The President of the High Court has suspended a doctor from practising medicine until further order over breaches of undertakings he gave after concerns were raised about him prescribing controlled drugs via 'Dr Online'.
Mr Justice David Barniville said the doctor, referred to as 'Dr Z', had breached three undertakings given to the court last February, including not to treat, including not to prescribe medication to, any patient who was not a patient of the hospital where he works as a medical registrar.
The other undertakings were that he would only prescribe to patients in the hospital under consultant supervision and with the written consent of the Medical Council, and that he would not communicate with anyone to whom he had issued prescriptions through DrOnline.ie.
Those undertakings were given to the court following an application by the Medical Council seeking his suspension. The council had been contacted by the Pharmaceutical Society of Ireland over concerns from a number of pharmacists about his prescribing practices through his work as part of an online doctors’ service.
Mr Justice Barniville, having heard evidence in February, decided that the undertakings the doctor was prepared to give would satisfactorily address the situation.
However, the council returned to court in April saying he had been in breach of the undertakings on at least two occasions. Dr Z disputed that he intentionally breached any of the undertakings.
The judge was satisfied that on the basis of what Dr Z said himself, he had "undoubtedly breached" all three undertakings he gave.
These breaches arose because twice after he gave the February undertakings he provided two repeat prescriptions, containing painkillers, opioids and benzodiazepines - Xanax, Fentanyl, Baclofen and Gabapentin.
The patient involved had visited him at the hospital after learning he could no longer provide an online prescription. He examined the patient and told her she should register with the hospital but she was in a hurry back to Dublin to collect her children from school and did not do so.
Dr Z said the patient had a history of back surgery and complained of back pain and nerve impingement. He issued adjusted prescriptions, on hospital notepaper, for her following a physical examination of her in the hospital.
Breach
In a ruling suspending Dr Z, which was given from the bench in April and published online on Friday, Mr Justice Barniville found he was clearly in breach of the undertakings when he wrote prescriptions for the patient on February 17th and March 20th.
He said it may be the case that Dr Z did not, as he said in an affidavit, set out intentionally to breach or disregard the undertakings, and it may be that his failure to stand up to the patient involved.
That may be an indication of a weakness on his part or an inability properly to exercise his independence as a doctor and to resist the pressure put on him by a patient, he said.
Dr Z asked the court to allow him to reaffirm the undertakings he gave in February on February 2nd, however, the judge said he was afraid he could not take that course of action.
The judge added he was satisfied to conclude and was persuaded by the Medical Council that this is such an exceptional case in which the public interest does require that I make the order suspending him until further order.
