Tribunal suspends GP for inappropriate prescribing

24 Dec 2019

A tribunal has suspended a specialist general practitioner, imposed conditions on his registration and reprimanded him for prescribing inappropriately, self-prescribing and prescribing for his own family members.

On 16 February 2016, the Medical Board of Australia (the Board) received a notification about Dr Stephen Hadges prescribing hormone therapy to a patient. On 17 March 2016, an Immediate Action Committee (IAC) accepted an undertaking from Dr Hadges to, among other things, not prescribe or administer anabolic steroids.

In December 2016, an IAC of the Board imposed conditions on Dr Hadges’ registration with his consent. Dr Hadges voluntarily ceased practising on 30 October 2017.

In March 2017, the Board referred the matter to the South Australian Health Practitioners Tribunal (the tribunal) alleging Dr Hadges engaged in professional misconduct by:

• inappropriately prescribing steroids to 15 patients over an extended period, including by:
  - failing to record and/or conduct adequate clinical assessments
  - making excessive and/or inappropriate use of investigations
  - failing to appropriately interpret and/or deliberately ignoring investigation results
  - making diagnoses without clinical justification
  - failing to consider other diagnoses
  - failing to consider the balance of benefit and harm in his clinical management decisions
  - failing to obtain informed consent, including a failure to provide and/or record the provision of information to the patients of the benefits and risks / adverse consequences associated with the use of the prescribed medications
  - prescribing anabolic androgenic steroids, anastrozole, steroid hormones and human growth hormones without clinical justification
  - prescribing anabolic androgenic steroids to be administered in excessive amounts
  - prescribing anabolic androgenic steroids despite investigation results reflecting excessive levels of testosterone and potential for harm
  - failing to work within the limits of his competence and scope of practice, and
  - providing drugs for recreational purposes rather than for therapeutic benefit
• inappropriately prescribing Stilnox and Valium to a patient over an extended period
• self-prescribing medication, and
• prescribing for family members.

On 14 February 2018, the tribunal decided to reprimand Dr Hadges, suspend his registration for eight months and imposed conditions on his registration, including:

• restricting his areas of practice to general practice and/or practice as a surgical assistant
• prohibiting him from performing cosmetic medicine or surgical procedures
• requiring him to be under supervision by another medical practitioner when practising
• requiring him to only practise at Board-approved places of practice
• prohibiting him from prescribing, supplying or administering anabolic steroids, thyroid hormone, medicines listed in Schedule 8 of the Standard for the Uniform Scheduling of Medicines and Poisons, benzodiazepine class medicines listed in Schedule 4 of the Standard for the Uniform Scheduling of Medicines and Poisons, tramadol and zolpidem (Stilnox)
• requiring him to keep records in accordance with Good medical practice
• requiring him to attend a GP as his treating practitioner for treatment and prescriptions, and
• completing education on various topics including clinical management, investigations, review of treatment, prescribing, informed consent and co-ordination of care.

The tribunal also ordered Dr Hadges to pay the Board’s costs of $15,000.

The tribunal has published the decision on its website.