Medical Board of Australia v Rohella [2026] QCAT 60

Craig v The Medical Board of South Australia [2001] SASC 169; (2001) 79 SASR 545

Health Care Complaints Commission v Litchfield [1997] NSWSC 297; (1997) 41 NSWLR 630

Health Ombudsman v Bevins [2025] QCAT 102

Health Ombudsman v Duggirala [2021] QCAT 326

Health Ombudsman v Vale [2020] QCAT 363

Medical Board of Australia v Arulanandarajah (Review and Regulation) [2021] VCAT 85

Medical Board of Australia v Bromeley [2018] QCAT 163

Medical Board of Australia v Evans [2013] QCAT 217

Medical Board of Australia v Griffiths (Review and Regulation) [2017] VCAT 822

Medical Board of Australia v Singh [2017] WASAT 33

Nursing and Midwifery Board of Australia v Lockie [2023] QCA 96

Nursing and Midwifery Board of Australia v Lockie [2022] QCAT 391

The Health Ombudsman v Masamba [2019] QCAT 227

[1] The National Law is the enabling Act for the purpose of section 9(1) of the Queensland Civil and Administrative Tribunal Act 2009 (Qld) ('QCAT Act'). Hearing the matter the Tribunal sits in its original jurisdiction pursuant to sections 9(2)(a) and 10(1)(b) of the QCAT Act.

[2] The Medical Board of Australia ('the Board') is established pursuant to section 31 of the National Law. It has the power, pursuant to section 35 of the National Law, to refer matters concerning health practitioners to this Tribunal.

[3] On 28 March 2024, the Board referred disciplinary proceedings against the Respondent to the Queensland Civil and Administrative Tribunal pursuant to ss. l93B(2) and 193B(3)(a)(i) of the National Law.

[4] On 20 October 2020, the Board took immediate action to suspend the Respondent's registration as a medical practitioner. The Respondent's registration currently remains suspended.

[5] The Respondent is a medical practitioner, originally trained in India as an orthopaedic surgeon. In or around 2006, the Respondent commenced work in Queensland hospitals, with the intention of qualifying as an orthopaedic surgeon in Australia. He worked in Queensland hospitals between 2006 and 2013.

[6] In 2013, after unsuccessfully completing his re-qualification as an orthopaedic surgeon, the Respondent commenced working in after hour doctor services.

[7] At all times relevant to the alleged conduct, the Respondent was a medical practitioner. Between October 2018 and March 2020, the Respondent was a medical practitioner with House Call Doctor Service, Hervey Bay. Between April 2019 and March 2020, the Respondent was a medical practitioner at Fraser Shores Medical Centre ("in clinic").

[8] At all times relevant to the alleged conduct the subject of the referral, the Respondent, was required to comply with the Board's 'Good Medical Practice: a code of conduct for doctors in Australia', which was in effect from 1 March 2014 until 30 September 2020 ('Code of Conduct').

[9] The onus rests with the Board to prove its case to the civil standard, namely on the balance of probabilities. However, the principles articulated in Briginshaw v Briginshaw[1] must be applied, having regard to the seriousness and nature of the allegations

[10] At the commencement of the oral hearing, the Tribunal clarified the Respondent's position in respect of the factual findings sought by the Board.[2] The Respondent confirmed that he agreed to the facts as alleged by the Board. As such, there is no dispute in terms of the facts.

[11] The Respondent did not seek to challenge the evidence of Dr Teague by way of cross-examination. He indicated during the hearing that he accepted the report of Dr Teague[3] and the findings Dr Teague had made.

[12] The Respondent also advised the Tribunal that he accepts the characterisation of Ground one, namely the boundary violation, is professional misconduct. In respect of Ground two, the Respondent does not accept his conduct was professional misconduct.

[13] The Respondent also opposes the cancellation of his registration and seeks that his registration continue with various conditions to be attached to his return to practice.

[14] As such, the issues that remained in dispute at the time of hearing were:

(a) the characterisation of the Respondent's conduct in respect of Ground two; and

(b) the appropriate sanction to be imposed.

[15] The first Ground relates to patient QL. The Respondent first treated QL through the House Call Doctor Service on 11 March 2019. QL's last consultation with the Respondent occurred at Fraser Shores Medical Centre on 29 January 2020. However, two further prescriptions were issued for QL by the Respondent on 25 February 2020 and 8 March 2020, without consultation notes or Medicare billing attached to the prescriptions.

[16] During the period from 11 March 2019 until 8 March 2020, QL attended a total of 54 consultations with the Respondent across the House Call Doctor Service and in clinic appointments. Additionally, there were a total of 10 occasions where prescriptions were issued to QL, without corresponding consultation notes.

[17] The Respondent engaged in an inappropriate personal relationship with QL by:

(a) lending QL money in the sum of $400 on 14 October 2019; and

(b) employing QL to perform cleaning services at his home on two occasions in between January 2019 and March 2020.

[18] In terms of the allegation, the Respondent admits that he lent QL $400 to assist in paying her car registration, and also that he arranged for QL to provide cleaning services at his home, on two occasions.

[19] The Respondent's conduct breached principle 3.14 (Personal Relationships) of the Code of Conduct, which strictly advises against providing medical care to anyone with whom a doctor has a close personal relationship, due to the risk of losing objectivity.

[20] It is accepted by the Respondent that the boundary blurring caused an environment susceptible to misunderstanding and exploitation.

[21] The Tribunal is satisfied of the facts as outlined above to the requisite standard in terms of Ground one.

Ground Two - Deficient Clinical Care and Record Keeping

[22] The second Ground relates to seven patients who were treated by the Respondent, either through the House Call Doctor Service or in clinic at Fraser Shore Medical Centre between January 2019 and March 2020.

[23] As outlined above, QL first consulted with the Respondent through the home doctor service on 11 March 2019. QL first attended a consultation with the Respondent at Fraser Shores Medical Centre on 23 April 2019.

[24] Between 11 March 2019 and 23 April 2019, when the first consultation occurred in clinic, the Respondent attended upon QL, by way of house call, on 11 occasions. During that period, namely a period of approximately three weeks, the dispensing records for QL indicate that the Respondent prescribed 140 oxycodone 5mg tablets to the patient. It is accepted by the Tribunal that given the short period of time over which the prescriptions were given by the Respondent to QL for oxycodone, the Respondent, by at least the first in clinic consultation on 23 April 2019, should have been alive to concerns that QL was showing signs of drug dependency.

[25] On 23 April 2019, QL first consulted with the Respondent at Fraser Shores Medical Centre. QL had previously attended Fraser Shore Medical Centre in 2004, at which time notes recorded that there were concerns about drug abuse and doctor shopping by QL. As such, at least from 23 April 2019, the Respondent should have been alerted to significant concerns as to QL's potential drug dependency. By 23 April 2019, the Respondent would have had access to the previous clinical notes for QL, highlighting the concerns as to drug abuse and doctor shopping in 2004, as well as his own prescribing knowledge over the three-week period prior to the in-clinic consultation.

[26] Despite those concerns, after the in-clinic consultation on 23 April 2019, QL's records show that she attended the following consultations with the Respondent:

Paracetamol + Codeine Paracetamol 500mg+ Codeine Phosphate Hemihydrate 30mg

Diazepam 5mg tablet Oxycodone Hydrochloride 5mg Tablet, 20

Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg

Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg

Paracetamol 500mg+ Codeine Phosphate Hemihydrate 30mg

[27] It is accepted by the Tribunal that at the time of prescribing QL oxycodone, hydrochloride, diazepam and codeine/paracetamol, as outlined in paragraph [26], the Respondent knew or ought to have known QL had a history of drug dependency.

[28] At page 13 of Dr Teague's report, she opines:

Review of the relevant dispensing records shows that in the period between 11/3/19 and 18/4/19 the Practitioner prescribed 140 oxycodone 5mg tablets to the Patient, totaling 700mg oxycodone, a morphine equivalence of 1050mg. This equates to the Patient having a minimum of 30 mg morphine/24 hours over this period (note: the addition of Panadeine Forte 2 tablets twice a day would increase her 24 hour opioid intake by 15mg).

There is no evidence that the Practitioner recognised that his prescribing placed the Patient at risk of iatrogenic opioid dependency, and that in an opioid naïve patient the amount of oxycodone and the frequency with which he was prescribing placed the Patient at risk of adverse effects, particularly when mixed with benzodiazepines.

[29] Additionally, pharmacy dispensing and Services Australia records show that the Respondent issued prescriptions to the patient on other occasions, where there is no correlating consultation notes nor Medicare billing information. Those occasions are as follows:

Amoxicillin + Clavulanic Acid Amoxicillin 875mg + Clavulanic Acid 125mg tablet

Paracetamol + Codeine Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg tablet

[30] In assessing the notes and relevant records for each of those appointments, Dr Teague made a number of findings and observations, which are accepted by the Tribunal. They are that the Respondent:

(a) did not take and/or record an adequate patient history;

(b) did not conduct and/or record a fulsome examination of QL;

(c) did not formulate and/or record an evidence-based understanding and assessment and management of the reported back pain of QL;

(d) did not properly assess and/or record his assessment of risks in prescribing opioids or benzodiazepines;

(e) did not comply with the relevant regulatory requirements including under the Health (Drugs and Poisons) Regulation 1996 (Qld);

(f) demonstrated dangerous prescribing practices of drugs of dependence and did not monitor side effects of the prescribed medications;

(g) did not take adequate clinical records; and

(h) did not conduct and/or record an adequate assessment or diagnostic process, including by conducting and recording a mental health examination.

[31] On or about 27 July 2019, the Respondent "blacklisted" QL from House Call Doctor Service. Despite "blacklisting" QL from House Call Doctor Service, the Respondent continued to prescribe QL Endone (oxycodone), Valium (diazepam), Serepax (oxazepam), Pristiq (desventafine) and Curam Duo Forte (amoxicillin and clavulanic acid) after 27 July 2019.

[32] Subsequent to the Respondent "blacklisting" QL from House Call Doctor Service, the Respondent consulted with QL at Fraser Shores Medical Centre on 18 occasions between 10 September 2019 and 29 January 2020. In addition, the Respondent issued prescriptions where there were no correlating consultation notes, nor Medicare billing information during this period, on nine occasions_._ In respect of Endone and Valium, in particular; after 27 July 2019, on most occasions, either one or both were prescribed.

[33] As to the period after the Respondent "blacklisted" QL, Dr Teague also opines at p. 21 of her report:

There is evidence of the Patient demonstrating drug seeking behaviours (21/11/19) and on 10/12/19 the Practitioner noted that the Patient "is possibly getting addicted to endone and consuming too many". Despite this, there is no evidence of his assessing the Patient for opioid dependency or of discussing the situation with a colleague, his MDU or Queensland Health monitored medicines staff. Between 10/12/19 and 21/1/20 he issued the Patient with a further six (6) scripts for oxycodone, with a further two prescriptions provided by GP colleagues in the Clinic. In this 6 week period the Patient was therefore prescribed 160 oxycodone 5mg tablets, a morphine equivalence of 1200mg which is an approximate 24 hour morphine use of 30mg. In the same period, the Practitioner prescribed oxazepam 30mg eight (8) times, and diazepam twice.

[34] Additionally, it is noted by Dr Teague at p. 21 of her report:

Despite there being no record of the Patient consulting with the Practitioner after 21/1/20, dispensing records show that he issued her with prescriptions for oxycodone on 25/2/20, 1/3/20 and 8/3/20 and diazepam on 8/3/20.

I can find no acceptable reason for the absence of medical records or Medicare billing data accompanying these prescriptions...

[35] The consultation notes subsequent to 27 July 2019 also:

(a) do not record any adequate patient history, including with regard to drug seeking behaviour;

(b) do not involve records of any evidence-based understanding and assessment and management of prescribing opioids or benzodiazepine to QL;

(c) indicate the Respondent did not comply with the relevant regulatory requirements, including under the Health (Drugs and Poisons) Regulations 1996 (Qld), that required the Respondent to seek approval from the Chief Executive of the Department of Health to prescribe a controlled drug to a person who a prescriber reasonably believes is a drug dependent person;

(d) did not record any monitoring of the side effects of the prescribed medications; and

(e) did not record any appropriate follow up of QL.

[36] By way of summary, in terms of the care provided by the Respondent to QL, Dr Teague opines at p. 22:

Dr Rohella's history taking, examination, assessment, diagnosis, and treatment plans for ...[QL] were inadequate with deficiencies in every aspect of clinical care apart from the occasion when he referred her to hospital with suspected pneumonia. His deficits include common GP conditions such as back pain, insomnia, anxiety, respiratory tract infections and urinary tract infections. His knowledge and clinical reasoning is substantially below the expected standard.

Dr Rohella's record keeping is substantially below the expected standard. A striking feature of the records is his indiscriminate use of autofill resulting in considerable doubt as to what actually occurred during the consultations...

[38] The opinions expressed by Dr Teague as to the deficiency of notes and practice by the Respondent when treating QL were not challenged by the Respondent. The Tribunal accepts the opinions and findings of Dr Teague as expressed above, and is satisfied of the factual findings as outlined in respect of QL.

[39] Between March 2019 and February 2020, the Respondent treated the patient NM though the House Call Doctor Service and Fraser Shores Medical Centre.

[40] NM first consulted with the Respondent through Fraser Shores Medical Centre on 4 April 2019. Records indicate that NM had also attended upon another doctor at the practice on 6 February 2019 and was prescribed opioids and benzodiazepines during that consultation.

[41] The records for NM show the following consultations were attended by NM, and prescriptions issued:

House Call Doctor Service consultation shows "Script for regular meds given"

Oxazepam 30mg Tablet, 25 Oxycodone + Naloxone Oxycodone Hcl 10mg + Naloxone Hcl 5mg Modified Release Tablet, 28

Oxycodone + Naloxone Oxycodone Hcl 10mg + Naloxone Hcl 5mg Modified Release Tablet, 28

Framycetin Sulfate + Gramicidin + Dexamethasone Framycetin Sulf 0.5% + Gramicidin 0.005% + Dexamethasone 0.05% Ear Drops, 3ml Oxazepam 30mg Tablet, 25

Amoxicillin + Clavulanic Acid Amoxicillin 875mg + Clavulanic Acid 125mg Tablet, 10

Oxycodone + Naloxone Oxycodone Hcl 10mg + Naloxone Hcl 5mg Modified Release Tablet, 28

Oxazepam 30mg Tablet, 25 Fluticasone + Salmeterol 250mcg/Actuation +

50mcg/Actuation Powder For Inhalation, 60 Actuations

Oxazepam 30mg Tablet, 25 Esomeprazole 20mg Enteric Tablet, 30

Oxycodone + Naloxone oxycodone Hcl 10mg + Naloxone Hcl 5mg Modified Release Tablet, 28

Oxycodone + Naloxone Oxycodone Hcl 20mg + Naloxone Hcl 10mg Modified Release Tablet, 28

Oxycodone + Naloxone Oxycodone Hcl 30mg + Naloxone Hcl 15mg Modified Release Tablet, 28

Oxazepam 30mg Tablet, 25 Oxycodone + Naloxone Oxycodone Hcl 20mg + Naloxone Hcl 10mg Modified Release Tablet, 28

Salbutamol 100 Microgram/Actuation Inhalation, 200 Actuations

Oxycodone + Naloxone Oxycodone Hcl 20mg + Naloxone Hcl 10mg Modified Release Tablet, 28

Oxycodone + Naloxone Oxycodone Hcl 30mg + Naloxone Hcl 15mg Modified Release Tablet, 28

Quetiapine, 300mg Tablet, 60 Oxycodone Hydrochloride 5mg Tablet, 20

Oxazepam 30mg Tablet, 25 Salbutamol 100mg /Actuation Inhalation, 200 Actuations Salbutamol 100

Oxazepam 30mg Tablet 25 Pantoprazole 40mg Enteric Tablet, 30

50mcg/Actuation Powder For Inhalation, 60 Actuations

Oxazepam 30mg Tablet, 25 Fluticasone + Salmeterol 250mcg/Actuation +

50mcg/Actuation Powder for inhalation. 60 Actuations

Oxycodone + Naloxone Oxycodone Hcl 20mg + Naloxone Hcl 10mg Modified

Oxycodone + Naloxone Oxycodone Hcl 20mg + Naloxone Hcl 10mg Modified Release Tablet, 28

[42] As to the Respondent's record keeping and clinical notes, it was observed by Dr Teague:

(a) in respect of the anxiety or mental health consultations, the Respondent:

(i) did not take and/or record adequate patient history;

(ii) did not conduct and/or record an adequate assessment of diagnostic process including by conducting and recording a mental health examination of NM;

(iii) did not formulate an appropriate management plan for LM's mental health; and

(iv) failed to refer NM to a specialist or organise a referral;

(b) in terms of the Respondent's clinical care of NM generally, the Respondent:

(i) used an identical autofill clinical note that had also been used for QL. The identical record was used for consultations with NM on 23/04/19, 15/05/19, 26/06/19, 02/07/19, 17/07/19, 17/9/2019, 24/10/19, 29/10/19, 12/11/19, 18/12/19, 31/12/19, 27/1/20, 29/1/20, 30/1/20;

(ii) despite the significant number of appointments and the prescribing of a schedule 8 drug approximately 25 times over a period of 11 months, the Respondent at no time sought approval from the Chief Executive of the Department of Health to prescribe a controlled drug to a person whom the Respondent believed to be a drug dependent person;

(iii) failed to integrate NM's care between Fraser Shores Medical Centre and House Call Doctor Service, or conduct a comprehensive review of NM when NM presented to Fraser Shores Medical Centre after consulting with the Respondent through the House Call Doctor Service;

(iv) did not properly assess and/or record his assessment of NM;

(v) prescribed opioid medications in circumstances where:

(vi) it was not clinically indicated; and

(vii) clinically unnecessary;

(viii) failed to record the prescription medications in medical records; and

(ix) did not record or manage appropriate follow up appointments of NM.

[43] Overall, the Tribunal is satisfied the facts as outlined above in respect of NM are proven to the requisite standard on the evidence. Additionally, the Tribunal accepts the opinions of Dr Teague as outlined above as to the Respondent's deficient care of NM during the relevant period.

[44] Between March 2019 and January 2020, the Respondent regularly treated patient BF through both the House Call Doctor Service and Fraser Shores Medical Centre.

[45] As to BF's appointments with the Respondent, they were as follows:

Diazepam 5mg Tablet 50 Oxycodone Hydrochloride 5mg Tablet, 20

Paracetamol + Codeine Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg Tablet, 20

Amoxicillin + Clavulanic Acid Amoxicillin 875mg + Clavulanic Acid 125mg Tablet, 10

[46] BF first attended an appointment in clinic with the Respondent on 18 September 2019. As to the in-clinic consultations, as opined by Dr Teague and accepted by the Tribunal, the Respondent:

(a) did not conduct and/or record an adequate assessment or diagnostic process including by conducting and recording a mental health examination;

(b) prescribed opioid medication in circumstances where it was not clinically indicated or justified, having regard to the lack of fulsome history and examination;

(c) did not monitor for side effects of prescribed medications; and

(d) did not record or manage appropriate follow up appointments.

[47] It was also noted by Dr Teague in her report that on four occasions where the Practitioner issued prescriptions for drugs of dependence, there are no associated medical records or Medicare billing data, namely:

(a) oxycodone 5mg x 20 tablets on 7/9/2019 and 28/9/2019; and

(b) diazepam 5mg x 50 tablets on 19/6/2019 and 8/8/2019.

[48] Of greater concern, on 27 November 2019, the Respondent prescribed Fentanyl to BF. To this end, Dr Teague opined at p. 34:

I note with extreme concern the consultation of 27/11/2019 where the Practitioner recorded a wholly inadequate history, his usual "low back pain" autofill examination and then prescribed the Patient a fentanyl (Durogesic) 50mcg. This is extremely dangerous prescribing, for reasons outlined below.

Fentanyl is a strong opioid with a limited role in the management of chronic non- cancer pain. It is associated with significant side effects and is reserved for patients with chronic pain and established opioid needs who are unable to take oral morphine. It can be fatal if used by opioid naive patients. It is relevant to this opinion to note that Fentanyl patches come in different strengths expressed as the number of micrograms of opioid delivered per hour i.e., 12, 25, 50, 75 and 100 micrograms per hour**. The Practitioner therefore prescribed a high dose patch.** Fentanyl is approximately twice as strong as oral morphine. Up to that point the Patient had been prescribed oxycodone 5mg twice daily, and Panadeine Forte 1-2 four times a day if required. The 24 hour morphine equivalence of 10mg oxycodone and 120mg codeine is a maximum of 30mg. The 24 hour morphine equivalence of a fentanyl 50mcg patch is approximately 120mg. In issuing the prescription for the fentanyl patch he therefore quadrupled the Patient's daily morphine dose, a potentially fatal dose in an opioid naïve person, and in combination with benzodiazepines a high risk scenario for unintentional overdose. There is no record of the Practitioner providing the Patient the counselling required with prescribing fentanyl.

(emphasis added)

[49] The Respondent further engaged in "dangerous prescribing" on 9 January 2020, in prescribing further 50mcg fentanyl patches, in conjunction with oxycodone 5mg. On 17 January 2020, BF attended upon another practitioner at the medical centre, who decided to decrease the strength of the patch and "wean" the patient off opioids.

[50] The provision of clinical care provided by the Respondent to BF during his consultations was clinically deficient in circumstances where the Respondent:

(a) did not take and/or record an adequate patient history in respect of either his back pain or his mental health;

(b) used auto fill to notes for consultation almost identical to those used for other patients, including QL;

(c) did not conduct and/or record a fulsome examination of BF;

(d) did not formulate and/or record an evidence-based understanding and assessment of BF's reported back pain, or mental health diagnosis;

(e) did not properly assess and/or record his assessment of risks in prescribing opioids or benzodiazepines;

(f) did not comply with the relevant regulatory requirements including under the Health (Drugs and Poisons) Regulations 1996 (Qld), that required the Respondent to seek approval from the Chief Executive of the Department of Health to prescribe a controlled drug to a person who a prescriber reasonably believes is a drug dependent person;

(g) did not monitor side effects of prescribed medications; and

(h) did not record or manage appropriate follow up with BF.

[51] In considering the records for BF, Dr Teague in her report formed the following opinions:

• Dr Rohella's history taking, examination, assessment, diagnosis, and treatment plans for ...[BF] were inadequate with deficiencies in multiple aspects of clinical care;
• the available medical record shows no clinical justification for the initiation and ongoing prescription of oxycodone and fentanyl. The Practitioner failed to apply evidence based guidelines in the management of [BF's] back pain. He failed to ensure that ... [BF] was appropriately followed up and that the efficacy and side effects of the medication was assessed;
• the dosage of fentanyl represents dangerous prescribing;
• the records do not record evidence of the Respondent assessing BF for the use, efficacy, or side effects of opioids or diazepam including tolerance and dependency. The records also do not indicate that the Respondent recognised that ... [BF] was using benzodiazepines in higher quantities than prescribed, or of assessing him for dependence; and
• Dr Rohella's record keeping is substantially below the expected standard, being neither adequate nor appropriate. A striking feature of the records is his frequent use of identical or nearly identical autofill resulting in considerable doubt as to what actually occurred during the consultations.

[52] The Tribunal is satisfied of the facts as outlined above in respect of BF are proven to the requisite standard on the evidence. Additionally, the Tribunal accepts the opinions of Dr Teague as outlined above as to the Respondent's deficient care of BF during the relevant period.

[53] DL consulted with the Respondent through the House Call Doctor Service on three occasions for back pain. It is noted that in terms of the record, the "auto fill" for "back pain" was used by the Respondent for all three consultations.

[54] Additionally, the Respondent prescribed opioids, namely codeine, to DL 17 April 2019 and 19 August 2019. It is noted that there are no consultation notes nor Medicare billing information related to either prescription.

[55] The provision of clinical care provided by the Respondent during the back pain consultations was clinically deficient in circumstances, where the Respondent:

(a) Did not take/and or record an adequate patient history, despite prescribing Oxycodone during the first consultation;

(b) Did not conduct and/or record a fulsome examination of DL;

(c) Prescribed opioids in circumstances where it was not clinically indicated or justified having regard to the lack of fulsome history and examination;

(d) Provided clinical care to DL on three occasions when attending the same address on the same date as consultations with patient QL;

(e) Provided identical or near-identical progress notes for DL as for patient QL;

(f) Did not record or manage appropriate follow up appointments; and

(g) Did not take adequate clinical records.

[56] Dr Teague, in assessing the records of DL, opined at p. 40 of her report:

• Dr Rohella's history taking, examination, assessment, diagnosis and treatment plans for ...[DL] were inadequate
• The available medical record shows no clinical justification for the prescription of opioids
• Dr Rohella's record keeping is substantially below the expected standard, being neither adequate nor appropriate. His use of identical autofill results in considerable doubt as to what actually occurred during the consultations...

[57] The Tribunal is satisfied of the facts as outlined above in respect of DL are proven to the requisite standard on the evidence. Additionally, the Tribunal accepts the opinions of Dr Teague as outlined above as to the Respondent's deficient care of DL during the relevant period.

[58] Between February 2019 and November 2019, the Respondent regularly treated HP through the House Call Doctor Service, as follows:

Paracetamol + Codeine Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg

Paracetamol + Codeine Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg

Paracetamol + Codeine Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg

Paracetamol + Codeine Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg

Paracetamol + Codeine Paracetamol 500mg + Codeine Phosphate Hemihydrate 30mg

[59] The provision of clinical care provided by the Respondent during the back pain consultations was clinically deficient in circumstances, where the Respondent:

(a) Did not take and/or record adequate patient history;

(b) Prescribed opioids in circumstances where it was not clinically indicated or justified having regard to the lack of fulsome history and examination;

(c) Did not comply with the relevant regulatory requirements including under the Health (Drugs and Poisons) Regulations 1996 (Qld) that required the Respondent to seek approval from the Chief Executive of the Department of Health to prescribe a controlled drug to a person who a prescriber reasonably believes is a drug dependent person, in circumstances where the Respondent prescribed opioid medication to the patient on 10 occasions over a nine-month period; and

(d) Did not take adequate clinical records.

[60] In considering HP's patient records, Dr Teague considered the Respondent's history taking, examination, assessment, diagnosis and treatment plans for HP to be inadequate, even within the circumstances of those consultations occurring within the House Call Doctor Service environment.

[61] The Tribunal is satisfied of the facts as outlined above in respect of HP are proven to the requisite standard on the evidence. Additionally, the Tribunal accepts the opinions of Dr Teague as outlined above as to the Respondent's deficient care of HP during the relevant period.

[62] Between April 2019 and January 2019, the patient JJ was treated both through the House Call Doctor Service and in clinic at Fraser Shores Medical Centre by the Respondent.

[63] As to those consultations, they were as follows:

[64] The provision of clinical care provided by the Respondent to JJ was clinically deficient, in circumstances where he:

(a) did not take and/or record an adequate patient history;

(b) did not conduct and/or record a fulsome examination of JJ, even upon commencing to see him at the Fraser Shores Medical Centre;

(c) did not take adequate clinical records, including recording examination notes identical or nearly identical to those used for other patients, by way of autofill;

(d) did not properly assess and/or record his assessment of risks in prescribing opioids or benzodiazepines;

(e) as and from the first consultation with JJ at Fraser Shores Medical Centre on 3 September 2019, the Respondent should have been alert to concerns as to potential use of drugs of dependency by JJ, given the historical prescribing of opioid medication through the House Call Doctor Service by the Respondent;

(f) subsequent to 3 September 2019, the Respondent prescribed opioids and/or benzodiazepines to JJ on ten (10) subsequent occasions in a four (4) month period.

(g) did not comply with the relevant regulatory requirements including under the Health (Drugs and Poisons) Regulations 1996 (Qld) that required the Respondent to seek approval from the Chief Executive of the Department of Health to prescribe a controlled drug to a person who a prescriber reasonably believes is a drug dependent person;

(h) did not monitor for side effects of prescribed medications; and

(i) did not record or manage appropriate follow up appointments.

[65] The Tribunal is satisfied of the facts as outlined above in respect of JJ are proven to the requisite standard on the evidence.

[66] The Respondent consulted with QG on three occasions, namely:

[67] It is noted that the first of the consultations with the patient occurred at Fraser Shores Medical Centre. Despite the first appointment occurring in that setting, the Respondent failed to take adequate clinical notes, including failing to complete the Clinic Patient Summary, which was left blank with no components of the form completed. Additionally, the examination findings for the patient's "back pain" are identical to each patient reviewed by Dr Teague where the "low back pain" auto fill had been used by the Respondent.

[68] Overall, the clinical care provided to QG during the consultations was clinically deficient, in that the Respondent:

(a) did not take adequate clinical records;

(b) did not take and/or record an adequate patient history;

(c) did not conduct and/or record a fulsome examination of QG;

(d) recorded an examination identical to that used for other patients by use of autofill;

(e) did not formulate and/or record an evidence-based understanding and assessment and management of the reported back pain and head injury of QG;

(f) did not monitor side effects of prescribed medications; and

(g) did not record or manage appropriate follow up appointments.

[69] The Tribunal is satisfied of the facts as outlined above in respect of QC are proved to the requisite standard on the evidence.

[70] The Board contends that the Tribunal would find that both Ground one and Ground two amount to professional misconduct.

[71] The Respondent concedes that his conduct in respect of the first Ground amounts to professional misconduct. As to the second allegation, the Respondent does not accept that the conduct amounts to professional misconduct and does not accept that his conduct should be viewed as a substantial departure from the expected standards of practice of a general practitioner.

[72] Pursuant to section 5 of the National Law professional misconduct of a registered health practitioner includes:

(a) unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and

(b) more than one instance of unprofessional conduct that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and

(c) conduct of the practitioner, whether occurring in connection with the practice of the health practitioner's profession or not, that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession.

[73] As to unprofessional conduct, it is defined in section 5 of the National Law as professional conduct that is of a lesser standard than that which might be reasonably expected of the health practitioner by the public or the practitioner's professional peers.

[74] Pursuant to section 41 of the National Law, the Code of Conduct is admissible in proceedings against a health practitioner, as evidence of what constitutes appropriate professional conduct or practice for the health profession.

[75] The Respondent's conduct and performance in respect of the factual findings outlined at [15] to [69] above was contrary to the following principles in the Code of Conduct:

(a) Principle 2.1.1 which requires practitioners to have regard to a patient's history when assessing a patient;

(b) Principle 2.1.2 which requires practitioners to formulate and implement a suitable management plan;

(c) Principle 2.1.3 which requires practitioners to facilitate the coordination and continuity of care of a patient;

(d) Principle 2.2.2 which requires practitioners to ensure they have adequate knowledge and skills to provide safe clinical care;

(e) Principle 2.2.3 which requires practitioners to maintain adequate records;

(f) Principle 2.2.4 which requires practitioner to consider the balance of benefit and harm in all clinical management decisions;

(g) Principle 7.2.1 which requires practitioners to keep their knowledge and skill up to date;

(h) Principle 7.2.3 which requires practitioners to ensure that their practice meets the standards reasonably expected by the public and their peers; and

(i) Principle 8.4.1 which requires practitioners to keep accurate, up to date and legible records that report relevant details of clinical history, clinical findings, investigations, diagnosis, information given to patients, medication, referral and other management in a form that can be understood by other health practitioners.

[76] In terms of the characterisation of the conduct, in determining whether it is conduct inconsistent with the Respondent being a fit and proper person to hold registration, the determination is to be made at the time of the conduct.[4]

[77] Further, for a finding of professional misconduct falling within paragraph (c) of the definition, the Tribunal is required to determine whether the conduct itself is inconsistent with the practitioner being a fit and proper person to hold registration. The assessment is not concerned with the personal characteristics of the practitioner.

[78] In terms of the boundary violation by the Respondent, it is accepted by the Respondent that his conduct was unacceptable and inappropriate. In terms of the conduct, the Respondent submits that he provided both the money and work to QL to assist her, but realises to do so was not appropriate, given his relationship with the patient.

[79] As outlined by Judge Sheridan in the matter of The Health Ombudsman v Masamba:[5]

Any form of social contact with a patient will not be tolerated. It is inconsistent with the importance of having a system of independent health care professionals, particularly in the mental health sphere given the power imbalance and the vulnerability of patients.

[80] The Tribunal accepts that the Respondent's conduct in respect of ground one can be characterised as professional misconduct, as conceded by the Respondent, and contended by the Board.

[81] As to the second allegation, the Respondent contends that his conduct would not amount to professional misconduct in circumstances where:

(a) he had, prior to this incident, practiced without incident since 2006, and had practiced in Australia for some 13 years;

(b) the conduct only related to a small number of patients, amongst a voluminous number of patients the Respondent treated, across both the House Call Doctor Service and the in clinic service he was working at;

(c) his conduct must be considered within the prism of his house call patients, where he did not have access to notes of others, and was "blind" in terms of patients' prior care when he treated them;

(d) he was a "soft target," in that he struggled to say no to patients when they asked for the medications, with many of them being forceful, and as such the Respondent was also concerned for his safety; and

(e) when he noticed QL for instance was engaging in drug seeking behaviour he "blacklisted" her from the House Call Doctor Service.

[82] Dealing with the "blacklisting" as submitted by the Respondent, the records do indicate this did occur. However, it did not cease the prescription of medication to the patient. For instance, when QL was blacklisted from the House Call Doctor Service, the prescribing of Endone and other drugs of dependence continued, but it occurred either in clinic, or at times where there are no consultation notices, nor Medicare billing information.

[83] As to the volume of patients, it is accepted that these patients were a few of many of Dr Rohella's patients. However, his conduct in respect of these patients must be considered for the level of care provided to those patients, and not just other patients that may have been treated at the same time. In terms of the house call patients, it is not accepted that the Respondent was absolved from his obligations to provide proper notes, and proper assessments of patients, even within the house call setting. Many of the patients were seen multiple times within short periods, and prescribed twenty Endone tablets at one time, rather than one or two tablets, to ensure they had enough medication to get to a in clinic appointment, if further medication was required. Additionally, many were subsequently treated in clinic by the Respondent, and yet their records were still below standard, as clearly articulated by Dr Teague in her report.

[84] As to the years of practice by the Respondent, although it is accepted by the Tribunal that there is no evidence that suggests prior concerns, the Respondent's level of experience is not in his favour, in circumstances where, given his experience and years of work in Australia, he should have been well aware of his obligations as to Schedule 8 drugs, and should have been well aware of his obligation to ensure his records are appropriate, and his examination of patients, or record of such examination is appropriate.

[85] In Medical Board of Australia v Evans [2013] QCAT 217 at [19]- [20], the then Deputy President of this Tribunal, his Honour Judge Horneman-Wren SC, opined:

[19] Failings of the kind ... are not to be seen to be mere technical breaches of regulations. The systems of controls established by the Regulation are integral to the protection of members of the community from potentially harmful drugs. The privilege of an endorsed medical practitioner to prescribe such drugs brings with it the burden of responsibility of doing so only in compliance with the regulatory regime.

[20] This is particularly so when the persons for whom the drugs are being prescribed may be drug dependent... The vulnerability of each person is patent. For these reasons, such failures are serious matters indeed.

(a) demonstrated substantial deficiencies in knowledge of common GP presentations;

(b) did not follow the principles of accountable prescribing;

(c) demonstrated dangerous prescribing practices of drugs of dependence;

(d) kept medical records that were substantially below expected standard, in that the notes:

(i) did not record any evidence of complying with the relevant regulatory frameworks for prescribing drugs of dependence;

(ii) did not record any evidence of the Respondent checking whether the patient/s were being prescribed drugs of dependence by other doctors;

(iii) were almost identical across several different patients, and in respect of multiple consultations with the same patient, leading to concerns as to the veracity or reliability of the notes. Further, the notes also had identical examination findings. As Dr Teague states: 'it is entirely implausible that every patient not only had the same history and examination findings at different times, but also the same as other patients...I cannot identify an acceptable reason for this aspect of Dr Rohella's practice...';

(iv) The notes do not record the Respondent reviewing the efficacy and side effects of drugs of dependence when prescribing them to multiple patients across both the home doctor service and in clinic;

(e) the Respondent's performance in relation to the care and treatment he provided to the subject patients was 'substantially below the standard reasonably expected of a General Practitioners with equivalent level of training or experience'; and

(f) '...demonstrates substantial deficits in his knowledge of common GP presentations and appears to have no insight into this. His medical records do not allow for another clinician to understand his clinical reasoning and management decisions. He does not demonstrate accountable prescribing...'

[87] In respect of Ground two, having regard to the evidence as a whole, and the opinions expressed by Dr Teague, the Tribunal is satisfied that the Respondent's conduct relevant to Ground 2, and his deficient clinical care of the seven patients, does amount to professional misconduct. To that end, the Tribunal is satisfied that the Respondent's conduct as a whole:

(a) was substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and

(b) was conduct inconsistent with the practitioner being a fit and proper person to hold registration in the profession.

[88] The purpose of a sanction is the protection of the public. It is not imposed to punish the practitioner, notwithstanding that a practitioner may experience a protective order as punitive in its practical effect. The Tribunal's disciplinary jurisdiction is exercised for the paramount purpose of safeguarding the health and safety of the public and preserving the standing and reputation of the profession in the eyes of the community.

[89] The Tribunal has a wide discretion to impose sanctions ranging from a reprimand of the practitioner to cancellation of registration.[6]

[90] An assessment of any ongoing risk posed by the practitioner is an essential aspect of determining sanction. In that context, the practitioner's level of insight into their conduct is a relevant and often important consideration. [7]

[91] In Medical Board of Australia v Singh[8] the State Administrative Tribunal of Western Australia provided a useful summary of the factors to be considered when determining sanction, namely:

1. Any need to protect the public against further conduct by the practitioner.
2. The need to protect the public through general deterrence of other practitioners from similar conduct.
3. The need to protect the public and maintain public confidence in the profession by reinforcing high professional standards and denouncing transgressions and thereby articulating the high standard expected of the profession, such that, even where there may be no need to deter a practitioner from repeating the conduct, the conduct is of such a nature that the Tribunal should give an emphatic indication of its disapproval.
4. Whether the practitioner has breached any:

1. Act;
2. Regulations;
3. Guidelines or Code of Conduct, issued by the relevant professional body; and
4. whether the practitioner has done so knowingly.

1. Whether the practitioner's conduct demonstrated incompetence, and if so, to what level.
2. Whether or not the incident was isolated such that the Tribunal can be satisfied of his or her worthiness or reliability for the future.
3. The practitioner's disciplinary history.
4. Whether or not the practitioner understands the error of his ways, including an assessment of any remorse and insight (or a lack thereof) shown by the practitioner, since a practitioner who fails to understand the significance and consequences of misconduct is a risk to the community.
5. The desirability of making available to the public any special skills possessed by the practitioner.
6. The practitioner's personal circumstances at the time of the conduct and at the time of imposing the sanction. However, the weight given to personal circumstances cannot override the fundamental obligation of the Tribunal to provide appropriate protection of the public interest in the honesty and integrity of ... practitioners and in the maintenance of proper standards of ... practice.
7. The Tribunal may consider any other matters relevant to the practitioner's fitness to practice and other matters which may be regarded as aggravating the conduct or mitigating its seriousness. In general, mitigating factors such as no previous misconduct or service to the profession are of considerably less significant than in the criminal process because the jurisdiction is protective not punitive.

[92] It is the Board's position that the appropriate sanction is the cancellation of the Respondent's current registration.

[93] To that end, Counsel for the Board made clear during his submissions that it is not the Board's intention to prevent the Respondent from immediately re-applying, but rather the cancellation is the most appropriate sanction in circumstances where it will then allow the Board to assess the appropriate transition back into practice for the Respondent and put in place appropriate conditions.

[94] Counsel for the Board also drew the Tribunal's attention to s. 112B of the National Law, which is relevant in terms of considering the appropriate sanction. Section 112B relevantly provides:

(1) The persons registration as a registered health practitioner is reinstated on the day the suspension period ends.

(2) If the registered health practitioner intends to renew the practitioner's registration in the profession, the practitioner must apply to the National Board established for the health for the practitioner's health profession within one month after the suspension period ends.

[95] As submitted by Counsel for the Board, whether the Respondent's registration is cancelled or not, he will need to renew his registration with the Board within a month in any event. As such, it could lead to a situation where the Respondent practices for a month without the appropriate checks and balances put in place by the Board, and confirmation of things such as ongoing professional development. As such, the Board contends that the immediate cancellation will best protect the public and ensure the Respondent does not practice without the proper scaffolding and protections in place.

[96] It is the Respondent's case that he ultimately does not wish to practice in the next month in Australia, in any event. The Respondent informed the Tribunal he remains living in India caring for his elderly mother, and he is also currently working as a doctor whilst in India. The Respondent also sought the decision be delayed until he was back in Australia. The Tribunal indicated that the matter needed a resolution, and that it was not minded to simply leave the decision until his return.

[97] It is the Respondent's case that the Tribunal could put in place the appropriate conditions to allow the Respondent to continue to practice, rather than cancelling his registration. The Respondent made submissions that he would agree to conditions such as not prescribing schedule 8 drugs, or schedule 4 drugs of dependence, as well as a supervision condition, and further education and training conditions.

[98] Unfortunately, despite the passage of time, the Respondent continues to demonstrate a lack of insight into the seriousness of the conduct underpinning Ground two. Although he has accepted the factual basis of that ground, he maintains the view that his conduct was not substantially below the standard expected of a General Practitioner with his level of experience. As is evident from the findings above, and from the opinions expressed by Dr Teague, the Respondent's conduct was indeed substantially below the required standard, irrespective of the care and treatment he provided to other patients at the time. His record‑keeping and prescribing practices in relation to those patients were entirely unacceptable and placed them at risk.

[99] Although the Respondent informed the Tribunal that he has undertaken work to ensure he is not a "soft target" in future patient interactions, no evidence of any treating professional has been presented to the Tribunal to support the Respondent's contention.

[100] It is accepted that s 196(2)(b) of the National Law provides the Tribunal with the ability to impose conditions on the Respondent's practice. However, the Tribunal accepts that the Board is best placed to deal with those matters, given the limited evidence placed before the Tribunal as to the Respondent's rehabilitation. The Respondent has been suspended from practicing in Australia since October 2020, namely a period of almost 5 ½ years. It is unclear on the evidence whether the Respondent has continued with professional development, or what other courses or work he has done in recent times to deal with his personality vulnerabilities, nor in terms of his record keeping. However, it is noted that the Respondent has completed some training, since the suspension of his registration, in respect of prescribing drugs of dependence.

[101] General deterrence also looms large in respect of the Respondent's conduct, which includes the boundary violation and the deficient clinical care of patients. It is accepted, as submitted by the Board, both grounds are significant contraventions of the fundamental obligations of a general practitioner in respect of the care of patients and the operation of a medical practice.

[102] In its written submissions, the Board has referred the Tribunal to a series of authorities said to assist in determining the appropriate sanction. While each matter must ultimately be resolved on its own facts and circumstances, relevant to the individual, those authorities provide a "yardstick" against which proportionality and consistency may be assessed. The Tribunal has considered those decisions.

[103] In respect of the boundary violation cases cited, it is apparent that the conduct in those matters was of greater seriousness than the conduct presently before the Tribunal. Nevertheless, the authorities concerning inappropriate prescribing and deficiencies in clinical care offer relevant and persuasive assistance in determining the appropriate sanction.

[104] As previously noted, the Board does not seek a disqualification period, and rather seeks orders which cancel the Respondent's registration to ensure the proper protections upon re-registration. The Respondent, per s 112B, must re-register with the Board within one month of the cessation of his suspension, in any event. As such, in a practical sense, there is little difference for the Respondent, particularly in circumstances where he contends he will not be in Australia to commence practice in the next month. Further, the Tribunal accepts the public is best protected by the Board monitoring the re-registration of the Respondent, rather than the Tribunal attempting to put in place appropriate conditions given the interplay with s. 112B of the National Law, and the uncertainties in respect of the Respondent's current rehabilitation and professional development.

[105] The Board also seeks a reprimand. It appears that the Respondent accepts that a reprimand is appropriate. The Tribunal considers that a reprimand is appropriate in the circumstances of the matter. A reprimand is not a trivial penalty, and it represents a 'serious form of censure and condemnation.'[9]

[106] In assessing the evidence as a whole, the relevant cases provided and the submissions of both the Board and the Respondent, the Tribunal is satisfied that the appropriate sanction is as follows:

(a) Pursuant to s 196(1)(b)(iii) of the National Law, the Respondent has behaved in a way that constitutes professional misconduct.

(b) Pursuant to s 196(2)(a) of the National Law, the Respondent is reprimanded.

(c) Pursuant to s 196(2)(e) of the National Law, the Respondent's registration is cancelled.

[107] The Tribunal has been assisted by the assessors in relation to factual matters and thanks them for their careful and considered contribution.

1. Pursuant to s 196(1)(b)(iii) of the National Law, the Respondent has behaved in a way that constitutes professional misconduct.
2. Pursuant to s 196(2)(a) of the National Law, the Respondent is reprimanded.
3. Pursuant to s 196(2)(e) of the National Law, the Respondent's registration is cancelled.

[1] [1938] HCA 34; (1938) 60 CLR 336.

[4] Medical Board of Australia v Arulanandarajah (Review and Regulation) [2021] VCAT 85.

[5] [2019] QCAT 227 [45].

[6] Nursing and Midwifery Board of Australia v Lockie [2023] QCA 96 at [45].

[7] Nursing and Midwifery Board of Australia v Lockie [2022] QCAT 391 ('Lockie') at [71] citing Medical Board of Australia v Bromeley [2018] QCAT 163 at [142].

[8] [2017] WASAT 33 [23]-[30].

[9] Health Ombudsman v Bevins [2025] QCAT 102 at [55].