Tribunal dismisses allegations against medical practitioner

07 Oct 2016

The Health Practitioners Tribunal (Tasmania) (the tribunal) has dismissed Tasmanian Board of the Medical Board of Australia (the Board) allegations of unprofessional conduct against general practitioner Dr Gregory Pitt.

The matter related to the prescribing and administering of steroid medication in the form of testosterone to a patient on a number of occasions where it was submitted there was no therapeutic purpose or justification for administering that medication.

The Board referred the matter to the tribunal in December 2014, initially alleging that the prescribing of testosterone to a patient for body building purposes without any obvious therapeutic need amounted to professional misconduct.

At the commencement of the hearing of the matter, held on 11 May and 17 May 2016, counsel for the Board advised it was no longer seeking to establish that the respondent was guilty of professional misconduct, but rather the factual matters amounted to unprofessional conduct.

That followed the Board’s receipt of an endocrinologist’s report dated 19 October 2015. In his report, the endocrinologist considered Dr Pitt exercised bad judgment in prescribing testosterone to the patient but understood the circumstances in which the decision was made. Following the receipt of the report it was decided that the practitioner’s conduct ought to be characterised less seriously as unprofessional conduct, rather than professional misconduct.

It was evident that the patient had been a long-term abuser of testosterone which was obtained from a variety of sources in addition to his medical practitioner. The patient had attended the practitioner’s medical practice between 1992 and 2007.

The Board’s referral to the tribunal alleged:

• On or about 18 August 1992, Dr Pitt prescribed injectable testosterone for the patient in the form of ‘Sustanon 250’ for a non-therapeutic purpose. Subsequently, on four occasions over the following weeks, he prescribed that substance by injection where there was no indication of a legitimate therapeutic requirement 
• On or about 8 June 2007, Dr Pitt supplied a sample pack of ‘Testogel’ (testosterone) to the patient knowing that its purpose was for body building and not a legitimate treatment of any identified medical condition 
• On or about 10 October 2007, Dr Pitt prescribed testosterone for the patient in the form of ‘Testogel’, for a non-therapeutic purpose and when it was not medically indicated. The substance was prescribed for supply in form of 30 satchels of 50mg/5cc with a single repeat to be used every two days over a four month period, and 
• On or about 7 June 2010 and 29 December 2010, the practitioner prescribed and/or administered (injected by an enrolled nurse under Dr Pitt’s direction) knowing that its purpose was body building and not a legitimate treatment of any identified medical condition.

Dr Pitt had no issue with factual details concerning the actual prescribing or administering of the pharmaceutical product, but maintained in relation to each incident there was either a therapeutic basis, it was in the patient’s best interests or that he was misled or unaware as to material clinical information. In his response, he documented the patient’s recent injury and slow post-operative recovery.

In its determination, the tribunal did not accept the limited amount of testosterone Dr Pitt prescribed was the cause of the side effects reported by the patient a number of years later. It found Dr Pitt had been misled by the patient but had on at least two occasions failed to exercise proper and safe clinical practice in his failure to check the patient’s records.

In dismissing the Board’s application on 2 June 2016, the tribunal noted general practice can at times be ‘an extremely busy undertaking’ and considered as tolerable an occasional deviation from the highest standards. It found Dr Pitt’s omission did not necessarily amount to conduct below the expectations of his peers and the public, considering it ‘unrealistic to expect in any profession, perfection in the performance of that profession’.

The decision will be published on AustLii.