Health Care Complaints Commission v Dr Tat Kong Joseph Tiong [2012] NSWMT 6

Medical Tribunal New South Wales Medium Neutral Citation: Health Care Complaints Commission v Dr Tat Kong Joseph Tiong [2012] NSWMT 6 Hearing dates: 13,14 February,4 April 2012 Decision date: 05 April 2012 Before: Kavanagh J; Dr C Berglund PhD, Dr J Sammut, Dr J Briedis Decision: Orders: 1.The Tribunal marks its strong disapproval of Dr Tiong's conduct by reprimanding Dr Tiong pursuant to s 149A(1) of the Health Practitioner Regulation National Law (NSW) No 86a. 2.Dr Tiong is restricted from the practice of cosmetic surgery for a period of six months. 3.Dr Tiong's registration as a general practitioner is to be also subject to the following conditions: Educational Courses (i)To participate in and complete within 12 months of the date of this Decision and at his own expense, the course "Dealing with Difficult Doctor-Patient Relationships" conducted by the Cognitive Institute. The doctor is required to supply to the Council a copy of the Institute's Certificate detailing satisfactory completion (or otherwise) within two weeks of its receipt. (ii)Dr Tiong is to complete at his own expense prior to resuming his cosmetic surgery practice the course on Medical Ethics conducted in distance mode by the Department of General Practice, Monash University, Victoria. Within two weeks of completing the Ethics course, Dr Tiong is to provide documentary evidence to the Council that he has satisfactorily completed the course. (iii)Dr Tiong is to complete at his own expense prior to resuming his cosmetic surgery practice the course on Mastering Shared Decision-Making conducted in distance mode by the Cognitive Institute. Within two weeks of completing the Mastering Shared Decision-Making course, Dr Tiong is to provide documentary evidence to the Council that he has satisfactorily completed the course. (iv)Dr Tiong is to participate and complete the Australian College of Cosmetic Surgeon's Continuing Medical Education Course requirement each year for the next three years. The doctor is required to supply to the Council a copy of the satisfactory completion (or otherwise) within two weeks of its receipt. Supervision 4.Dr Tiong is to nominate a supervisor within 28 days of the date of this Decision (to be approved by the Medical Council) to monitor and review his clinical practice and compliance with Conditions in accordance with Level 3 Supervision as contained in the Council's Guidelines for Supervision. The supervisor should have surgical qualifications acceptable to the Medical Council. The approved supervisor is to be provided with a copy of the Council's Guidelines and a copy of this Decision. The practitioner is to be responsible for all costs associated with the supervision arrangement. The supervisory arrangement remains in place over his general practice and when he resumes his surgical practice until such time as the Medical Council considers it is no longer necessary. The practitioner is to ensure that: (a)he and the supervisor meet on a monthly basis for at least one hour, the first meeting to occur within one month of being advised by the Council that his nominated supervisor has been approved; (b)at each meeting they address clinical cases and selection, record keeping and surgical practices; (c)at each meeting, the supervisor completes a record of matters discussed at the meeting in a format prescribed or approved by the Council; (d)the supervisor forwards to the Council each month a Supervision Report in a format prescribed or approved by the Council; (e)the supervisor is authorised to inform the Council immediately if there is any concern in relation to the practitioner's compliance with the supervision requirements, compliance with other conditions of registration, clinical performance or if the supervisor relationship ceases; (f)in the event that the approved supervisor is no longer willing or able to provide the supervision required, details of a replacement supervisor are to be forwarded for approval by the Council within 21 days of the cessation of the original supervisory relationship. 5.Following the period of suspension Dr Tiong on resuming his practice of cosmetic surgery must practice under the following special condition: Dr Tiong is not to perform surgery that requires intravenous sedation or anaesthesia unless an anaesthetist is present. 6.Medical Records Audit Dr Tiong is to submit to an audit, at the premises where he conducts his medical practice, of a random selection of his medical records by a person or persons nominated by the Council, to assess his compliance with Part 4 of the Health Practitioner Regulation (NSW) Regulation 2010 and the standards set out in the Standards for General Practice 3rd Edition, Royal Australian College of General Practitioners (RACGP) and to ensure that Dr Tiong is complying with practice conditions. An audit is to occur within two months following the doctor's return to surgical practice and at six monthly intervals until the Medical Council determines they are no longer required. Dr Tiong will meet all costs associated with any audit/s and report/s. 7.Infection Control That the Medical Council of NSW arrange an inspection of Dr Tiong's medical premises within three months of the date the restriction is lifted and thereafter at six monthly intervals until no longer required by the Council, in order to assess and ensure his compliance with the Infection Control Standards as set out in Part 3 of the Health Practitioner Regulation (NSW) Regulation 2010. The doctor is to meet the cost of the inspection. 8.The Medical Council of NSW is the appropriate review body for the purpose of a review under Part 8 Div 8 of the Health Practitioner Regulation National Law (NSW). 9.The respondent to pay the complainant's costs. Catchwords: UNSATISFACTORY PROFESSIONAL CONDUCT AND PROFESSIONAL MISCONDUCT - Doctor charged with failure to obtain informed consent for unique cosmetic surgery - failure to keep proper medical records - failure to ensure proper post-operative care - failure to ensure safe aseptic practices in day surgery - doctor's treatment one patient considered - doctor's conduct both unsatisfactory professional conduct and professional misconduct - limitation placed on doctor's practice of medicine - appointment of an independent supervisor - retraining recommended in many aspects of practitioner's medical practice - orders accordingly - costs Legislation Cited: Health Practitioner Regulation National Law (NSW) No 86a Medical Practice Act 1992 Cases Cited: Buttsworth v Walton, NSW Court of Appeal, Unreported, 19 December 1991 Childs v Walton, NSW Court of Appeal, Unreported, 13 November 1990 Council of Law Society of New South Wales v Foreman (1994) 34 NSWLR 408 Health Care Complaints Commission v Litchfield (1997) 41 NSWLR 630 Law Society of New South Wales v Bannister (1993) 4 LPDR 24 Law Society of New South Wales v Walsh (NSW Court of Appeal, Unreported, 15 December 1997) Category: Principal judgment Parties: Health Care Complaints Commission (Complainant) Dr Tat Kong Joseph Tiong (Respondent) Representation: R Mathur (Complainant) G M Gregg (Respondent) Health Care Complaints Commission (Complainant) Dibbs Barker (Respondent) File Number(s): MT40026 of 2011