A Limerick-Based Doctor Faces Professional Misconduct Inquiry Over Prescription Incident
A doctor from Limerick has been accused of professional misconduct for using a prescription form from a hospital where he no longer worked to prescribe a high-strength, highly-addictive painkiller to a family friend.
The doctor appeared before a fitness-to-practise hearing of the Medical Council on Monday. During the hearing, he admitted the facts of certain allegations but made no admissions regarding whether these amounted to professional misconduct or poor professional performance.
### Prescription Raised Concerns
The inquiry heard that a complaint was made to the Medical Council after a pharmacist at a Boots pharmacy in Limerick became suspicious about a prescription submitted by a woman referred to as Patient A on October 6th, 2021.
The fitness-to-practise committee overseeing the inquiry ruled that the identity of the doctor cannot be made public.
### Details of the Prescription
The prescription was written on notepaper from the Department of Psychiatry at St Luke’s General Hospital in Kilkenny, dated September 29th, 2021, and signed by the doctor. The form contained a watermark stating “not for MDA drugs,” although the prescription was for a 28-day supply of OxyNorm — a strong opioid analgesic classified as a controlled drug under the Misuse of Drugs Act.
Counsel for the Medical Council, Eoghan O’Sullivan BL, explained that the pharmacist then confirmed with the hospital that the woman had never been a patient at St Luke’s, and the doctor had not worked there for approximately a year.
### Admissions and Explanation from the Doctor
Mr. O’Sullivan acknowledged that the doctor made certain admissions of fact in December 2021, including that he had written the prescription, which he accepted was inappropriate. However, the doctor claimed he prescribed the medication for special and substantial reasons, specifically to help a family friend who was in severe pain from a long-term condition, erosive esophagitis. The inquiry was told that the doctor intended the prescription to tide her over for a number of days.
### Additional Allegations
The doctor also faced two other allegations: failing to carry out an examination of Patient A and maintain adequate medical records of her treatment, as well as the unauthorized use of a HSE prescription pad.
The inquiry noted that the doctor, who qualified in 2011 and has been registered to work in Ireland since 2017, has not practised medicine since the complaint was filed. He was not suspended in relation to this case.
### Expert Witness Opinion
Fiona Fenton, a consultant psychiatrist specializing in substance misuse, gave expert evidence on behalf of the Medical Council. She stated that writing a prescription for a controlled drug when the doctor was not employed at St Luke’s, and for someone who was not his patient, constituted professional misconduct. According to Prof. Fenton, the doctor’s actions fell considerably short of the standards expected of medical professionals.
Prof. Fenton explained that the appropriate treatment for the patient’s condition was a proton pump inhibitor and antacid medication aimed at reducing stomach acid. OxyNorm, a strong opioid painkiller, is only recommended for advanced cancer or post-operative pain management and should be prescribed short-term due to its addictive nature. The psychiatrist emphasized that OxyNorm is not used in psychiatry.
She added that the proper course of action for the doctor, when asked for pain relief, should have been to refer Patient A to an on-call doctor service or the emergency department of a local hospital. Prof. Fenton also noted that suitable medication for the patient’s condition could have been obtained over the counter at pharmacies or even supermarkets.
While she considered the doctor’s actions amounted to poor professional performance, she did not believe they met the legal threshold for such a finding, as there was no adverse outcome for the patient.
### Legal Representation and Outcome
David Higgins, the doctor’s solicitor, said his client was genuinely remorseful and had learned from the incident. Mr. Higgins described the event as a one-off incident, admitted at an early stage, with no personal gain for the doctor. He characterized it as an isolated error made under stressful circumstances while assisting a family friend experiencing chronic pain.
The fitness-to-practise committee made no findings against the doctor after accepting his offer of an undertaking regarding future conduct. Additionally, the doctor agreed to complete a continuous professional development course on prescribing before resuming medical practice and consented to be censured.
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*This case highlights the importance of adhering to proper medical protocols when prescribing controlled substances and the consequences of unauthorized use of medical resources.*
https://www.breakingnews.ie/ireland/doctor-prescribed-highly-addictive-painkiller-from-a-hospital-he-no-longer-worked-at-1812652.html
