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.

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Sexual Misconduct by Doctors, Health Care Professionals in NSW | Cases 2017-2018

List of health care practitioners prosecuted by the Health Care Complaints Commission in NSW for misconduct of a sexual nature/ boundary violations with patients.

2018

Dr Ian De Saxe, Psychiatrist
Mr Youngjin Jung, Physiotherapist
Dr David Kingston, Doctor and Pharmacist
Dr Anil Mathad, General Practitioner
Dr Keith Ian Brennan, General Practitioner
Dr Ibrahim Hanna, Neurologist
Mr Russell Harvey, Registered Nurse
Mr Edward Keegan, Registered Nurse

2017

Dr Phillipa Rickard
Dr Nirmit Milan Sheth, General Practitioner
Mr Robert Ferguson (Bray-Ferguson), a non-registered health practitioner providing counselling services as a qualified social worker.
Mrs Brooke Ledner, Psychologist
Dr Teresa Wong, General Practitioner
Dr Mohamed Payenda Zhouand Safi, General Practitioner
Dr Elvin Suet Pang Cheng
Dr Saeid Saedlounia
Dr Miodrag Huber, General Practitioner
Dr Elvin Suet Pang Cheng.
Mr Harry Mayr, Psychologist
Dr Aamer Sultan, Medical Practitioner
Mr Anthony Elliot, Enrolled Nurse

… more info to come on sexual misconduct and disciplinary cases.

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Youngjin Jung, NSW Physiotherapist jailed for Indecent Assault and Deregistered

Central Coast Physiotherapist jalied and deregistered

Name: Youngjin Jung

Education: Physiotherapist; graduated from Curtin University, 2009.

Practice: Ocean Beach Physiotherapy Practice at Umina Beach, Central Coast, NSW.

Criminal case: Jung v R [2017] NSWCCA 24 (6 March 2017)

Civil case/disciplinary action: Deregistered 7 years from 19 April 2018; Health Care Complaints Commission v Jung [2018] NSWCATOD 53

Overview of legal action against Youngjin Jung

In 2016 Mr Jung was convicted of eight counts of indecent assault in relation to six female patients that occurred between 23 April and 12 June 2014. Mr Jung was sentenced to an aggregate sentence of five years’ imprisonment with a non-parole period of three and a half years. He will be eligible for parole on 22 August 2019.

Indecent assault accusations against the physiotherapist included massaging patients’ breasts and touching pubic area of a patient. The “conduct was not in any way related to therapeutic treatment,” Judge Clive Jeffreys said in handing down his sentence. “It was undertaken by the offender for sexual gratification.”

The Health Care Complaints Commission (‘the Commission’) prosecuted Mr Youngjin Jung before the NSW Civil and Administrative Tribunal (‘the Tribunal’). The Commission alleged that because Mr Jung had been convicted of criminal offences in NSW he was not a suitable person to hold registration as a physiotherapist.

On 19 April 2018, the Tribunal found that Mr Jung was not a suitable person to hold registration as a physiotherapist. The Tribunal cancelled Mr Jung’s registration and ordered a non-review period of 7 years. The Tribunal also made a prohibition order that Mr Jung be prohibited from providing any health services for a period of seven years.

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Dr Ian De Saxe, Psychiatrist, Professional Misconduct Case

Professional Misconduct case against Dr De Saxe, Psychiatrist

Name: Dr Ian De Saxe

Specialty: Psychiatry. Graduated from the University of Sydney, Dr De Saxe had been practising since 1987.

Practiced at: The Rocks, Sydney; Mosman Private Hospital.

Summary: Engaged in mutual masturbation and penetrative sex with male patient; massaged legs of another patient; made statements that sexual conduct with under-aged children was “okay”. Inappropriate prescribing and self-prescribing; and inadequate record keeping.

Findings: Professional misconduct; registration cancelled for 2 years. Date of order: 29 March 2018.

Case: HCCC v De Saxe [2018] NSWCATOD 45

Facts of Case

The Tribunal found that the practitioner engaged in inappropriate sexual conduct with patient A. Dr de Saxe engaged in mutual masturbation with patient A on two occasions and engaged in penetrative sexual intercourse with patient A on one occasion.

Dr de Saxe prescribed Methadone/Physeptone, a Schedule 8 drug of addiction to patient A in quantities which did not accord with the recognised therapeutic standard for the appropriate treatment in the circumstances. The patient was not the subject of a treatment plan and the practitioner was not an accredited NSW OTP prescriber and accordingly held no authority to prescribe such drugs. The practitioner prescribed patient A other drugs in similar circumstances, namely Alprazolam and Dexamphetamine. The records of such treatment were not maintained.

Patient B, a 27-year-old male was referred to the practitioner for an opinion and management of alcoholism and major depression. During one consultation Dr de Saxe massaged patient B’s legs and asked patient B words the effect: “Do you want me to go any higher?”. The practitioner acknowledged that he was sexually attracted to patient B.

Dr de Saxe treated patient C whilst he was under his care at the Mosman Private Hospital between 16 August 2010 and 15 September 2010. He consulted patient C on at least six occasions between 17 August 2010 and 10 September 2010. He did not communicate with the patient’s former treating psychiatrists or psychologists; nor put a treatment plan in place. Further, the Tribunal found as a fact that Dr de Saxe engaged in inappropriate discussion concerning the patient’s sexuality and desires and made statements to the effect that sexual conduct with under-aged children was “okay”. Not that patient C had been charged with child sex offences involving a 15 year old male.

The Tribunal found, but that Dr de Saxe claimed to have no recollection, that he looked into the patient’s eyes whilst the patient was talking about his sexuality and invited the patient to engage in a sexual act with him by saying to the patient “suck my cock”. The Tribunal found that the patient’s version of events was correct in respect of the words used by Dr de Saxe to the patient concerning the writing of a report that was required to be used in pending court proceedings involving the patient.

The Tribunal also found that Dr de Saxe stated words the effect that he was willing to lie for the patient in respect of the report. He also failed to keep adequate records of his treatment for patient C. He failed to prepare a comprehensive admissions assessment and treatment plan; to record sufficient corroborative information from other mental health practitioners; to record specific information concerning treatment during admission and to record sufficient detail in the progress notes and discharge summary.

The Tribunal also found that between 7 April 2010 and 28 October 2014, Dr de Saxe inappropriately self-prescribed medication including Schedule 4D prescribed restricted substances.

News Articles for further reading:

Sydney psychiatrist banned for 2 years (news.com.au)

“Sydney psychiatrist suspended over telling an accused paedophile having sex with an underage boy ‘wasn’t that bad’ and that he was ‘willing to lie for him’ after asking him for oral sex”, dailymail.co.uk

Banned Psychiatrist starting another career: “The tribunal heard that Dr de Saxe was attracted to young men and had moved his practice away from ‘the sort of risky type’. Since being suspended from practising medicine, he had started a course to teach English as a second language and told the tribunal he thought it would ‘be helpful to be able to test his boundaries around students’, despite acknowledging that being around young men was a ‘potential risk’.” Source: ABC news.

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Dr Gregory Robinson – drug addicted surgeon Shoalhaven Hospital banned

The HCCC prosecuted general surgeon Dr Gregory Robinson before the NSW Civil and Administrative Tribunal (‘the Tribunal’), in relation to his management of 4 patients at Shoalhaven District Memorial Hospital.

Allegations were found proven as follows:

On 17 February 2015, a patient was admitted under Dr Robinson with symptoms of vomiting and suspicion of an incarcerated abdominal wall hernia. Dr Robinson performed a laparotomy and bowel resection on the patient later that day. Dr Robinson delayed his review of the patient and he inappropriately conducted major surgery on the patient contrary to his agreement with the anaesthetist to limit the surgery, given the patient’s clinical condition.
On 10 December 2013, a 10 year old boy, was admitted under Dr Robinson to the hospital complaining of abdominal pain. Dr Robinson failed to examine or assess the boy until the morning of 13 December 2013 and he inappropriately relied on a first year surgical trainee and resident to examine the patient in his absence.
On 24 November 2010, a patient was on the operating table, anaesthetised and intubated with Dr Robinson ready to perform repair of a left inguinal hernia. Dr Robinson left the patient on the operating table intubated without allowing the operation to proceed for some time, and threatened to stop operating on the patient until another of his patients was admitted into hospital.

Dr Robinson had a history of depression and narcotics abuse from 2000, which lead to the him being on the New South Wales Medical Council and Board’s impairment program from 2002.

The doctor explained that he had voluntarily ceased practising in 2015 because he felt that he needed time to heal after the incidents which gave rise to these proceedings. The Tribunal noted that during the last 12 months he had undertaken reading, meditation, engaged in Buddhism and developed strategies for dealing with stress.

The Tribunal found that Dr Robinson was impaired and imposed a 2 year ban from practice from 26 February 2018.

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Robert Starkenburg, Bondi Dentist Deregistered

Dr Robert Starkenburg, a Bondi Junction dentist was found to have engaged in professional misconduct. The New South Wales Civil and Administrative Tribunal found that the dentist’s surgery had inadequate infection control and he was de-registered from the profession of dentistry.

This was a dentist with a history of hygiene issues, stemming back to inspection in 1998. Further complaints arose in 2014 and 2016. In 2016, the inspector found that he was “now mostly compliant with infection control requirements” but there were on-going concerns with hand hygiene, out of date stock and inadequate health records. The tribunals concern was that despite the dentist’s extensive experience, “the breaches that occurred have been gross, repeated, and occurred over a considerable period.”

Whilst this is not a medical negligence action for compensation, it is a disciplinary case, and it is however quite possible for a civil suit to arise where failing to observe proper standards of cleaning of instruments and hygiene results in a patient being infected with HIV and other blood-borne viruses. Establishing causation in these cases can be problematic however.

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Dr Jonathan Stern, GP misdiagnosed heart attack

The HCCC recently prosecuted a complaint involving an alleged failure by Dr Jonathan Stern, General Practitioner to make a diagnosis of a heart attack and administer Aspirin.

The patient in question attended the GP’s St Ives’ medical practice complaining of chest pains. He was briefly seen by Dr Stern and was advised by the doctor to go to the hospital. The doctor did not call an ambulance nor phone the hospital ahead, and his referral letter was deemed to be inadequate. There was no provision of aspirin however Dr Stern did afford the patient some treatment by administering a Nitrolingual spray.

The patient’s work colleague who turned up to the practice drove the patient to the hospital. Unfortunately the patient collapsed and died at the reception desk at the hospital. The cause of death was ischemic heart disease and coronary atherosclerosis.

Expert evidence suggested that in situations like this a GP should-

Give aspirin
Perhaps give nitrolingual spray.
Call an ambulance
Monitor the patient whilst waiting for the ambulance to arrive
Be ready to administer CPR

The Professional Standards Committee imposed restrictions on Dr Stern’s registration, the main one being that he be mentored for a minimum period of 12 months.

Whilst this case is a disciplinary case, and not a tort action for medical negligence, it is important that medical practitioners take appropriate and timely action when a patient presents with symptoms of a heart attack.

In civil law suits for medical negligence however, medical evidence will need to be adduced to show that taking appropriate action would have made a material difference to the patient’s outcome in order for damages to be awarded. This legal issue is known as “causation”, and is not often addressed in disciplinary cases.

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