UK psych nurse struck off for patient abuse

A NURSE who was aggressive to patients at an East Lancashire mental health unit – and hurled abuse at them – has been struck off.

In one episode Iain Fletcher, a staff nurse at Hillview unit, Royal Blackburn Hospital , interrupted colleagues and patients preparing a Christmas hamper and told them it was ‘tat’, the Nursing and Midwifery Council heard.

Hampers were being created to raise funds for the ward and Fletcher’s behaviour ‘was wholly inappropriate’, a fitness to practise panel was told.

Fletcher also indulged in a foul-mouthed rant about how he enjoyed restraining problem patients, the disciplinary hearing was told.

And he carried on regardless when ward sister Cath Rigg warned him about his language, which was peppered with F-words.

Fletcher denied several of the allegations at an internal hearing, conducted by Lancashire Care NHS Foundation Trust, which runs the unit.

But he failed to attend the NMC hearing and a three-strong panel ruled that three main charges against him were found proven.

NMC counsel Moloney said Fletcher had returned to work after a lengthy absence and was on a trial placement in the 18-bed Ward L3 which deals with older adults with conditions such as depression and bipolar disorder.

One woman, named as Patient A, who suffered from bipolar disorder, was in the ward dining area when she began repeatedly washing her hands.

Fletcher said to her: ‘Have you finished with your OCDs?’ Later in the presence of the same patient he told a colleague: ‘All the people that are a pain should be shoved in PICU’.

This was a reference to the psychiatric intensive care ward, which colleagues felt was an ‘awful’ thing to say to a patient, the hearing was told.

Panel chairman Alexander Coleman said Fletcher had a ‘woeful lack of interpersonal skills’.

He added: “The panel found Mr Fletcher used his authority as a nurse in a bullying and dictatorial manner which distressed patients and staff.”

Source: Peter Magill, “East Lancashire nurse struck off for abuse of patients,” Lancashire Telegraph, August 16, 2012.

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Psychiatrist Jonathan D. Sommers charged by license board for excessive prescribing

On October 7, 2010, the Medical Board of California issued an Accusation against psychiatrist Jonathan David Sommers, seeking to suspend, revoke or otherwise discipline his license.

According to the Board’s document, it opened and investigation of Sommers based on information received from the Humboldt County Department of Health and Human Services, where Sommers was employed.

A review of his treatment of patients and prescribing practices was undertaken.  The investigation detected departures from the standard of care relative to five patients.

In general, the accusations center around prescribing psychiatric drugs to elderly patients at excessively high doses as well as numerous departures in the standard of care in the treatment of a 17-year-old suicidal patient.

Source: Accusation in the Matter of the Accusation Against Jonathan David Sommers, M.D., license no. G41535, Case No. 12-2008-193482, Medical Board of California.

State seeking to revoke psychiatrist’s license for incompetence, gross negligence, false claims

On September 22, 2010, the Medical Board of California issued an Accusation and Petition to Revoke Probation on psychiatrist Joseph Ling-Hang Chan and is seeking to revoke his license, among other disciplinary measures.

The Board issued an Order on January 12, 2009, suspending Chan for 30 days and placing him on probation for seven years for gross negligence, repeated acts of negligence, incompetence and excessive prescribing involving seven patients, most of whom were elderly. The Order details how Chan prescribed multiple atypical antipsychotic drugs (Seroquel, Clozaril, etc.) in excessive amounts and failed to maintain appropriate medical records, failed to order appropriate lab tests (specifically with regard to the use of Clozaril) and/or failed to maintain adequate and appropriate records of the results of such tests.

A typical scenario in the January 2009 Order: Chan maintained a 68-year-old patient on Prolixin and Zyprexa (both atypical antipsychotics), among other drugs, and noted in the chart that he would taper the patient off of Prolixin and keep him on Zyprexa, but that did not actually occur for four months.  In another entry, Chan wrote that he would “clean up Prolixin when [the patient] is stable.” That note was repeated verbatim in the patient’s record for five consecutive months and then was dropped with no explanation.  The notes don’t explain why Chan intended to cross-taper the patient from one drug to the other or why it was not carried out and the records do not provide justification for maintaining the patient on excessive doses of the two drugs.  The records show that shortly after, Chan added an additional antipsychotic, Seroquel, the patient’s regimen, but there was no rationale in the patient’s records for this addition and there was no justification noted when the dosage was increased.

In one incident, Chan continued to submit claims for payment of service for nine consecutive months after the patient died.

Additionally, the Order noted that Chan’s patient records in general were not adequate or accurate and that he submitted false billings to public heath plans (Medicare and Medi-Cal).  Specifically, he routinely failed to appropriately document patients’ medications; his rationale for treatment with multiple antipsychotic agents; reasons for making (or failing to make) medication changes; review of laboratory test results; follow up on drug side effects and his communications with the patients’ other health care providers.  Additionally, Chan’s patient records for numerous visits were identical or nearly identical for extended periods; contained factual errors and were missing documentation for numerous months during his care of multiple patients.

Lastly, Chan submitted inaccurate or false health care claims to state and federal health plans (including Medicare and Medi-Cal) for services he had not provided.  In one incident, Chan continued to submit claims for payment of service for nine consecutive months after the patient died.

The Board’s current Accusation and Petition to Revoke is based on Chan’s identical or similar treatment of five additional patients, as well as his failure to consult the patients’ prior medical records and filing false documents, among other things.

The Board noted that “despite remedial clinical education,” Chan “demonstrated little understanding of the purpose of medical records or the importance of maintaining adequate and accurate records; rather, [he] stated that he made trivial changes in his records from visit to visit for the sole purpose of deflecting criticism.”  Additionally, with regard to the false billings, the Board noted that Chan “routinely prepared medical records and bills for services…with the intent to receive compensation for services not rendered” and “admitted to excessive billing, which he justified on the basis that he was not paid enough for his services….”

Source: Accusation and Petition to Revoke Probation in the Matter of the Accusation Against Joseph Ling-Hang Chan, M.D., Physician and Surgeon certificate F50691, Case Nos. D1-2006-174722 and 03-2008-193948 and Stipulated Settlement and Disciplinary Order in the Matter of the Accusation Against Joseph Ling-Hang Chan, M.D., Physician and Surgeon certificate F50691, Case No. 03-2008-193948, Medical Board of California.

This information was used with permission of the Citizens Commission on Human Rights International.