Dr Paul Cozzi, Urologist, Sydney – Reprimanded in Conduct Case

The Health Care Complaints Commission of NSW prosecuted a complaint against Dr Paul Cozzi, a consultant urologist before the Medical Professional Standards Committee (the Committee).

The complaint alleged that Dr Cozzi, in November 2015, failed to properly supervise a trainee urologist operating at St George Public Hospital, Sydney, in circumstances where Dr Cozzi was operating elsewhere at a private hospital at the same time; did not have appropriate medical records; and made false or misleading statements to investigators in 2016-2017.  

On 3 November 2020, the Committee found Dr Paul Cozzi guilty of unsatisfactory professional conduct on the basis that:  

Failure to Supervise Trainee Doctor

  1. Dr Cozzi was responsible for supervising a trainee urologist (“Dr X”) operating on his patients at St George Public Hospital, Kogarah, Sydney (SGH). After his public list started, Dr Cozzi then drove to the Mater Private Hospital and operated on his private patients, whilst Dr X operated without direct supervision on 4 patients at St George Public Hospital. Dr Cozzi did not tell Dr X where he was going.
  2. Dr Wong, the expert witness for the Commission, stated that a supervising consultant must be available to assist in case of difficulty or emergency. Patient safety requires this. He was strongly critical of a supervising consultant leaving the grounds of SGH during an operating list, and particularly leaving to go to another operating theatre.
  3. The Committee was of the opinion that having two concurrent surgical lists is not acceptable professional practice. Dr Cozzi’s failure to properly supervise the trainee was significantly below the relevant standard.
  4. “His conduct is reprehensible and it is only fortuitous that no patient suffered as a result of his actions,” paragraph 176, Professional Standards Committee Enquiry; Dr Paul Joseph Cozzi, Decision 3/11/2020.

Lack of credibility and trustworthiness as a witness

  1. The Committee did not find Dr Cozzi to be a credible or trustworthy witness. Dr Cozzi gave inconsistent and contradictory information about his conduct and activities on 12 November 2015. He made incorrect statements to the investigators on five occasions.  
  2. The Committee considered that “many of his answers were designed to obfuscate and deflect attention from the relevant issues. He did not make a genuine attempt to answer questions in a frank or open manner,” paragraph 49.

Signing of blank documents

  1. Dr Paul Cozzi pre-signed blank count sheets and safety checklists for surgeries on patients at St George Public Hospital which he did not attend.
  2. The procedures for signing count sheets and safety checklists are designed to ensure patient safety.
  3. Signing sheets for surgeries when he was not present infringes basic standards of professional practice and contravenes the record keeping regulations.

Determination: Unsatisfactory Professional Conduct

The Committee found that Dr Paul Cozzi’s conduct was reprehensible and unsatisfactory professional conduct. He was reprimanded in the strongest possible terms.

The Committee ordered that Dr Paul Cozzi must be subject to supervision, must complete an ethics course and must not supervise trainees.

Source:  HCCC media release: Dr Paul Cozzi ; Statement of Decision.

UPDATES:

According to the article “Dr Paul Cozzi reprimanded by the Health Care Complaints Commission over unsatisfactory professional conduct” by M Porter, The Leader 16.11.2020, Dr Cozzi has defended his actions and said he would be appealing the decision. The article quotes Dr Cozzi as saying “The decision to proceed and supervise the experienced trainee both directly and indirectly to complete the list without incident was made in the patients’ best interests and after careful consideration, knowing that the nature and complexity of the cases was such that they could be completed safely… The decision was made with the full approval of the Department of Urology and the trainee.”

However a letter to The Leader published on 07.03.2021 from a group of urological surgeons comprising the Department of Urology at St George Hospital (Dr Peter Aslan, Prof David Gillatt, Dr Anthony Hutton, Dr Dominic Lee, Dr David Malouf, Dr Peter Nash, Dr Anu Ranasinghe and Dr James Thompson) stated:

“There was written and verbal discussion between Dr David Malouf, Dr Anthony Hutton and Dr Cozzi in the days prior to the list. It was noted he had simultaneous operating lists in different hospitals scheduled on the Thursday morning and that this represented a breach of his duties as a surgical trainer.

It was made clear to Dr Cozzi that if his supervision of the trainee was not going to be appropriate, then the only option would be to cancel the St George Hospital list. Dr Cozzi gave a verbal undertaking that he would appropriately supervise the list, and this was the basis for the agreement to allow the list to proceed.”

Dr Joseph Grech, Sydney GP Suspended

Dr Joe Grech, General Practitioner has been suspended by the Civil And Administrative Tribunal, NSW, for a period of 6 months. It was found that-

  1. Dr Grech inappropriately prescribed erectile dysfunction medication, benzodiazepines, anti-psychotic drugs, Duromine- a weight loss medication. With one minor exception, the Tribunal found Complaint 1 to constitute unsatisfactory professional conduct.
  2. Dr Grech breached professional boundaries with patients, particularly by providing medical treatment to his mentally ill girlfriend, and this amounted to unsatisfactory professional conduct.
  3. Dr Grech gave false and misleading information to the Medical Council when he denied that Patient C had ever been his patient. This is unethical, and the Tribunal found that it constituted unsatisfactory professional conduct.
  4. Dr Grech failed to notify the National Board within 7 days, that he had been charged on 24 April 2018 with criminal offences punishable by 12 months imprisonment or more and that on 4 February 2019 he had been the subject of findings of guilt for offences punishable by imprisonment. Technically, this complaint constitutes unsatisfactory professional conduct.
  5. The Tribunal found: “… we consider the appropriate order to be that Dr Grech be reprimanded and that his registration be suspended for 6 months. During that time, if Dr Grech wishes to resume practice, he must satisfactorily complete a tailored education program….On resuming practice, Dr Grech’s registration will be subject to the conditions identified below. He must practise under what is known as category C supervision. He must practise only in a group practice where there are at least two other registered medical practitioners. Such a condition helps ensure that Dr Grech will receive support from professional colleagues. He will not receive that support if he engages in home visits or visits to aged care facilities, so he is prohibited from consulting in those environments. Although Dr Grech’s inappropriate prescribing related to Schedule 4D drugs, he should also be prohibited from dealing with Schedule 8 drugs. Both Schedules comprise drugs of dependence and Dr Grech has not demonstrated that he can appropriately prescribe such drugs. In addition, we strongly recommend that Dr Grech be subject to a Performance Assessment.”
  6. Dr Grech had practised in various locations in Sydney including Broadway and Darlinghurst.

Source: Health Care Complaints Commission v Grech [2021] NSWCATOD 14

According to the Herald, “for nearly two decades police received a steady stream of intelligence suggesting that Dr Grech has been involved in drug supply and possession and has been providing false medical certificates in return for cocaine, heroin and ice.”

Source: “Prominent GP suspended for lying to medical body, inappropriately prescribing drugs”, SMH 04.02.21

Nouri v Australian Capital Territory [2020] ACTCA 1 (13 February 2020) – Wrongful Birth

In this wrongful birth case, the Australian Capital Territory Court of Appeal decided in favour of the hospital. Although it was found that the Canberra Hospital had breached its duty of care to the child’s parents, the parents failed to establish causation.  

Ms Nouri and Mr Shaor (the appellants) sued the Canberra Hospital for losses associated with their baby’s severe birth defects. The child, Saba Nouri, was born on 3 November 2011 suffering from trachea-oesophageal fistula (a TOF) which is an abnormal connection between the oesophagus and the trachea.

The appellants were expecting twins, and argued that had they been told that Twin B may have had a trachealoesophageal fistula (a TOF) earlier, they would have undergone a termination of the fetus.

On 6 September 2011 (gestation 28 weeks and 2 days), there was a discussion about Ms Nouri’s pregnancy at a high-risk meeting at the Fetal Medicine Unit at Canberra hospital. In particular, there was discussion about the increased amniotic fluid together with the possibility of a trachealoesophageal fistula (TOF).  Dr Robertson did not discuss the meeting with the Appellants. The twins were delivered on 3 November 2011, and it was later that day that Mr Shaor was told that Twin B had a TOF. 

The main issues were when disclosure ought to have taken place, and whether the parents would have and could have obtained termination at that point. In the primary judge’s view, 30 weeks and 4 days gestation was the earliest date when a duty to inform the Appellants of a possible TOF may have arisen. Expert evidence indicated that a termination would have been refused in Australia would have been available in the US.    

The primary judge identified a number of different factual obstacles to the success of the Appellants’ case and the Court of Appeal ultimately agreed, saying “It is certainly theoretically possible that a person in Ms Nouri’s position, with an extraordinary degree of determination, effort and organisation, could have achieved the outcome of a selective termination. However, the absence of a firm diagnosis, the lack of encouragement that she would have received from her treating medical specialists, the need to locate and decide to be treated by a suitable practitioner in the United States, the risks of travel to the United States to both herself and the healthy twin, the logistical hurdles that would need to be overcome in getting to and from the United States, the significant expense that would be involved in such an exercise and the shortness of the time available mean that the balance of probabilities is not in favour of her having achieved that outcome,” Paragraph 103. 

The Doctor/Patient Relationship

The following are some guidelines as to what to expect of a professional relationship between doctor and patient:

  1. The doctor/patient relationships is built on trust.
  2. When a patient is undressing for an examination, the doctor should leave the room unless the patient needs assistance. If this is the case, another person should be present to assist the patient.
  3. A doctor should not use inappropriate language, such as telling jokes with sexual content, and never use racial slurs.
  4. When a doctor is conducting an intimate examination (such as a Pap
    smear), there should be another healthcare professional present (eg a nurse). Conversations should be limited to informing the patient of what is being done
    during these types of examinations or treatments.
  5. A doctor should listen to the patient without judging.
  6. A patient needs to feel respected and cared for, but this must be done on a professional level. Questions about marital status, sexual orientation, religion, and other highly sensitive areas should be avoided unless they directly relate to the medical concern.
  7. Sexual contact (even flirting) is unprofessional and unethical, and should be
    completely avoided.
  8. It is unethical for a doctor to visit with a patient outside of the healthcare setting. Obviously some doctors make house calls, but this is a professional call, and not the same as a personal visit.
  9. Doctors should not borrow from or loan money to patients.
  10. Patients who feel that a doctor has acted unethically or violated the doctor/patient relationship have the right to make a complaint to the Medical Board or AHPRA.
  11. A violation of the doctor/patient relationship may constitute professional misconduct resulting in sanctions against the doctor and possible deregistration.

Complaints against Mental Health Practitioners

According to a study using complaints data from health regulators in Australia, mental health practitioners (psychiatrists and psychologists) are more likely to be the subject of complaints than physical health practitioners.

Areas of increased risk are related to professional ethics, communication skills and the health of mental health practitioners themselves.

Other findings included:

  1. The complaint rate among psychiatrists was more than double than among physicians.
  2. The complaint rate among psychologists was nearly treble than among other allied health practitioners.
  3. Psychiatrists had nearly double the risk of complaints about communication and nearly five times the risk of complaints about prescribing as their physician colleagues.
  4. Male psychiatrists and psychologists had higher complaint rates than their female peers .
  5. Mental health practitioners had three times the risk of complaint regarding sexual boundary breaches compared with physical health practitioners.
  6. Older mental health practitioners had a higher risk of complaints than their younger peers, after adjusting for sex and practice location. For both psychiatrists and psychologists, complaint risk increased steadily by age band, with practitioners aged ≥65 years having around twice the risk of complaint compared with those aged 36–45 years.

The authors of the study analysed 7903 complaints over a 6 year period from 2011-2016. The complaints dataset consisted of information on all complaints about these practitioners lodged with regulators during the study period. AHPRA provided complaints data for all states and territories, except New South Wales. HPCA provided equivalent data for New South Wales.

It was also noted that “the complaints in our study probably underrepresent harm and concern experienced by patients as we only included complaints to regulators, thus missing complaints made directly to the practitioner, their employer or other agencies, and adverse events where no complaint was laid.”

Source: Veness BG, Tibble H, Grenyer BFS, et al. Complaint risk among mental health practitioners compared with physical health practitioners: a retrospective cohort study of complaints to health regulators in Australia. BMJ Open 2019;9:e030525. doi:10.1136/ bmjopen-2019-030525

Dr William Mooney ENT and Cosmetic Surgeon under investigation

UPDATE 02.07.19 – Media story about Dr Bill Mooney to air tonight on A Current Affair, Channel 9. William (Bill) Mooney is an ENT surgeon under investigation by the HCCC regarding the death of 2 patients, one at Strathfield Private Hospital and the other at East Sydney Private Hospital. Details regarding the cases (as reported in the media) can be found below. As it currently stands, the Medical Council has allowed Dr Mooney to continue to practise under supervision and with various restrictions, pending an investigation by the Health Care Complaints Commission.

EARLIER UPDATE: 03.06.19 – The Medical Council undertook a review of Dr Mooney’s suspension:

“The Council remains concerned about Dr Mooney’s ability to practice surgery safely while unsupervised.
Accordingly:
• Dr Mooney may not conduct most surgeries;
• Other surgeries which he is permitted to undertake may be performed only under the direct observation of a specialist supervisor approved by the Council• Dr Mooney must meet with his specialist surgical supervisor each fortnight who will report back to Council each month.
• Dr Mooney may conduct consultations, again under supervision by a specialist medical practitioner who will ensure Dr Mooney understands relevant professional obligations and report accordingly to the Council.”

Source: Media Release from Medical Council of NSW.

According to AHPRA’s website:

“The Medical Council of New South Wales has considered it appropriate to impose the following conditions on Dr William Wall Warner Mooney’s registration under section 150(1)(b) of the Health Practitioner Regulation National Law (NSW) for the protection of the health and safety of any person or persons, or because it is satisfied that action is otherwise in the public interest. The matter giving rise to the conditions will be referred to the Health Care Complaints Commission. These conditions will have effect until the matter about the practitioner is disposed of, or the conditions are removed by the Medical Council of NSW.

1. Not to perform any paranasal procedures including the following procedures:

• External fronto-nasal ethmoidectomy (MBS 41731)
• Radical fronto-ethmoidectomy (MBS 41734)
• Intranasal operation on the frontal sinus or ethmoidal sinuses (MBS 41737).
• Intranasal operation on sphenoidal sinus (MBS 41752)
• Catheterisation of frontal sinus (MBS 41740)
• Trephine of frontal sinus (MBS 41743)
• Radical obliteration of frontal sinus (MBS 41746)
• External operation on the ethmoidal sinuses (MBS 41749)
• Transorbital ligation of the ethmoidal artery or arteries (MBS 41725)
• Intranasal operation on or removal of foreign body from Antrum (MBS 41716)
• Removal of nasal polyp or polypi (MBS 41662 and 41668)
• Antrostomy (Radical) (MBS 41710)
• Antrostomy (Radical) with transantral ethmoidectomy or transantral vidian neurectomy (MBS 41713)
• Proof puncture and lavage of maxillary antrum (MBS 41698)
• Proof puncture and lavage of maxillary antrum, under general anaesthesia (requiring admission to hospital) (MBS 41701)
• Lavage of maxillary antrum (MBS 41704)

2. To practise under category A supervision when in the operating theatre in accordance with the Medical Council of NSW’s Compliance Policy – Supervision (as varied from time to time) and as subsequently determined by the appropriate review body.

a. The Council-approved supervisor must have Specialist Otolaryngology registration and directly observe the practitioner performing all procedure/s in the operating theatre.

b. The practitioner is to have review meetings with his Council-approved supervisor each fortnight for at least one hour and authorise the Council-approved supervisor to provide reports to the Council on monthly basis.

c. At each supervision meeting the practitioner is to review and discuss his operating practice with his approved supervisor with particular focus on:

i. Operative technique and outcomes
ii. Planned surgeries, including indications and patient selection
iii. Time management of procedures including concerns about the speed some surgeries have been conducted

d. To authorise the Medical Council of NSW to provide proposed and approved supervisors with a copy of the decision which imposed this condition.

e. Not to perform any procedures in the operating theatre until supervisor has been approved by the Council.

3. To practise under category C supervision for all other non-operating theatre practice in accordance with the Medical Council of NSW’s Compliance Policy – Supervision (as varied from time to time) and as subsequently determined by the appropriate review body.

a. The practitioner is to have review meetings with his Council-approved supervisor each month for at least one hour and to authorise the Council-approved supervisor to provide reports to the Council (in a Council approved format) on a 3 monthly basis.

b. At each supervision meeting the practitioner is to review and discuss his practice with his approved supervisor with a particular focus on:

i. Boundaries with patients
ii. Appropriate prescribing practices
iii. Clinical outcomes
iv. Medical record reviews
v. Work load and work related stress
vi. Overall patient care and management

c. To authorise the Medical Council of NSW to provide proposed and approved supervisors with a copy of the decision which imposed this condition.

4. Within 7 days of the end of each calendar month, the practitioner is to provide the Medical Council of NSW with a record of all procedures performed in the operating theatre in the last month. The record must include the following:

• the full name and date of birth of the patient
• the date and start and finish time of each procedure
• the name of the procedure
• Medicare item number
• the name and signature of the Council-approved Category A supervisor present throughout the procedure
• any complications arising during and/or as a result of the procedure (and specifically advising of any unplanned return to theatre and/or any post-operative infection).

5. To practise no more than a total of 35 hours per week.

6. Not to possess, supply, administer or prescribe:

a. Phentermine
b. Orlistat
c. Liraglutide
d. Topiramate
e. Phentermine/topiramate combination
f. Altrexone/bupropion combination
g. Lorcaserin

7. To submit to an audit of his medical practice, by a random selection of his medical records by a person or persons nominated by the Medical Council of NSW and:

a. The audit is to be held as required by the Council.

b. The auditor(s) is to examine and assess the following aspects of his practice including:

i. a general medical records audit of his practice
ii. an audit of operative procedure records, including the indications and compliance with conditions

c. To authorise the auditor(s) to provide the Council with a report on their findings.

d. To meet all costs associated with the audit and any subsequent audits and reports.

8. To authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia for the purpose of monitoring compliance with these conditions.

This registration is also subject to other conditions. These conditions are not publicly available due to privacy considerations.”

EARLIER UPDATE: 13.11.18 – media reports that Dr Mooney has been suspended.

It has been reported in the media, that celebrity nose job doctor William Mooney is under investigation by the coroner in relation to the deaths of 2 patients.

Dr Mooney boasts on his website that not only is he “Australia’s leading ENT, specialising in Facial Plastic Surgery” but also  “Sydney’s Premiere Rhinoplasty Surgeon.” He has clinics in Bondi Junction and Bankstown, and founded Face Plus Medispa, on Bondi Beach, a day spa offering beauty treatments.

ABOUT THE CASES (AS REPORTED IN THE MEDIA)-

Patient Death: East Sydney Private Hospital

The Sydney Morning Herald reported on 2 March 2018, that Alex “Little Al” Taouil, a feared standover man and a close associate of bikies and Melbourne identity Mick Gatto, died after undergoing nasal surgery by Dr William Mooney at East Sydney Private. Dr Mooney says Mr Taouil had a post operative stroke that was not directly related to any trauma from the surgery. This case has  however been referred to the coroner.

Second Patient Death: Strathfield Private Hospital

On 15 February  2018, Pouya Pouladian underwent surgery by Dr William Mooney ENT for sinus problems/sleep apnoea at Strathfield Private Hospital. Dr Mooney allegedly nicked an artery during the surgery.

Nurses told the family that Dr Mooney would come to see them after the surgery. That night they waited until 8pm only to be told Dr Mooney had gone home. “He never came,” Mrs Pouladian said. The family said that, in the two days Pouya was in Strathfield Private, Dr Mooney did not see or speak to him or his family.

Pouya was discharged from hospital on 17 February, and within hours began vomiting. He collapsed and was taken to Canterbury Hospital by ambulance. He was then transferred to Concord hospital, where he subsequently went into cardiac arrest and died.

It was reported on 31/07/18 by media outlets that Pouya’s sister and mother died in a suicide pact on 30/07/18, and that Pouya’s sister was suffering from depression following her brother’s death.

Dr William Mooney and drug testing

Medical sources have confirmed that further restrictions have been placed on Dr William Mooney’s registration on top of the current conditions which require him to undergo random drug testing.

A search of AHPRAs database revealed that Dr William Mooney currently (22/03/18) has the following conditions imposed on his registration:

1. Not to perform the following frontal and ethmoidal sinus procedures:•

    • External fronto-nasal ethmoidectomy (MBS 41731)
    • Radical fronto-ethmoidectomy (MBS41734)
    • Intranasal operation on the frontal sinus or ethmoidal sinuses (MBS 41737)
    • Catheterisation of frontal sinus (MBS 41740)
    • Trephine of frontal sinus (MBS 41743)
    • Radical obliteration of frontal sinus (MBS 41746)
    • External operation on the ethmoidal sinuses (MBS 41749)
    • Transorbital ligation of the ethmoidal artery or arteries (MBS 41725)
    • Removal of nasal polyp or polypi (MBS 41662, 41665 and 41668)

2. To nominate an experienced ENT surgeon to act as his professional mentor for approval by Medical Council of NSW in accordance with the Medical Council of NSW’s Compliance Policy – Mentoring (as varied from time to time) and as subsequently determined by the appropriate review body.

(a) The first mentoring meeting is to occur within a week of being advised that his mentor is approved and thereafter at a frequency to be determined by the mentor.

At each mentoring meeting the practitioner is to include discussion of the following:

i) the personal and professional effect that the issues which brought the practitioner to the attention of the Council have had on the practitioner

ii) possible clinical concerns raised by the Council, such as his current heavy workload, patient and procedure selection, and time management of procedures including concerns regarding the speed of those procedures

iii) how the practitioner has reflected on his practice, and whether changes to his practice are required.

(b) To authorise the mentor to report, in an approved format, to the Council within one month of being advised that his mentor is approved and every three months thereafter about the fact of contact, and to inform the Council if there is any concern about his professional conduct, health or personal wellbeing.

(c) To authorise the Medical Council of NSW to provide proposed and approved mentors with a copy of the decision which imposed this condition.

3. To submit to an audit of his medical practice, by a random selection of his medical records by a person or persons nominated by the Medical Council of NSW and:

a) The audit is to be held within 3 months from 21 March 2018 and subsequently required by the Council.

b) The auditor(s) is to examine and assess the following aspects of his practice including:

i) a general medical records audit of his ENT practice

ii) an audit of operative procedure records, including the indications, compliance with conditions, and where possible, duration of such procedures against complexity and reasonably expected duration

c) To authorise the auditor(s) to provide the Council with a report on their findings.

d) To meet all costs associated with the audit and any subsequent audits and reports.

4. To authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia for the purpose of monitoring compliance with these conditions.

This registration is also subject to other conditions. These conditions are not publicly available due to privacy considerations.

Sources:

Psychiatrist Dr Anthony Slowiaczek disqualified

Dr Anthony Slowiaczek was a specialist psychiatrist practising at the Maitland Specialist Centre, attached to the Maitland Private Hospital in Maitland (“Centre”).

Between 2012 and 2016 he engaged in an improper personal and sexual relationship with Patient A, a vulnerable female patient.  Patient A had a history of childhood sexual abuse and sexual exploitation and had been previously diagnosed as suffering from Attention Deficit Hyperactivity Disorder, complex Post-traumatic Stress Disorder and depression.

Dr Slowiaczek:
• inappropriately prescribed to Patient A a drug of addiction
• inappropriately prescribed medication to a friend and a close family member
• failed to maintain adequate medical records, and
• suffers from an impairment which is managed by medication and continuing weekly psychiatric consultations and psychotherapy. 

Dr Anthony Slowiaczek was found guilty of professional misconduct; is disqualified from registration as a medical practitioner; may not file any application to review the disqualification until after 30 September 2023.

Plastic surgeon Dr Ian Holton suspended

Dr Holten is a plastic surgeon and between July 2011 and January 2014 he provided cosmetic medical and surgical services to the patient on 10 occasions. Before he provided professional services to her, they had met on numerous occasions and were in a friendship circle that revolved around common interests.

Over the period of the professional relationship, Dr Holten and the patient contacted each other regularly via telephone calls and text messages, met for coffee, and sat in his car together and discussed their personal lives and the patient’s marital difficulties. He failed to manage professional boundaries for some time. In January 2014, he had sexual intercourse with her. On or about 11 and 12 January 2014, Dr Ian Holten behaved in a way that constituted professional misconduct by engaging in sexual misconduct, in that he had sexual intercourse with a patient.

Tribunal findings:

Between about 12 July 2011 and 17 January 2014 (inclusive), Dr Ian Holten, behaved in a way that constituted unprofessional conduct, in that he failed to maintain the professional boundaries that should, and ordinarily do, exist between a  medical practitioner  and their patient .

Dr Holten’s registration is suspended for a period of three months, the suspension to commence on 11 July 2019.

The tribunal stated: “We are satisfied that Dr Holten is at low or no risk of repeating the conduct. He has practised safely not only for the last five years, but also for decades prior to that. He is otherwise of good character. His early admissions and cooperation are to his credit. There has already been a considerable personal impact on him. “

Source: http://www6.austlii.edu.au/cgi-bin/viewdoc/au/cases/vic/VCAT/2019/837.html

Psychiatrist gets vulnerable patient pregnant

A Melbourne psychiatrist got a patient pregnant after she was referred to him following a workplace sex assault.

The patient saw Dr Luke Ainsworth five times during 2016 and a personal relationship unfolded between them. A sexual relationship ensued and she soon discovered she was pregnant. She alleged she felt pressure by him to terminate the pregnancy, which she did.

The Medical Board of Australia was notified of his conduct in August 2016 and referred the matter to the tribunal. After this, Dr Ainsworth gave an undertaking not to practise and allowed his registration to lapse.

The Victorian Civil and Administrative Tribunal found him guilty of professional misconduct and disqualified him from applying to register as a medical practitioner before December 31.

The Tribunal noted “We regard it as appropriate to take into account Dr Ainsworth’s period of non-practice when he was fit to practice and reject the submission of the Board that this was not relevant as he did not seek to practise during this time. We are of the view that it demonstrates some insight into the seriousness of his conduct. We felt that a period of three years of non-practice was warranted to reflect the seriousness of the conduct and to send a message to Dr Ainsworth and other practitioners and thus determined that Dr Ainsworth should be disqualified until 31 December 2019.”

http://www6.austlii.edu.au/cgi-bin/viewdoc/au/cases/vic/VCAT/2019/734.html

Dr Hugh Joffe Psychologist Banned

Here we have a case of a psychologist over-servicing and taking advantage of a vulnerable patient.

Dr Hugh Ian Joffe, a registered psychologist practising in Vaucluse, Sydney, charged his banker patient almost $220,000 in sessions that were overtaken by his plans to make a Holocaust documentary with the patient.

The Tribunal heard Dr Joffe proposed to see the patient six days a week and, knowing what salary he was earning, told him he would need to borrow money to fund the therapy. The patient claimed that he had spent a total amount (on therapy and film): $360,000 plus ongoing interest on mortgage payments.

Dr Joffe also advised the patient to reconnect with Judaism, in particular Orthodox Judaism, and to worship at the same synagogue as him; stop eating non-Kosher food and attended the patient’s home for religious ceremonies.

The patient said, “I believe I was taken advantage of by Dr Joffe. I believe I was over-serviced by Dr Joffe and that he was wrong to enter into a film project with me and to encourage me to incur excessive costs, funded [by] my mortgage.”

After 41 years, Dr Joffe retired from practising in April 2017, surrendering his registration the following month.

The Civil and Administrative Tribunal of NSW found that Dr Hugh Joffe’s “conduct was aimed at his own gratification; was egregious in that it was an extreme and invasive manipulation of Patient A’s life at many levels; and that it took advantage of Patient A’s weaknesses that he, Dr Joffe, as therapist, had a unique insight into.”

The Tribunal further stated “the conduct complained constitutes boundary violation of the most serious kind and exploitation of a vulnerable patient, and breaches all relevant codes of conduct in relation to the maintenance of trust and confidence in the psychologist/patient relationship. The Tribunal finds that the respondent has consistently displayed a concerning lack of insight into the seriousness of his conduct.”

The Tribunal cancelled Dr Joffe’s registration, prohibiting from providing any health services, and barred him from re-registering for 4 years.