07 Jul 2021
A tribunal has set aside the decision of the Medical Board of Australia (the Board) to impose conditions on the registration of a medical practitioner following allegations of inappropriate conduct and/or performance.
The Board took immediate action on 5 January 2021 and suspended Dr Pradeep Hanumantha Rao’s registration following a complaint made by a female patient on 1 September 2020. On 27 August 2020, the female patient presented to the emergency department of St Andrew’s War Memorial Hospital where a physical examination, including a breast examination, was conducted by Dr Rao. The female patient alleged that Dr Rao had not gained consent for the breast examination and his conduct made her feel uncomfortable and violated.
On 11 February 2021, the tribunal invited the Board to reconsider its decision to take immediate action following an application to the Queensland Civil and Administrative Tribunal (the tribunal) by Dr Rao for review of the decision. On 18 February 2021, the Board set aside its original decision with a new decision to revoke the suspension but to impose conditions on Dr Rao’s registration. The Board considered that Dr Rao continued to pose a serious risk to persons because of the alleged conduct and/or performance and that immediate action was necessary to protect the public. The conditions provided that Dr Rao practise in places approved by the Board, not treat female patients, only treat patients allocated by a Board approved supervisor and be supervised by another registered health practitioner.
Internal reviewers at St Andrew’s acknowledged that Dr Rao believed there was a clinical reason to progress to a breast examination. However, there was no documentation in the patient’s medical record that a breast examination was completed or that consent was obtained. Given the intimate nature of the examination, the responsibility rested with Dr Rao to properly document informed consent, which he failed to do. Dr Rao accepted this failure to document was unacceptable.
The Board raised concerns that the overall management of the patient who had presented with cardiac issues was not in line with chest management protocols. The tribunal considered the real question was whether the breast examination gave rise to a reasonable belief that Dr Rao might indecently assault a female patient or breach appropriate professional boundaries.
The tribunal considered that Dr Rao showed insight into his inadequate communication with the patient and empathy to the adverse consequences she had suffered. The tribunal also noted that prior to this matter, Dr Rao had never been the subject of a patient complaint to a regulatory body in his 20 years practice of medicine.
While Dr Rao’s motivation in performing the breast examination remains in dispute and not a matter for resolution in these proceedings, the tribunal observed it was not accompanied by any type of other explicit sexual behaviour or inappropriate comments and is quite capable of being regarded as unorthodox and unfortunate but clinically motivated.
The tribunal set aside the Medical Board’s decision of 18 February 2021, which means that Dr Rao’s registration does not have conditions. In setting aside the Board’s decision, the tribunal noted that Dr Rao was well aware that an investigation continues and that any failure to adhere to professional standards would be of interest to investigators.
The tribunal’s decision was published on the AustLII website on 6 May 2021.