Laois GP found guilty of misconduct for prescribing large quantities of drugs to known addicts

Seán McCárthaigh

A Laois-based family doctor who prescribed large quantities of highly addictive drugs to patients with a known drug addiction has been found guilty of professional misconduct by an Irish Medical Council (IMC) inquiry.

A total of 14 allegations against Dr Patricia Black that she had inappropriately prescribed benzodiazepines and other drugs to three patients while she worked as a GP in Tallaght, Dublin several years ago were found to be proven.

The IMC’s fitness to practise committee ruled the allegations individually constituted poor professional performance but cumulatively amounted to professional misconduct.

Announcing the inquiry’s findings on Wednesday, the committee’s chairperson, Ronan Quirke, said Dr Black’s behaviour in prescribing such drugs was “reckless and dangerous”.

“There can be no justification for such prescribing,” he added.

Mr Quirke said there “not a scintilla of evidence” that Dr Black had taken any steps to reduce or limit the amount or strength of highly addictive medication to affected patients. “Rather the picture is to the contrary,” Mr Quirke said.

He repeatedly stated the committee regarded the doctor’s conduct and treatment of patients as “shocking”.

The inquiry also found Dr Black guilty of professional misconduct over her failure to comply with an undertaking which she had given the IMC in 2018 not to prescribe controlled drugs, including benzodiazepines, to patients.

The inquiry heard evidence that Dr Black had prescribed such drugs on eight occasions between May 22nd and November 2nd, 2018.

Suspension

In December 2018, Dr Black was suspended from practising as a family doctor by order of the High Court due to patient safety concerns arising from her alleged prescription practices and the breach of her undertaking to the IMC.

Five other related allegations were found not proven beyond reasonable doubt, while another 10 allegations were withdrawn.

The committee noted that an expert witness had taken a conservative approach in that the doctor’s behaviour did not amount to professional misconduct because he did not have access to Dr Black’s medical records.

However, Mr Quirke noted that Dr Black had not provided such records to the inquiry, despite repeated requests.

Dr Black, of Castletown, Co Laois, did not attend the three-day medical inquiry which concluded in May and also failed to attend a  hearing on the findings on Wednesday.

During the hearing, the fitness to practice committee was informed that the maximum recommended number of 5mg tablets of benzodiazepine which should be prescribed in a month was 168, except in exceptional circumstances.

However, Dr Black had prescribed 275 tablets to one patient and prescribed a second quantity of another 290 tablets of the same drug 18 days later.

'Reckless'

The committee heard claims by an expert witness that Dr Black’s prescribing behaviour was “reckless” and “off the charts,” while also increasing the risk that certain drugs could be sold on the black market which posed a public health risk.

Significant quantities of benzodiazepines prescribed to one male increased the risk that he could die of an overdose, the inquiry heard.

Another patient was prescribed four times the recommended maximum limit of a drug.

Mr Quirke noted the GP’s conduct also facilitated the danger of patients getting drugs from multiple sources.

Dr Black, who qualified as a doctor in Ireland in 1991, had worked at a number of practices in the Dublin area up to 2018, including at a surgery on Knockmore Avenue in Tallaght and the Aylesbury Clinic in Old Bawn, and more recently at the Hope Medical Centre with clinics based in Mountrath and Castletown in Co Laois.

The inquiry heard that concerns about Dr Black’s prescribing practices were raised with the IMC by two community pharmacies.

It was also told that she should have questioned why medical card holders were going to see her privately when they could just attend their own doctor free of charge.

Dr Black informed the IMC in 2018 that she was only trying to help patients, but had admitted that she had given patients doses that were “colossally high” which she could not stand over as a doctor.

The FTP committee will notify the IMC of its findings and any recommended sanctions, which will not be made public