Doctor Questioned About Fatal Morphine Overdose
The Age
Thursday November 20, 2008
A MOUNT Waverley doctor who allegedly prescribed an excessive dose of morphine to a woman on the day she fatally overdosed on the drug had been warned by health authorities that she might be an addict, the Medical Practitioners Board has heard.
Dr Robert Molnar, a general practitioner at Pinewood Medical Clinic, has been accused of unprofessional conduct for prescribing the woman a large dose of morphine to be injected at home on January 16, 2004.The woman, who had a two-month-old baby at the time, accidentally overdosed on the drug later that day and died in hospital the next day.Counsel assisting the board, Fiona McLeod, SC, said yesterday that Dr Molnar had received a telephone call from the Department of Human Services in December 2003, informing him that another doctor had previously reported the woman as a drug-dependent patient.Despite this notification, he went on to prescribe five ampoules for the woman, each containing 50 milligrams of hydromorphine, a potent painkiller up to eight times the strength of ordinary morphine, the next month.The prescription ordered her to inject all of one ampoule - equivalent to about 400 milligrams of morphine - when it should have been one fifth of an ampoule. Earlier this week the board heard that although Dr Molnar incorrectly ordered the woman to take one ampoule, he claimed to have provided her with handwritten instructions that were correct.The patient, who suffered depression and back and leg pain, allegedly told Dr Molnar she knew a nurse who could help her inject it at home. But the nurse did not exist and Dr Molnar did not attempt to verify her claim, the board heard.Dr Nick Carr, a general practitioner called to give expert evidence about Dr Molnar's management of the patient, yesterday described it as "extraordinary" and "unacceptable".He said Dr Molnar should have checked the woman's history with other doctors after two or three consultations during which she continued to seek opiates for ongoing pain."Giving this level of medication to someone about whom no other information is known is high risk ... You don't know the risks of them misusing it," he said.Dr Carr said Dr Molnar should have also taken into account the woman's infant because it could have affected breastfeeding and her ability to look after the child.The board also heard yesterday that Dr Molnar told a coronial inquest into the woman's death that he intended to keep increasing her doses until her pain was relieved. The hearing continues on Monday.
© 2008 The Age