|Charge Characteristics:|| Inadequate informed
Did not follow patient's instructions
|Additional Orders:||Denied application for private hearing:
Doctor granted name suppression:
Name suppression for Doctor confirmed: 9833cfindingslaw
A CAC charged that the Doctor was guilty of professional misconduct in that:
(The particulars are as amended by the Tribunal at the commencement of the hearing.)
The Tribunal found the Doctor was not guilty of professional misconduct.
The Tribunal found that particular 1 of the charge could only be established if the CAC could show on the balance of probabilities first that a "medical controversy" surrounding the use of depo-medrol epidurally existed at the time of the 1989 consultation. The Tribunal found that was not established on the evidence.
The Tribunal also determined that particular 2 of the charge was not established. It found that what the complainant stipulated could not now be determined with a sufficient degree of certainty to find the particular proven. The Tribunal was satisfied on the balance of probabilities that the patient told the Doctor she did not want him to use the "same steroid drug" used in 1989. The Tribunal was equally satisfied that the Doctor either did not hear the instruction, or failed to appreciate the significance of what the patient was saying to him regarding her concerns. If the Doctor did not hear the patient's stipulation then the administration of depro-medrol was "mere inadvertence" and not necessarily culpable. In support of the Doctor's position that he did not understand any such stipulation to be made it was significant that an alternative steroid drug, kenacort, was readily available and could have been substituted. There was no record of a reported allergy or of the patient's request for an alternative steroid in the complainant's hospital records made at the time of her admission to the hospital for the spinal injection
When considering particular 3, the Tribunal found that such controversy regarding the use of depro-medrol as did exist related only to its use epidurally and itrathecally and not to its administration by facet joint injection. In any event the expert evidence given to the Tribunal was that the body of medical opinion in New Zealand regarded such controversies as had arisen as being settled by October 1994. On this basis, the Tribunal determined that particular 3 was not established.