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08 Mar 2019
A specialist general practitioner from Victoria has been suspended for six months by a tribunal after it found he had provided care to family members in circumstances that were avoidable, and his clinical management of 23 patients was not clinically justified and exposed patients to potential harm.
The Victorian Civil and Administrative Tribunal (the tribunal) reprimanded Dr Nicholas Sevdalis, suspended him from being able to practise as a medical practitioner for six months and imposed conditions on his registration after finding he had engaged in professional misconduct.
On 12 November 2014, the Professional Services Review (PSR) made a notification to the Medical Board of Australia (the Board). The PSR had completed an investigation into whether Dr Sevdalis had engaged in inappropriate practice in providing services under the Medicare Benefits Schedule (MBS). The PSR found that Dr Sevdalis had engaged in inappropriate practice and he was reprimanded and counselled, disqualified from rendering services under the MBS for two years, and ordered to repay Medicare benefits in the amount of $453,656.75 to the Commonwealth. Dr Sevdalis appealed this decision unsuccessfully before the Federal Court and then before the Full Court of the Federal Court.
Dr Sevdalis admitted to the two allegations that were referred to the tribunal.
The first allegation related to Dr Sevdalis providing medical care to two close family members in circumstances that were avoidable between 1 December 2011 and 20 November 2012. During the 12-month period, Dr Sevdalis saw one family member on 81 occasions and another on 60 occasions.
The second allegation related to Dr Sevdalis treating 23 patients in their homes between 6 December 2011 and 1 November 2012 where he administered intravenous Keflin (an antibiotic). It was agreed that Dr Sevdalis’s clinical management was not clinically justified or evidence-based and exposed patients to potential harm.
The Board submitted two expert opinions to the tribunal. The first concluded that ‘taking on the role of GP for his close family member would be regarded by the body of other GPs and the general public to be unacceptable’. The tribunal further made the point that it should have occurred to Dr Sevdalis that his conduct was clearly out of step with clause 3.14 of the Good medical practice: a code of conduct of doctors in Australia (the code), which requires that whenever possible, a doctor should avoid providing medical care to anyone with whom they have a close personal relationship.
The second expert opinion took the view that Dr Sevdalis’ treatment of the 23 patients was substantially below the standard reasonably expected of a medical practitioner with his level of training and/or experience because, among other things, it exposed patients to a risk of adverse effects of the intravenous therapy and antibiotic resistance. The tribunal added that this was contrary to clause 2.2.2 of the code which states, ‘Maintaining a high level of medical competence and professional conduct is essential for good patient care. Good medical practice involves…Considering the balance of benefit and harm in all clinical- management decisions.’
The tribunal noted Dr Sevdalis had repeated the conduct. The Board had previously sanctioned Dr Sevdalis on earlier occasions. In 2011 he had completed a reflective report about the treatment of family members as a result of a panel hearing. The conduct being heard by the tribunal occurred just months after Dr Sevdalis completed that report. Furthermore, in 2001 Dr Sevdalis had also received training about the administration of intravenous antibiotic treatment, specifically regarding appropriate dosage and indicated use.
The tribunal agreed both allegations amounted to professional misconduct and reprimanded Dr Sevdalis. The tribunal also imposed conditions on his registration that require further education on the therapeutic guidelines for the administration of antibiotics, education about ethical decision-making and conflicts of interest. Dr Sevdalis will also have to undergo a period of mentoring and submit his clinical records for audit once he returns to practice.
The decision is published on the Austlii website.