Health Care Complaints Commission v Carayannis [2021] NSWCATOD 81

Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Health Care Complaints Commission v Carayannis [2021] NSWCATOD 81 Hearing dates: 31 May – 1 June 2021 Date of orders: 15 June 2021 Decision date: 15 June 2021 Jurisdiction: Occupational Division Before: Balla ADCJ, Principal Member Dr M Cooper, Senior Member Dr G Dore, Senior Member D Telford, General Member Decision: The orders we make are the following: (1) Dr Carayannis is reprimanded. (2) The following conditions are placed on Dr Carayannis' registration: Practice Conditions 1. To obtain Medical Council of New South Wales' approval prior to changing the nature or place of his practice; 2. Not to undertake locum positions; 3. Not to participate in any on-call rosters; 4. Not to participate in retrieval medicine; 5. Not to prescribe, possess, supply, administer, handle or dispense any Schedule 8 drug as defined by the Poisons and Therapeutic Goods Act 1966 (NSW), except in a hospital where he is working. Dr Carayannis is permitted to prescribe, administer, handle or dispense Schedule 8 drugs only in a hospital to inpatients during the practice of anaesthesia, or on a hospital medication chart, or as patient discharge prescriptions; 6. Not to possess, supply, administer or prescribe any Schedule 4 drug listed in Appendix D to the Poisons and Therapeutic Goods Regulation 2008 (NSW), except in a hospital where he is working. Dr Carayannis is permitted to prescribe, administer, handle or dispense Schedule 4 Appendix D drugs only in a hospital to inpatients during the practice of anaesthesia, or on a hospital medication chart, or as patient discharge prescriptions; 7. To practise under category C supervision in accordance with the Medical Council of New South Wales' "Compliance Policy – Supervision" (as varied from time to time) and as subsequently determined by the appropriate review body; (a) The terms of the Council's "Compliance Policy – Supervision" are varied so that the practitioner is to: (i) have review meetings with his Council-approved supervisor(s), fortnightly, for a period of three months and monthly thereafter; (ii) authorise the Council-approved supervisor(s) to provide reports to the Council (in a Council-approved format) on a monthly basis; (b) At each supervision meeting the practitioner is to review and discuss his practice with his Council-approved supervisor with a particular focus on: (i) Clinical management; (ii) Documentation; (iii) Doses of opioid analgesia used during procedures in relation to accepted standards; (iv) Post-operative pain management; (c) The Council-approved supervisor is to conduct a random audit of the practitioner's: (i) Schedule 8 and Schedule 4 Annexure D drugs signed out during an operation; (ii) Drugs recorded as administered and drug discard witnessed; (iii) Recovery room analgesia required; (d) The Council-approved supervisor is to conduct a random audit of five of the practitioner's cases fortnightly, ensuring that at least one case is from each workplace; (e) Not to practise until a supervisor has been approved by the Council; (f) To authorise the Council to provide proposed and approved supervisors with a copy of the decision that imposed this condition; 8. To nominate an experienced anaesthetist to act as his professional mentor for approval by the Medical Council of New South Wales in accordance with the Council's "Compliance Policy – Mentor" (as varied from time to time) and as subsequently determined by the appropriate review body; (a) The terms of the Council's "Compliance Policy – Mentor" are varied so that the practitioner is to meet with the mentor on a monthly basis; (b) At each mentoring meeting the practitioner is to include discussion of the following: (i) Issues raised in supervision meetings; (ii) Challenges related to working with conditions on his registration; (iii) Career planning; (c) To authorise the mentor to report, in an approved format, to the Council every three months about the fact of contact, and to inform the Council if there is any concern about his professional conduct, health or personal wellbeing; 9. To forward evidence to the Medical Council of New South Wales, within 14 days of the making of these orders, that he has provided a copy of the full conditions to the head of the Anaesthetic Department at all places of practice; 10. Within 14 days of a change in the nature or place of his practice, he is to forward evidence to the Medical Council of New South Wales that he has provided a copy of the full conditions to the head of the Anaesthetic Department at all places of practice; Health Conditions 11. Further to the requirements of Condition 8, the practitioner is also required to discuss with his mentor at each mentoring meeting: (a) Work/life balance; (b) Progress with regard to his treatment; 12. Not to prescribe for self-medication; 13. To attend for treatment by a general practitioner of his choice. The frequency of treatment is to be determined by the treating practitioner. The practitioner: (a) is to authorise the treating practitioner to inform the Medical Council of New South Wales of any of the following: (i) Failure to attend for treatment; (ii) Termination of treatment; (iii) A significant change in health status (including a significant temporary change); (b) must provide the Council with the professional details of the treating practitioner; 14. To attend for treatment by a drug and alcohol clinician of his choice. The frequency of treatment is to be determined by the treating practitioner. The practitioner: (a) is to authorise the treating practitioner to inform the Medical Council of New South Wales of any of the following: (i) Failure to attend for treatment; (ii) Termination of treatment; (iii) A significant change in health status (including a significant temporary change); (b) must provide the Council with the professional details of the treating practitioner; 15. To attend for treatment by a psychiatrist of his choice. The frequency of treatment is to be determined by the treating practitioner. The practitioner: (a) is to authorise the treating practitioner to inform the Medical Council of New South Wales of any of the following: (i) Failure to attend for treatment; (ii) Termination of treatment; (iii) A significant change in health status (including a significant temporary change); (b) must provide the Council with the professional details of the treating practitioner; 16. To attend for treatment by a psychotherapist of his choice. The frequency of treatment is to be determined by the treating practitioner. The practitioner: (a) is to authorise the treating practitioner to inform the Medical Council of New South Wales of any of the following: (i) Failure to attend for treatment; (ii) Termination of treatment; (iii) A significant change in health status (including a significant temporary change); (b) must provide the Council with the professional details of the treating practitioner; 17. To take any medication as prescribed by his treating practitioners; 18. To comply with the Medical Council of New South Wales' "Drug Screening Policy" and "Participant Procedure: Drug Screening" (as varied from time to time) and attend for: (a) Urine drug screening three times a week; and (b) Quarterly hair drug screening; 19. To attend for review by a Council-appointed psychiatrist on a three-monthly basis or as otherwise directed by the Medical Council of New South Wales. 20. To attend a Medical Council of New South Wales' Review Interview on a three-monthly basis, or as otherwise directed by the Council. 21. To authorise the Medical Council of New South Wales to forward copies of the s 150 and s 150A written reasons, any subsequent Council Review Interview or other report, and any other information relevant to his health and treatment, to the Council-appointed practitioners and to his treating practitioners. 22. The Medical Council of New South Wales is the appropriate review body. (3) Dr Carayannis is to pay the costs of the Health Care Complaints Commission of the proceedings, as agreed or assessed. Catchwords: HEALTH — professional registration and discipline — unsatisfactory professional conduct – professional misconduct Legislation Cited: Health Practitioner Regulation National Law (NSW) Cases Cited: Briginshaw v Briginshaw (1938) 60 CLR 336; [1938] HCA 34 Clyne v The New South Wales Bar Association (1960) 104 CLR 186; [1960] HCA 40 Health Care Complaints Commission v Do [2014] NSWCA 307 Health Care Complaints Commission v Litchfield (1997) 41 NSWLR 630 Qidwai v Brown [1984] 1 NSWLR 100 Texts Cited: Medical Board of Australia, "Good Medical Practice: A Code of Conduct for Doctors in Australia" (March 2014) Category: Principal judgment Parties: Health Care Complaints Commission (Applicant) Daniel Carayannis (Respondent) Representation: Counsel: D New (Applicant) S Barnes (Respondent)