A doctor who inappropriately prescribed medication to treat depression and seizure disorders has been censured, with conditions, by a Medical Council fitness-to-practise committee.
The inquiry heard Dr Albina Maksimiuk inappropriately prescribed medication to eight adult patients while practising as a GP at North Clinic on North Circular Road, Dublin 7 and the Polish Dental Clinic, also North Circular Road.
Ten of the prescriptions were alleged to have been prescribed by Maksimiuk over a number of months in 2019.
Five allegations relate to the inappropriate prescribing of benzodiazepines, pregabalin and Z-drugs.
Benzodiazepines are a group of prescription drugs used to treat anxiety and depression.
Pregabalin is an anticonvulsant used to treat epilepsy, neuropathic pain and generalised anxiety disorder in adults.
Z-drugs, such as zolpidem and zopiclone, are non-benzodiazepine drugs used in the treatment of insomnia.
Chairwoman of the committee, Marie Culliton delivered their decision on Thursday.
She said they were satisfied Maksimiuk’s consent to being censured sent “a powerful indication” that she “truly understands the nature of her errors”.
Culliton said the registrant had apologised and demonstrated insight regarding the deficiencies in her practise and had co-operated with the investigation and inquiry.
Maksimiuk also undertook on Thursday to not repeat the conduct that was the subject of the allegations.
She further undertook to follow appropriate clinical guidelines for the prescribing of benzodiazepines, pregabalin and Z-drugs and to record the appropriate clinical rationale for prescribing these drugs.
Five of the allegations related to the inappropriate prescribing of these drugs.
Maksimiuk also undertook to maintain accurate and contemporaneous records of all consultations and to maintain a thorough patient history.
It was alleged that Maksimiuk failed to document, regarding some of the patients, an adequate history of their alcohol or drug intake, any past history of depression or anxiety or the risk of suicide.
Maksimiuk also undertook to arrange for the appropriate referrals of patients to psychiatry for review and assessment of anxiety, depression and serious psychological disturbances.
It was alleged that Maksimiuk failed to refer one patient, patient E, to psychiatry for review and assessment in respect of her anxiety disorder.
Maksimiuk further undertook to only work as a paediatrician and to not treat or prescribe for adult patients.
The inquiry heard Maksimiuk, who is Lithuanian, practised as a paediatrician at the North Clinic, where she also provided her services as a general practitioner to some adult patients.
The inquiry also heard Maksimiuk on occasion provided locum general practitioner services in other practices, including for adult patients.
Culliton said that Maksimiuk’s acceptance that she would confine her practise to paediatrics should adequately protect the public.
Maksimiuk further undertook to treat patients only in circumstances where she has sufficient language proficiency.
Maksimiuk, who is fluent in Russian and Lithuanian, was assisted throughout the inquiry by a translator. The inquiry heard she provided her services to Lithuanian- and Russian-speaking patients in Ireland.
She also undertook to not prescribe benzodiazepines, pregabalin and Z-drugs to paediatric patients except under the instruction of a hospital based consultant.
Maksimiuk further undertook to maintain a contemporaneous log regarding prescribing these drugs for a period of five years from Thursday.
She also undertook to identify within three months a practitioner of appropriate standing to review on a biannual basis for five years her prescribing log and to report to the Medical Council any such prescriptions and to identify any concerns.
Maksimiuk also undertook to complete three courses regarding the management of benzodiazepines and z-drugs, patient record keeping and prescribing within 12 months.
The inquiry arose from a complaint by the council prompted by an email to the regulatory body from Hanover Quay Pharmacy, which attached a prescription dated August 9th, 2019.
The email outlined that the prescription looked like a very poor photocopy, that it resembled a forgery and that it prescribed a very large quantity of pregabalin.
The acceptance by Maksimiuk of undertakings brings the three-day inquiry to a conclusion.