Medical practitioner’s treatment found to be unprofessional conduct

28 Sep 2017

A medical practitioner has been reprimanded by a tribunal and had conditions imposed on his medical registration for behaving in a way that constitutes unprofessional conduct.

Dr Mark Schulberg appeared before the Victorian Civil Administrative Tribunal (the tribunal).

The patient underwent a late term termination of pregnancy procedure over three days (16, 17, 18 August 2011) at a day procedure unit. The allegations before the tribunal related to Dr Schulberg’s conduct on 17 and 18 August. Dr Schulberg performed the procedure.

The patient had presented to the day procedure unit on 16 August 2011 for a termination of a 23 week, three day pregnancy. Dr Schulberg had ordered blood tests on 16 August that showed anaemia and thrombocytopaenia (reduced platelets). Dr Schulberg saw the test results on 17 August before he performed the second stage of the procedure. He ordered further urgent blood tests include full blood examination, urea and electrolytes, liver function tests and clotting profile, INR and serum vitamin K on 17 August.

When the patient re-presented on 18 August 2011 for the third stage of the procedure, she was noticeably jaundiced, initially responsive to movement but then later became unconscious.

Dr Schulberg gave evidence that he formed the belief that he needed to evacuate the patient’s uterus. Despite the patient’s condition, a decision was made to continue with the procedure. During the procedure to evacuate the uterine contents, the patient was unconscious and did not have any anaesthetic.

After the procedure, the patient was handed over to recovery nurses in the recovery area. Dr Schulberg attended upon the ambulance officers but then continued with the patient list.

The patient was ultimately transported by ambulance to a tertiary hospital with Mobile Intensive Care Ambulance (MICA) paramedics in attendance.

The tribunal found that Dr Schulberg had:

• failed to adequately clinically care for and treat his patient to the extent that he failed to access, follow-up or consider the results of urgent blood tests ordered on 17 August 2011
• should not have performed an operation (late stage termination) on his patient on 18 August 2011 in circumstances where the patient was unconscious; in renal and liver failure; no anaesthesia was administered; the procedure was performed at a day surgery and he did not adequately consider the urgent pathology results ordered on the morning of 17 August 2011
• failed to ensure an ambulance had been called within a timely manner on 18 August 2011, and
• should not have performed other operations leaving his unconscious patient without his direct medical supervision on 18 August 2011.

The tribunal found in respect of each of the proven allegations that Dr Schulberg’s treatment amounted to unprofessional conduct.

In late June, the tribunal declined the Board’s request to suspend Dr Schulberg’s registration noting, among other things, that:

• his registration had been cancelled in the intervening period in respect of other matters and that he had subsequently been re-registered
• he currently has practice restrictions in place that he has abided by, and
• that he has not performed termination procedures since 2013 and has no intention of doing so in the future.

The tribunal reprimanded Dr Schulberg and imposed a number of conditions on his practice, including education and a practice restriction that he not perform any surgical or operative procedures other than minor procedures under local anaesthetic that can be performed in his general practice rooms.

The reasons for the tribunal’s findings in May and final orders in June can be found on the Austlii website.