Tribunal suspends GP for inappropriate prescribing

29 May 2020

A general practitioner has been reprimanded, suspended for three months and had conditions imposed on her registration for inappropriate prescribing of drugs of dependence.

On 6 April 2020 the Victorian Civil and Administrative Tribunal (the tribunal) found that Dr Sarmin Sayeed had engaged in professional misconduct for inappropriate prescribing medication, including pethidine, alprazolam and lorazepam to three patients between September 2014 and March 2017.

Dr Sayeed's prescribing came to the attention of the Department of Health and Human Services (the Department) in its role monitoring drug prescribing and usage in Victoria. The Department notified the Medical Board of Australia (the Board) which took immediate action on 27 July 2017 to impose conditions on Dr Sayeed's registration, restricting her from prescribing Schedule 8 or 9 poisons, or drugs of dependence.

On 7 March 2018, Dr Sayeed pleaded guilty in the Moorabbin Magistrates' Court to four charges under the Drugs Poisons and Controlled Substances Act 1981 (DPCS Act) and two charges under the Drugs Poisons and Controlled Substances Regulations 2006 (DPCS Regulations). An aggregate fine of $7,500 was imposed, plus costs of $5,224, without conviction.

Following the conclusion of the criminal case and after further investigation, the Board referred the matter to the tribunal on 28 February 2019 and it proceeded to hearing on 18 February 2020.

The Board’s allegations include that Dr Sayeed:

In relation to Patient 1:

• prescribed pethidine without a permit for more than 8 weeks continuously (on 118 occasions)
• prescribed pethidine where there was reason to believe patient was a drug dependent person on 21 occasions
• prescribed pethidine without taking all reasonable steps to ensure therapeutic need on 88 occasions. 

These consultations were all via telephone and not face-to-face.

In relation to Patient 2:

• on one occasion, prescribed alprazolam without a permit for more than eight weeks continuously, where she had reason to believe the patient had been prescribed alprazolam by another practitioner.

In relation to Patient 3:

• prescribed lorazepam without taking all reasonable steps to ensure therapeutic need.
• prescribed lorazepam to a person she had reason to believe was drug dependent but failed to notify the Department.

Allegations also included that Dr Sayeed was found guilty of 6 charges under the DPCS Act and the DPCS Regulations, and by her conduct, was in breach of the Board’s Code of Conduct.

Dr Sayeed accepted that she had engaged in professional misconduct. In mitigation, it was noted that she was under enormous personal pressure from several sources during the period when she engaged in the prescribing, she pleaded guilty in the criminal proceedings and agreed to findings of professional misconduct in the tribunal matter at an early stage.

The tribunal reprimanded Dr Sayeed, imposed conditions on her registration and suspended her for a period of three months from 18 April to 19 July 2020.

The tribunal concluded that a three-month suspension reflected the seriousness of the inappropriate prescribing and satisfies the requirements of deterrence, noting that it will also have a serious impact on the practitioner.

The tribunal also noted that since May 2017, Dr Sayeed had undertaken a great deal of additional self­ education, far exceeding the minimum requirements. Dr Sayeed indicated that she now has a much more robust approach to such requests from patients. When she receives potentially dubious requests for prescribing, she advises the patients to go back to their own GP, or to hospital. She checks on SafeScript and makes appropriate notations on the patient's file.

After the period of suspension, Dr Sayeed’s registration will be subject to conditions requiring her to be supervised, restricting her from prescribing Schedule 8 or 9 medications, and requiring her to undertake education and an audit of her practice.

The tribunal has published the decision on its website.