28 Oct 2020
A Western Australian medical practitioner was found to have engaged in unprofessional conduct in the Supreme Court of Western Australia Court of Appeal (Court of Appeal).
The majority of the Court of Appeal found that Dr Peter Panegyres, a neurologist, had engaged in a single instance of unprofessional conduct by excessively charging for services to a patient who, to his knowledge, was mentally incompetent.
Dr Panegyres was reprimanded and ordered to pay a fine of $20,000. The Court of Appeal found that his knowledge that the patient was mentally incompetent placed the conduct at the more serious range of unprofessional conduct.
On 28 May 2015, the Medical Board of Australia (the Board) commenced proceedings in the State Administrative Tribunal of Western Australia (tribunal). The Board alleged that during 27 November 2012 and 21 February 2013, Dr Panegyres charged excessively for services he did not provide and were not clinically indicated for an elderly patient with dementia who was also suffering from Lewy Body Disease.
The Board alleged Dr Panegyres had provided services to the patient at Joondalup Health Campus on 78 occasions over an 87-day period that were not clinically-indicated; had failed to keep adequate and contemporaneous records; and charged the patient excessively ($25,265.10). It was also alleged Dr Panegyres had failed to obtain appropriate consent once an administrator had been appointed.
On 21 November 2017, the tribunal found that Dr Panegyres had engaged in professional misconduct, in that he had provided and charged for medical services for the patient which were not clinically-indicated and which were not reasonably required for the patient's wellbeing. He could not produce clinical notes to explain the need for those services.
The tribunal also found that Dr Panegyres did not gain consent of the patient's administrator for treatment, even though he knew the patient did not have the capacity to make those decisions himself. Further the tribunal found Dr Panegyres had charged Medicare Australia for other services for which he was not entitled to charge.
The tribunal found that Dr Panegyres engaged in professional misconduct and ordered that Dr Panegyres’ registration be suspended for a period of six months and he pay the Board’s costs of the proceedings in the sum of $264,000.
Dr Panegyres subsequently appealed the tribunal’s finding of professional misconduct and penalty orders on a number of grounds, including that the tribunal had failed to explain the intellectual process by which it arrived at a finding of professional misconduct and that a suspension of six months was manifestly excessive.
On 24 April 2020, the Court of Appeal found that the tribunal had not provided adequate reasons for the finding of professional misconduct or for awarding the sum of $264,000. The Court of Appeal set aside the tribunal’s findings and orders and substituted them with a finding of unprofessional conduct, a reprimand and a fine in the sum of $20,000.
The Board was unsuccessful in a cross appeal.
The decisions determined in this matter on 21 November 2017 and 24 April 2020 are published.