A DOCTOR appeared to be colluding to help a patient feed her drug habit when she agreed to spread a number of medications over two separate prescriptions, a fitness to practise commitee of the Irish Medical Council heard yesterday.
Prof Colin Bradley, chairman of general practice at University College Cork, said that he had studied the transcript of evidence given by a patient of Dr Iwona Kulczyk in which the patient told how she asked the GP for three different tranquillisers.
The patient, identified as LC, who had given evidence in private to the hearing, told Dr Kulczyk there was no way a pharmacist would give her all three tranquillisers on the one prescription and suggested instead that she give her two prescriptions which the doctor did.
“It smacks of a collusion going on between the doctor and the patient to feed the patient’s drug habit.
“I don’t know what other construct I could put on it – she suggested a ruse for circumventing the scrutiny of a pharmacist and the doctor went along with it,” Prof Bradley said.
Prof Bradley, who also works in general practice, described Dr Kulczyk’s overall pattern of prescribing as “irresponsible” and said there were a number of issues which concerned him including her frequent prescribing of Rohypnol which is marketed as a hypnotic for insomnia.
Rohypnol had a number of characteristics including its tendency to create anterograde amnesia leading to a belief that it is used in drug facilitated sexual assault and it is a tightly controlled drug that is only rarely prescribed by GPs in Ireland, he said.
He had studied 140 prescriptions relating to 86 patients for whom Dr Kulczyk had prescribed medication from her practice at Penrose Wharf in Cork. Rohypnol had been prescribed to 48 of these patients with most being prescribed in large doses of 30 and 60 tablets, he said.
Prof Bradley said that he was also concerned at Dr Kulczyk’s prescribing of two or more benzodiazepines such as Diazepam, Xanax or Halcion on the same prescription as this could increase the risk of toxicity and of a patient developing an addiction to the medication.
This was particularly true in the case of patients with previous drug or alcohol addictions and it was also a concern that Dr Kulczyk was prescribing such drugs for much longer than the two to four weeks recommended for hypnotic drugs and 10-12 weeks for anti-anxiety drugs.
Prof Bradley also expressed concern at the fact that one patient, JC, was able to obtain a prescription for tranquillisers on a date in September 2008 and then went back the following day and obtained a similar prescription using a false name.
Prof Bradley then gave his assessment on the various charges levelled at Dr Kulczyk regarding her prescribing and he said that in the majority of these, he believed her prescribing went beyond poor performance and amounted to professional misconduct.
The hearing is now adjourned until November 9th.