Experienced physician’s ‘tragic fall from grace’


By Tessa Hoffman

4 Jul 2017

A Perth immunologist has been banned from practice for a decade in a case that has been described by a tribunal as a “tragic fall from grace of a very well educated and experienced physician”.

The State Administrative Tribunal of Western Australia found Dr Anish Dwarka Singh prescribed patients androgenic-anabolic steroids, ephedrine, clenbuterol, iron infusions, fresh frozen plasma infusions (FFP) and DEXA scans where there was no therapeutic indication and the potential to cause harm.

The hearing largely concerned treatment of about 30 patients between 2008-2015, although the misconduct dated back to 2001.

Some patients had serious health conditions including body dysmorphic syndrome, hypertension, and substance misuse issues.

In one case, Dr Singh put a man with asthma and hypertension on an “unjustifiable body building regime of polypharmacy” including testosterone, human growth hormone, tamoxifen and clomid and then failed to monitor him.

The man – who was also misusing benzodiazepines and cocaine – was later hospitalised for an episodic seizure, and the tribunal found Dr Singh’s actions “may well have contributed” to the collapse.

Meanwhile, five patients given FFP infusions suffered moderate to severe adverse events.

Dr Singh told the tribunal he prescribed the infusions to patients to manage dysautonomia in order to increase blood volume (and thereby blood pressure), but the tribunal found the treatments were not clinically indicated.

One professor called to comment on the case described Dr Singh’s approach to pharmacology as “bizarre” and “not founded on any principle of science or evidence that I am aware of”.

The tribunal found while Dr Singh described his prescribing “in medical terms and with medical justifications” the objective evidence “paints a very different picture.”

The tribunal found Dr Singh did not show remorse or insight.

Instead he had defended his treatment regimes, claiming he had “done no harm and that ‘no-one had died on [him]’”.

But there was evidence of some harm to 30 patients, the tribunal was told.

Also criticised for failing to take adequate clinical notes, Dr Singh claimed this was to protect patients with public profiles.

“The ultimate findings of this Tribunal reflect a tragic fall from grace of a very well educated and experienced physician,” Justice Jeremy Curthoys said as he handed down his decision on June 22, which ordered the doctor be disqualified from registration for 10 years and pay $5000 fine and costs.

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