Doctor suspended from practise by High Court over online prescribing

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 “DrOnline”.

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 or prescribe medication to any patient who was not a patient of the hospital where he works as a medical registrar.

He also undertook to only prescribe to patients in the hospital under consultant supervision and with the written consent of the Medical Council. He also agreed that he would not communicate with anyone to whom he had issued prescriptions through DrOnline.ie.

February evidence

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 several pharmacists about his prescribing practices through his work as part of an online doctors’ service.

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The judge, having heard evidence in February, decided that undertakings the doctor was prepared to give would satisfactorily address the situation.

However, the council returned to court in April saying he had breached the undertakings on at least two occasions. Dr Z disputed that he intentionally breached any of the undertakings. But 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.

April ruling

In a ruling suspending Dr Z, which was given from the bench in April and published on Friday, the judge found he was clearly in breach of the undertakings when he wrote prescriptions for the patient on February 17th and March 20th last.

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 was an indication of a weakness on his part or an inability to properly exercise his independence as a doctor and resist the pressure put on him by a patient.

Dr Z asked the court to allow him to reaffirm the undertakings he gave in February.

The judge said he was afraid he could not take that course of action.

He was satisfied to conclude and was persuaded by the council that this was such an exceptional case in which the public interest required him to make the order suspending him until further order.