by a psychiatrist specialising in addiction medicine, during which time she has remained abstinent from alcohol consumption. She will also be required to provide a report from her psychiatrist that she is fit to return to practise.
Once registered, the proposed conditions impose stringent requirements for 12 months. She must:
- remain abstinent from alcohol;
- continue treatment with her psychiatrist;
- undergo rigorous and regular testing;
- not practise as a sole practitioner;
- be subject to supervision;
- authorise her psychiatrist and supervisor to report to the Board; and
- bear the costs of compliance with the conditions.
These conditions address the risk factors involved in Ms Sanderson’s dependence. The Tribunal is satisfied they are adequate to determine when she is fit to return to practise and appropriately monitor her conduct in her first year of registration.
Ms Sanderson has had a long term struggle with alcohol abuse, on her own account. Although this is the first time Ms Sanderson has been the subject of a specific complaint to the Board, the material discloses there was a similar workplace incident at a private facility, which resulted in her employment being terminated. It is concerning that employer did not report her conduct to the Board. Had it done so, as it is now obliged to do[6], Ms Sanderson may have developed insight about the seriousness of her condition and resolved to deal with it properly, at an earlier stage.
[6] Health Practitioner Regulation National Law, ss 140, 142.
Ms Sanderson now appears determined to deal with her condition. Breaking free of a long-standing dependence will require ongoing support and vigilance. The requirements imposed upon Ms Sanderson’s return to practise are onerous. She must comply with them fully if she is to resume and retain her right to professional practice.
Costs
The only matter in dispute between the parties is whether Ms Sanderson should pay the Board’s costs of and incidental to these proceedings. The parties have cooperated to bring this matter to a very speedy resolution. Ms Sanderson’s regret and remorse is evident in the way in which she has conducted herself. The Board accepts her remorse is genuine, as does the Tribunal. Ms Sanderson’s cooperation in the proceedings has ensured that it has proceeded as expeditiously as it possibly could, given her residence is out of the jurisdiction.
The Tribunal has acknowledged Ms Sanderson’s significant cooperation in imposing a preclusion period of only nine months. Her cooperation has also meant that the proceedings have been dealt with more quickly and more cost effectively than they might otherwise have been.
Nevertheless, the Tribunal considers Ms Sanderson should meet the Board’s costs of and incidental to these proceedings. The Board is fulfilling a statutory function in investigating and prosecuting such matters. The costs of doing so are a burden upon the profession as a whole. An order for costs does not cover all of the costs the Board will have incurred in these proceedings. Ms Sanderson will have the benefit of a smaller costs order to meet than she would otherwise have faced had she not cooperated in expediting the proceedings.
Non-publication order
Ms Sanderson has requested a non-publication order in relation to her medical records. The Board has not opposed that request. The Tribunal may make a non-publication order to avoid the publication of confidential information.[7] There is information in Ms Sanderson’s medical records that is confidential, including some details that are not relevant to the issue in these proceedings. The Tribunal considers they should not be on the public record. However, the report of Dr Storor provides the foundation for the Tribunal’s conclusion. Its focus is the conduct under review. It will not be subject to the non-publication order.
[7] Queensland Civil and Administrative Tribunal Act 2009, s 66(2)(d).
Orders
Ms Sanderson is reprimanded.
Ms Sanderson is prohibited from applying for registration until the following conditions have been satisfied:
a.A period of nine months has elapsed from the date of these orders.
b.Ms Sanderson must undergo treatment for her alcohol dependence with a psychiatrist specialising in addiction medicine. The psychiatrist must be nominated by Ms Sanderson and approved in writing by the Board. Ms Sanderson must provide the psychiatrist with a copy of these orders, the Tribunal’s reasons and the report of Dr David Storor dated 28 March 2011. The treatment must be at the frequency and for the duration as determined by the psychiatrist. Ms Sanderson must be fully compliant with this treatment, including all directions and taking any medications prescribed by the psychiatrist, for a period of not less than six months immediately prior to lodging the application with the Board (‘the 6 month period’).
c.Ms Sanderson must undergo monthly haematological testing (Carbohydrate Deficient Transferrin (CDT), Liver Function (LF) and Mean Corpuscular Volume (MCV)) to demonstrate total abstinence from alcohol consumption during the six month period, or such longer period as determined by the psychiatrist.
d.Ms Sanderson has provided to the Board a report of the psychiatrist advising that Ms Sanderson is fit to return to practise.
The following conditions must be imposed upon any future registration of Ms Sanderson for a period of not less than 12 months:
a.Ms Sanderson must remain totally abstinent from alcohol.
b.Ms Sanderson must continue treatment with the psychiatrist at the frequency and for the duration as determined by the psychiatrist. Ms Sanderson must be fully compliant with this treatment, including all directions and taking any medications prescribed by the psychiatrist. Ms Sanderson will authorise the psychiatrist to report to the Board as to Ms Sanderson’s health status as the psychiatrist sees fit, or as requested by the Board.
c.Ms Sanderson must undergo alcohol breath testing in accordance with the Board’s protocol.
d.Ms Sanderson must undergo haematological testing (CDT, LT and MCV) in accordance with the Board’s protocol. Attendance for such testing shall occur within seven days of this condition becoming effective, unless otherwise directed by the Board.
e.Ms Sanderson must not work in sole practice.
f.Ms Sanderson must work only in a supervised position as nominated by Ms Sanderson and approved in writing by the Board. Ms Sanderson must recruit a radiographer colleague of not less than five years experience (to be nominated by Ms Sanderson and approved in writing by the Board) to act as a workplace supervisor.
g.Ms Sanderson must provide a copy of these orders and the Tribunal’s reasons to both the supervisor and her employer. Ms Sanderson must authorise, in writing, both the supervisor and her employer to report to the Board as to Ms Sanderson’s competence and fitness to practice:
i.If the supervisor or employer have a concern about Ms Sanderson’s competence and fitness to practice;
ii.As requested by the Board; and
iii.In any event, at 3 monthly intervals.
- Ms Sanderson will notify the psychiatrist and the Board immediately upon becoming aware of any material change in her health.
- Ms Sanderson will authorise the Board, in writing, to advise both the supervisor and her employer if notified by the psychiatrist (pursuant to paragraph 3(b) of these orders) or Ms Sanderson (pursuant to paragraph 3(g) of these orders) of any concerns in respect of Ms Sanderson’s health status.
Ms Sanderson must bear all costs of and associated with compliance with paragraphs 2 and 3 of these orders.
Ms Sanderson must pay the Board’s costs of and incidental to these proceedings on the standard basis on the District Court scale as agreed, or failing agreement as assessed by QICS, within one month of the Tribunal fixing those costs (or such further time as the Board may allow).
Publication of the medical records pertaining to Ms Sanderson filed in these proceedings, other than the report of Dr Storor, is prohibited.
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