Doctor addicted to opioids cannot be identified, judge directs

A doctor who admitted working under the influence of opioids cannot be named although a hearing concerning sanctions to be imposed on him can be held in public, the president of the High Court has ruled.

The doctor admitted taking medication from practice stocks and using “left overs” from opioid vials which he had only part administered to patients to feed his own opioid addiction.

On Friday, Mr Justice Peter Kelly ruled the Medical Council would have to hold a hearing in public at which it will censure him for misconduct along with a series of conditions on his registration.

The doctor has taken steps to recover from his addiction and other mental health problems and has spent a substantial period not practising medicine.

The judge said the doctor’s name cannot be published and can only be referred to by initials. The Medical Council had sought a ruling on whether the sanction hearing should be in public and whether the report of its Fitness to Practise Committee (FtPC) should be published. It followed a FtPC hearing into an investigation arising out of complaints that, over a five-year period, the doctor was using opioids which arose after he had been prescribed pain relief for injuries he suffered some years earlier.

He admitted a number of allegations including administering opioids to 36 named patients where he knew it was not clinically warranted or was inappropriate.

He also admitted prescribing opioids to six patients in excessive strengths and/or quantities.

Anything left over in the vials of medication, he admitted using on himself. He admitted that on one or more occasions during a three-year period, he took Tramadol samples from one or more pharmaceutical company representatives for himself.

He also obtained Tramadol and/or Cyclimorph and well as Pethidine and/or morphine sulphate from practice stock supplies or by using stock practice prescriptions.

He admitted prescribing 10 vials of Cyclimorph for an identified patient and presenting that prescription to a pharmacy in circumstances where the doctor knew or ought to have known this was inappropriate.

He admitted he was under the influence of opioids while engaged in practice and that this may impair his ability to do so.

The FtPC recommended censure although the Medical Council CEO said his registration should be cancelled because his conduct was “at the most serious end of the spectrum”.

The full Medical Council agreed with the FtPC censure sanction given the admissions he made and his rehabilitation.

The council then asked the High Court to consider the appropriateness of having the sanctions hearing in private and of anonymising the names of patients, or other appropriate measures.

Its view was disclosure of such material would potentially be detrimental to the doctor and named patients.

Mr Justice Kelly said a hearing in public in which all names are anonymised would accommodate the constitutional rights of all involved. The Council also recommended the patients involved be provided with the FtPC report so they can be made aware of how they have been treated. However, it said it was not in the public interest to publish a transcript of the FtPC inquiry and did not believe the public at large should be informed of the conditions to be imposed on the doctor’s registration. Mr Justice Kelly agreed the patients involved should be advised. He said the Medical Practitioners Act 2007 clearly gives discretion in relation to advising the public. While the term “public” was not defined in the Act, it appeared to him the Council was entitled to advise “a limited constituency of the public”. It was a matter for the Council to exercise its discretion in this regard. The advice “will have to be given in a sensitive way since I am sure that it will come as a great shock to the patients”, he said.