Tribunal suspends, reprimands and imposes conditions on GP for inappropriate prescribing

05 May 2020

A tribunal has reprimanded and imposed conditions on the registration a general practitioner for treating a patient at his home and for providing her with take-away doses of ketamine.

On 27 April 2015 patient XY consulted Dr Graham Barrett at his home. Dr Barrett administered 40mg of ketamine subcutaneously to patient XY’s left shoulder and provided three take away syringes for her to self-administer at home.

Following a notification, the Medical Board of Australia (the Board) started an investigation into Dr Barrett’s conduct on 26 May 2015, and considered taking immediate action. During the immediate action process the Board accepted an undertaking from Dr Barrett that he would not possess, prescribe, dispense or administer ketamine until approved to do so by the Board.

After investigating the matter, the Board referred Dr Barrett to the Victorian Civil and Administrative Tribunal (the tribunal) for professional misconduct.

On 21 October 2019, the tribunal determined that Dr Barrett’s conduct in treating patient XY at his home and providing multiple doses of ketamine to self-administer amounted to professional misconduct for the following reasons:

• there did not appear to be any urgent reason for patient XY to be treated at Dr Barrett’s home rather than at a medical clinic
• his home lacked the necessary monitoring equipment in the event of patient XY suffering an adverse reaction to the ketamine dose administered
• it is generally not appropriate for patients with psychiatric, chronic pain of other mental health issues to be seen at a medical practitioner’s private residence
• Dr Barrett failed to properly consider the risks that may arise in relation to the self-administration of the ketamine doses provided to the patient
• Dr Barrett’s failure to arrange for any follow up or monitoring of the self-administration of the ketamine doses, either by himself or patient XY’s treating GP, was considered particularly unprofessional given the possible risk of harm to the patient given their mental health history, and
• the provision of ketamine for unsupervised self-administration to XY was substantially below the standard reasonably expected of a medical practitioner.

The tribunal reprimanded Dr Barrett and imposed conditions on this registration to not possess, prescribe, dispense, or administer ketamine until he has successfully completed education in respect of providing medical care to patients in the home environment and prescribing and administering ketamine.

The tribunal considered that education conditions were necessary to ensure that he gains full insight into the way in which his conduct has been inconsistent with good medical practice and why it amounts to professional misconduct.

The decision is published on the Austlii website.