Shelley v Nurses & Midwives Tribunal of NSW & Anor - [2007] NSWSC 1240 - NSWSC 2007 case summary — Zoe

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Shelley v Nurses & Midwives Tribunal of NSW & Anor

[2007] NSWSC 1240

Supreme Court of NSW|2007-03-20|Before: Hislop J

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At a glance

Source facts

Court

Supreme Court of NSW

Decision date

2007-03-20

Before

Hislop J

Catchwords

Administrative law - nurse - professional misconduct - impairment - removal of name from Register - period before reapplication for registration.

Source

Original judgment source is linked above.

Catchwords

Administrative law - nurse - professional misconduct - impairment - removal of name from Register - period before reapplication for registration.

Judgment (76 paragraphs)

[1]

Introduction 1 The plaintiff is a married woman, born on 19 December 1953. She obtained her general nursing certificate in 1974 and completed her midwifery training in 1976. Thereafter she worked as a registered nurse and registered midwife at various hospitals in and around the Newcastle area. In 1995 she completed a Masters Degree in Health Service Management and from 1996 to 1999 was a clinical educator for the University of Newcastle. 2 The plaintiff was employed as a registered nurse at a private hospital from 1991 to 1999. Her employment at that hospital was terminated on 4 February 1999 for alleged breach of policy and wilful misconduct. 3 After ceasing work in that employment the plaintiff worked for a nursing agency for a short time. In 2000 she commenced employment as a registered nurse at another hospital. Her employment at that hospital ceased in 2003. She has not worked as a registered nurse or midwife since that time. 4 On 10 December 2004 a written complaint was made against the plaintiff pursuant to s 46 of the Nurses and Midwives Act 1991, formerly the Nurses Act 1991 ("the Act"). The complaint was amended, in writing, on 6 March 2006. 5 The complaint was referred, pursuant to s 46(4) of the Act, to the Tribunal constituted pursuant to s 59 of the Act. The Tribunal conducted an inquiry into the complaint pursuant to s 61 of the Act. 6 The Tribunal found the plaintiff guilty of professional misconduct. It also found the plaintiff was impaired in accordance with s 4A of the Act as she suffered from migraine headaches. The Tribunal published a written statement of its reasons for decision on 22 May 2006. 7 On 19 July 2006 further evidence was tendered by the plaintiff following which the Tribunal heard submissions from the parties in relation to orders under s 64 of the Act. 8 On 20 July 2006 the Tribunal ordered, pursuant to s 64 that "The name of [the plaintiff] is to be removed from the Register of Nurses and from the Register of Midwives. The [plaintiff] is not to reapply for registration for a minimum period of 2 years 9 months from the date of these orders."

[5]

(4) Costs." The complaint 10 The amended complaint alleged the plaintiff, being an accredited nurse under the Act: Complaint One Has been guilty of unsatisfactory professional conduct within the meaning of section 4 of the Act in that the nurse: (i) has demonstrated a lack of adequate knowledge, skill, judgment and/or care in the practice of nursing; and/or (ii) has been guilty of improper or unethical conduct relating to the practice of nursing. Particulars of Complaint One: On 7 June 2003 the nurse performed an evening shift in Ward G3 surgical at John Hunter Hospital Newcastle. During the shift:

The nurse rubbed Patient A's bottom, thigh and hip in an inappropriate manner, prior to administering an injection.
The nurse addressed Patient A in an inappropriate manner calling her darling and sweetheart.
The nurse rubbed and stroked Patient A's bottom, thigh and hip in an inappropriate manner whilst offering to shower Patient A.
Whilst showering Patient A the nurse: (a) threw a face washer and soap at Patient A which hit her in the groin, (b) washed Patient A's legs in an inappropriate and suggestive manner, (c) inappropriately touched and rubbed Patient A's breasts, (d) hit Patient A on the head with a shampoo bottle.
After Patient A had been showered the nurse…swung Patient A's underpants above her head and laughed.
The nurse gave Patient A an injection of Pethidine at about 18:15: (a) less than three hours after the patient's last injection of Pethidine given at about 17:15, contrary to the patient's written medication order, (b) in circumstances where the patient indicated to the nurse she did not require further analgesia.
The nurse gave Patient A a further injection of Pethidine at about 21:15 in circumstances where the patient indicated to the nurse she did not require further analgesia and the patient had been given three doses of Pethidine 50mg in the previous seven hours.
The nurse gave Patient B an injection of Pethidine at about 21:00: (a) less than four hours after the patient's last injection of Pethidine given at 19:40, contrary to the patient's written medication order, (b) in circumstances where the patient indicated to the nurse she did not require further analgesia, (c) the drug was administered intravenously when the patient's medication order specified it should be given intramuscularly, (d) the nurse failed to properly record the dose of Pethidine the patient received in that the nurse's entries in the patient's records show that the patient was given 75mg at 19:40 and 21:00 whilst the nurse's corresponding entries in the drug register show that the patient received 50 mg and 25 mg was discarded on each occasion.
The nurse provided nursing care when she was adversely affected by drugs and/or alcohol.
The nurse self administered Pethidine whilst on duty. Complaint Two

[6]

This complaint was in the same terms as complaint one save that the words 'unsatisfactory professional conduct' in the first line of complaint one were replaced by the words 'professional misconduct' in complaint two. Complaint Three Has been guilty of unsatisfactory professional conduct within the meaning of section 4 of the Act in that the nurse: (i) has demonstrated a lack of adequate knowledge, skill, judgment and/or care in the practice of nursing; and/or (ii) has been guilty of improper or unethical conduct relating to the practice of nursing. Particulars of Complaint Three

At about 1245 hours on 22 April 1998 at Warners Bay Hospital the nurse administered to Patient C an injection of Pethidine less than four hours after the patient's last injection of Pethidine given at 10.35 hours the same day, contrary to the patient's written medical order.
On 12 August 1998 at Warners Bay Hospital the nurse destroyed 25 millilitres (25 milligrams) of Pethidine without having the destruction witnessed in accordance with Clause 123(2)(a) Poisons and Therapeutic Goods Regulations 1994.
On 12 August 1998 at Warners Bay Hospital the nurse recorded a telephone order from Dr Mitchell to administer 75 to 100mg of Pethidine to Patient D but did not have the telephone order witnessed by another nurse as required by the hospital and New South Wales Health Department policy.
At 0915 hours on 20 September 1998 at Warners Bay Hospital the nurse administered an injection of Pethidine to Patient E when the administration of that drug had not been authorised or directed by a medical practitioner. Clause 100 Poisons and Therapeutic Goods Regulations 1994.
At 1210 hours on 20 September 1998 at Warners Bay Hospital the nurse administered Pethidine to Patient E when the administration of that drug had not been authorised or directed by a medical practitioner. Clause 100 Poisons and Therapeutic Goods Regulations 1994.
At 1400 hours on 20 September 1998 at Warners Bay Hospital the nurse administered Pethidine to Patient E when the administration of that drug had not been authorised or directed by a medical practitioner. Clause 100 Poisons and Therapeutic Goods Regulations 1994.
At 1210 hours on 20 September 1998 at Warners Bay Hospital the nurse administered to Patient E an injection of Pethidine to Patient E: (a) Less than four hours after the patient's last injection of Pethidine given at 0915 hours, contrary to the patient's written medical order. (b) When the nurse should have known the interval for administration in the medical practitioner's order had been altered and not initialled by the authorising medical practitioner. Clause 100 Poisons and Therapeutic Goods Regulations 1994.
At 1400 hours on 20 September 1998 at Warners Bay Hospital the nurse administered an injection of a schedule 8 drug, Pethidine to patient E contrary to the medical officer's written order for Patient E.
On 20 September 1998 at Warners Bay Hospital the nurse destroyed Pethidine without having the destruction witnessed in accordance with Clause 123(2)(a) Poisons and Therapeutic Goods Regulations 1994.
About 2100 hours on 30 January 1999 at Warners Bay Hospital the nurse dispensed Pethidine 300mg into a patient controlled analgesia syringe driver for patient F without having the removal of the drug from the drug safe or the dispensing of the drug into the syringe driver witnessed by a second registered or enrolled nurse.
About 1300 hours on 31 January 1999 at Warners Bay Hospital the nurse destroyed 10 millilitres of Pethidine without having the destruction witnessed in accordance with Clause 123(2)(a) Poisons and Therapeutic Goods Regulations 1994.
On 31 January 1999 at Warners Bay Hospital the nurse recorded a telephone order from Dr Santhanan to administer 100mg of Pethidine to Patient G every three to four hours but the nurse did not have that telephone order witnessed by another nurse as required by the Hospital and New South Wales Health Department policy. Complaint Four

[22]

The Tribunal's decision in relation to s 64 orders 16 Section 64 of the Act confers various powers upon the Tribunal where the subject matter of a complaint has been proved. The powers range from a caution or reprimand to directing that the person's name be removed from the Register, the latter pursuant to s 64(1)(g)(ii). Section 64(5) provides: "If the Tribunal makes an order under subsection (1) (g) (ii) or the Tribunal finds the subject-matter of a complaint against a person who has ceased to be registered or enrolled to be proved: (a) the Tribunal may by its order fix a time after which the person whose name is removed from a Register or the Roll, or a person who has ceased to be registered or enrolled, may apply to be registered or enrolled, and (b) if a time has been so fixed, the person is not entitled to be registered or enrolled before that time, despite Part 4." 17 The second defendant submitted the plaintiff's name should be removed from the registers of nurses and midwives and that an order should be made fixing a time of three years after which the plaintiff may apply to be registered. The plaintiff submitted that the matter should be dealt with by imposing appropriate conditions on her registration. 18 The Tribunal concluded that the only order that would satisfy the Tribunal's obligations was to remove the name of the plaintiff from the Register and that a period of 2 years 9 months from the date of these orders was required to elapse before the plaintiff was entitled to make an application for re-registration. The appeal 19 Section 67 of the Act provides: "(1) A person about whom a complaint is referred to the Tribunal under s 45, 46 or 54, or the complainant, may appeal to the Supreme Court against: (a) a decision of the Tribunal with respect to a point of law, or (b) the exercise of any power under s 64 by the Tribunal, within the prescribed time. (2) The Supreme Court may stay any order made by the Tribunal, on such terms as the Court sees fit, until such time as the Court determines an appeal made under this section. (3) In determining an appeal under this section, the Supreme Court may: (a) dismiss the appeal, or (b) make such order as it thinks proper having regard to the merits of the case and the public welfare and, in doing so, may exercise any one or more of the powers of the Tribunal under section 64. (4) In any case where the Supreme Court dismisses an appeal against an order directing that the name of a nurse or midwife be removed from a Register or the Roll or a person has ceased to be registered or enrolled: (a) the Court may by its order fix a time after which the person whose name is removed from a Register or the Roll, or the person who has ceased to be registered or enrolled, may apply to be registered or enrolled, and (b) if a time has been so fixed, the person is not entitled to be registered or enrolled before that time despite Part 4…" 20 The plaintiff's appeal is against the Tribunal's exercise of power under s 64 to order that her name be removed from the Register of Nurses and the Register of Midwives and to order that she is not to reapply for registration for a minimum of two years nine months from the date of the orders. 21 The right of appeal pursuant to s 67(1) of the Act is limited. The Court has no authority to make a general review of the Tribunal's findings of fact - Childs v Walton (unreported, NSWCA, 13 November 1990). The extent of the limitation has been the subject of consideration by the Court of Appeal in respect of similar legislation relating principally to medical practitioners. The principles established by the Court of Appeal in those cases have application to this case. 22 Those principles are:

[32]

(c) the Tribunal, in its reasons dated 20 July 2006, stated that it substantially accepted the submissions made by the second defendant but did not identify which of those submissions was accepted by it. 28 The second defendant's written submissions, in relation to the s 64 hearing, reviewed the Tribunal's original findings, the law, the evidence adduced on 19 July 2006 and other matters, and concluded: "It is the submission of the complainant that the only appropriate order having regard to (a) the seriousness of the proved misconduct, (b) the nurse's lack of insight; (c) the nurse's lack of contrition; (d) the nurse's lack of candour; (e) the lack of any evidence of rehabilitation or other measures taken for the protection of the public; (f) the unsuccessful efforts made by the nurse's employer to assist her to continue in her role as a registered nurse by providing further education and counselling in a system whereby she could cease work whenever she felt a migraine developing; and (g) the nurse's failure to heed both formal and informal warnings, is deregistration. All the evidence suggests that the factors in the nurse's personal circumstances which may have contributed to her committing the proven misconduct are still operating and there is a significant risk she would misconduct herself again." 29 The second defendant spoke to its written submissions, observing that the Tribunal should not accept the plaintiff's migraine condition had currently stabilised; that the plaintiff was an unreliable witness whose attitude was unacceptable; that the plaintiff had not admitted to using pethidine, as found by the Tribunal; had not given evidence at the s 64 hearing, and was apparently still taking pethidine as treatment for migraine headaches; there had been no change in the plaintiff's responses to directions given to her by her employers and the Pharmaceutical Services Branch in the past, and her own undertakings in regard to the handling of S 8 drugs, there was no evidence her future behaviour would be any different or that conditions on her practice would be effective; the plaintiff had worked as a nurse educator, had undertaken further nursing studies, was familiar with the regulations and policy regarding S 8 drugs, therefore further education courses would not be expected to have any effect on her conduct; there was a difference between inadvertent errors and those made to hide misconduct, the plaintiff's "errors" were in the latter category; the plaintiff caused distress to patients on 7 June 2003 and concern to the nursing staff; the appropriate order was removal of the plaintiff's name from the register and the period before she be permitted to reapply for registration should be three years. 30 The Tribunal's decision in relation to the s 64 orders initially referred to its prior findings and stated: "These orders should be read in conjunction with the reasons for decision dated 22 May 2006." Thereafter, the decision was divided under the following subheadings: "Undertaking made by the respondent"

[55]

It is these factors and the causes of them which were the "issues raised in the matter" which the plaintiff will require time to address. I am unable to accept the plaintiff's submission that the Tribunal did not identify "the issues raised in this matter". 35 A comparison of the Tribunal's written reasons with the written and oral submissions of the second defendant as to the s 64 orders sufficiently identifies the submissions of the second defendant which were accepted by the Tribunal. I am unable to accept the plaintiff's submission that the Tribunal did not sufficiently identify the submissions of the second defendant which were accepted by it. 36 An order removing a person's name from the register is made in protection of the public. It is not intended to be punitive. The likelihood of misconduct recurring is of vital importance in determining the nature of the order. The fact that the Tribunal found the plaintiff had not been truthful is itself a circumstance touching the plaintiff's fitness to practice - Childs v Walton. 37 The determination of the period before which the plaintiff will be permitted to reapply for registration involved the weighing by the Tribunal not only of the plaintiff's situation but the obligations to protect the safety of the public, to prevent the recurrence of professional misconduct, to act as a deterrent to other members of the profession and to maintain the profession's standards and public confidence therein. In determining this matter, the Tribunal had the advantage of observing the plaintiff and forming an opinion as to her attitude and demeanour. 38 The Tribunal's ultimate conclusion is the product of the weighing by it, as a specialist tribunal, of the various factors identified by it in its written reasons. The nature of the weighing process does not lend itself to an arithmetical process. Rather, the process is one of instinctive synthesis in which relevant factors are identified and then weighed as a whole using the specialist experience and knowledge of the Tribunal. 39 In my opinion, the reasons which led the Tribunal to determine that the plaintiff's name should be removed from the Register of Nurses and the Register of Midwives and that the s 64(5) period be two years nine months from the date of the orders is adequately set out in the written reasons of the Tribunal. The Tribunal has a broad discretion. Had it been necessary to do so, I would have concluded that the period of two years nine months was within the discretionary range open to the Tribunal. 40 In my opinion, grounds of appeal (i) and (ii) have not been established.

[57]

Ground (iv) The Tribunal erred in the exercise of its discretion in failing to act on and/or consider and/or give any or sufficient weight to [six specified matters of evidence] 42 Three of these matters ((c), (d) and (e)) relate to the Tribunal's reasoning process leading to its ultimate finding that the complaint was proven. No error in point of law is asserted or arises. These grounds fail. Matters (a), (b) and (f) are considered hereunder. 43 Sub-paragraph (a) asserts that the plaintiff had not worked as a registered nurse since 7 June 2003 and therefore could not provide relevant testimonials from professional nursing colleagues which would be helpful to the Tribunal. 44 The Tribunal, in its decision dated 20 July 2006, noted that the plaintiff did not tender any references from professional nursing colleagues. 45 The plaintiff submitted that in taking into consideration that the plaintiff did not tender any references from professional nursing colleagues the Tribunal failed to take into consideration the fact that the plaintiff had not worked as a registered nurse since 7 June 2003 and did not give weight to the fact that the plaintiff therefore could not provide relevant testimonials from professional nursing colleagues which could be of any assistance to the second defendant. 46 In my opinion, the fact that the plaintiff had not worked as a registered nurse since 7 June 2003 did not prevent her providing testimonials from professional nursing colleagues. Such testimonials would have been relevant to the plaintiff's character generally and to her professional capacity and commitment as observed prior to June 2003. The plaintiff gave no explanation for the absence of testimonials from nursing colleagues. It was relevant for the Tribunal to note the absence of such testimonials. 47 In my opinion, the Tribunal did not err in noting the absence of any references from professional nursing colleagues of the plaintiff. In any event, the Tribunal, in its reasons, accepted the plaintiff was an experienced and senior nurse. 48 Sub-paragraph (b) stated that "two medical practitioners who had worked in a professional capacity with the plaintiff to the effect of her considerable skill and expertise as a registered nurse". 49 The plaintiff submitted this evidence was not taken into consideration by the Tribunal. 50 There was no obligation on the Tribunal to advert to every possible relevant fact - Prakash at [99]. The medical practitioners referred to did not give the plaintiff unqualified support and it may be inferred the Tribunal attached little or no weight to their evidence in this regard. In any event, the Tribunal, in its reasons for its s 64 orders, referred to the loss of the plaintiff as the loss of an experienced and senior nurse. Even if the Tribunal had failed to have regard to the evidence of these practitioners, (which has not been established), such an error is not of such significance as to call for the intervention of this Court. 51 Sub-paragraph (f) stated that when a nurse found a yellow injection tray with an empty ampoule of pethidine in the S 8 drug cupboard, there was no evidence that the plaintiff had put it there. 52 The question whether there is any evidence of a particular fact is a question of law. If the Tribunal erred in this respect, its conclusion can be reviewed on appeal as long as the error vitiated the decision - Hevi Lift (PNG) Ltd v Etherington (2005) 2 DDCR 271 at [63]. 53 The plaintiff's submission is, however, misconceived. There was evidence from which the inference could be drawn that the plaintiff had placed the injection tray where it was found. 54 The nurse who found the tray on 21 September 1998 gave evidence that she did not know who had placed it on the shelf. The plaintiff denied any recollection of the incident. However there was evidence that on 20 September 1998 at 1000 a nurse saw the plaintiff draw up an injection which the plaintiff said was for patient E. This was noted in the S 8 register. Patient E's chart did not show the administering of pethidine to the patient at 1000 hours. At 2100 hours the tray was found. The next morning an asterisk was placed at the end of the top line and at the bottom of the page of the drug register where it was written "1000 drawn up not given discarded on 21/9" signed by the plaintiff and the nurse who found the tray. It was thus open to the Tribunal to infer that the plaintiff put the tray with the syringe into the drug cupboard . No error in point of law is demonstrated.

[72]

(vii) The Tribunal erred in the exercise of its discretion by failing to take into account the following material considerations: (a) The fact that the two issues of self-administration of Pethidine and the plaintiff suffering migraine, stood alone and separate from each other. (b) The fact that in relation to the Plaintiff administering a Schedule 8 drug, namely Pethidine, to patients on 7 June 2003, there was only one occasion when a second nurse ('the witnessing nurse') did not undertake the process with the Plaintiff in accordance with the requirements of policies and procedures which included checking the patient's medication chart, witnessing the removal of the drug from the locked cupboard, drawing the Pethidine into a syringe, discarding excess, and observing the administration to the patient. (c) The fact that on the one occasion the witnessing nurse who undertook the process up to the administration of the drug with the Plaintiff failed to complete the process because she was called away and that error in the administration process was the error of the witnessing nurse. (d) The fact that in relation to the administration of Pethidine to Patient A on 7 June 2003, a doctor provided a telephone order which she subsequently confirmed and then made a further order for Pethidine. (e) The fact that in relation to Complaints 3 and 4 relating to the mishandling of drugs at Warners Bay Private Hospital in 1998 and 1999, the medical records of patients demonstrate that it was common for nursing staff not to undertake the proper process for the administration of Schedule 8 drugs and to make errors in documenting nursing care. (f) The fact that in relation to Complaints 3 and 4 relating the mishandling of drugs at Warners Bay Private Hospital in 1998 and 1999, the evidence of nursing staff was that it was not unusual for them not to undertake the proper process for the administration of Schedule 8 drugs. (g) The fact that an audit of the Schedule 8 drugs in stock and the Drug Register was conducted by the After Hours Nurse Manager on 7 June 2003. (h) The evidence of the Plaintiff's treating doctors in relation her use of Pethidine in the treatment of symptoms of migraine to the effect that the use was appropriate and effective to her condition and/or that she had significant sensitivities/allergies to other medications. (i) The evidence of Doctor Kirkpatrick that he was alert to the possibility that the Plaintiff was a 'doctor shopper' using him to gain Pethidine when it was not medically required and his own investigations to satisfy himself that she was not. (j) The fact that all of the witnesses, other than Patient A, who gave evidence before the Tribunal in March 2006 including the Plaintiff had significant difficulty remembering events and incidents that occurred in 1998, 1999 and 2003. (k) The period of time which had elapsed between the incidents in January, March, July, August & November 1998, January 1999, September & October 2002 and June 2003 and the Tribunal hearing in March 2006. (l) The evidence of Doctor Kirkpatrick that the medical bags carried by out of hours treating doctors do not contain Schedule 8 drugs. (m) The fact that the investigations carried out by the Pharmaceutical Services Branch in relation to the prescribing of Pethidine to the Plaintiff revealed that the source of prescription was from the same medical practice and/or medical practitioner. (n) The fact that although the Plaintiff was seen by more than one general practitioner from 2000 to July 2006, all of the general practitioners were from the same medical practice and all recorded those attendances in the same medical records. (o) The fact that the plaintiff was accompanied by another nurse when she administered Pethidine to Patient B and that nurse did not give evidence that the injection was given intravenously rather than intramuscularly.

[73]

(viii) The Tribunal erred by failing to have any or sufficient regard to the following that: (a) The Plaintiff had voluntarily not worked as a registered nurse since 7 June 2003. (b) In relation to the Plaintiff's alleged conduct on 7 June 2003, the hospital undertook no proper investigation of the allegations. (c) The evidence of the Plaintiff's treating doctors in relation her use of Pethidine in the treatment of symptoms of migraine to the effect that the use was appropriate and effective to her condition and/or that she had significant sensitivities/allergies to other medications. (d) The difference between prophylactic medications and symptom treatment. (e) The evidence of Doctor de Souza in relation to the effects of Pethidine on a person who was not opiate naïve as in the case of the Plaintiff. (f) The Plaintiff's treating doctors and psychologist were responsible for the records they kept in relation to the treatment of the Plaintiff and the reports they wrote to other practitioners. (g) The Plaintiff's treating doctors and psychologist only requiring and/or recording information relevant to why the Plaintiff was consulting them. (h) The weight to be given to the evidence of Doctor de Souza to the effect that he had extensive experience in mental health and his assessment that it has not been necessary to refer the Plaintiff to a psychiatrist. (i) The medical records of Patient E in relation to the administration of Pethidine by the Plaintiff on 20 September 1998 to the effect that Patient E's treating doctor made an error in the recording of the date in the progress notes and that Patient E was having physical therapy for the first time post-operatively on 20 September 1998. (j) There was no evidence of complaints by the treating doctors of the patients from Warners Bay Private Hospital or John Hunter Hospital (including Doctor Malcolm and Doctor Kirkpatrick) to the effect that the Plaintiff had administered Pethidine to their patients contrary to their prescriptions and/or in a manner which was not appropriate in the circumstances. (k) The weight to be given to the evidence of Doctor Kirkpatrick to the effect that he was a member of the Medical Advisory Committee at Warners Bay Private Hospital overseeing all critical incidents including issues relating to inappropriate administration and/or over-medication and that no such complaints regarding the Plaintiff were brought to the committee by management. (l) The investigator from Pharmaceutical Services Branch, when investigating the Plaintiff in 1999, did not seek any information from the Plaintiff's treating doctors which would have either support or not support the statements made by the Plaintiff in relation to the interaction of medication problems she had experienced. (m) Inconsistencies in the evidence of time lines provided by Patient A compared to the evidence of four nurses and other patients who saw the Plaintiff and Patient A on 7 June 2003. (n) The fact that Doctors Kirkpatrick and de Souza and the Psychologist Ms McKimm were seeing the Plaintiff on a regular basis and in the case of the latter two, at least monthly, over a long period of time. (o) The evidence of Doctor Kirkpatrick that the Plaintiff did not have an addiction to Pethidine. (p) The fact that because the Plaintiff was being treated reasonably often with Pethidine by her treating general practitioner, a urinalysis would be of no evidentiary benefit.

Shelley v Nurses & Midwives Tribunal of NSW & Anor

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Judgment (76 paragraphs)

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Cases Cited (8)

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