Blood cancers

SA haematologist reprimanded and fined for chemo underdosing failures

South Australian haematologist Associate Professor Ian Lewis has been reprimanded and fined $10,000 by the Medical Board for his role in the state’s chemotherapy underdosing scandal.

Dr Lewis was Clinical Director of Haematology and Lead Clinician in AML at the Royal Adelaide Hospital (RAH) when 10 patients with leukaemia were mistakenly given only a single daily dose of cytarabine instead of the appropriate twice daily dose. The incident arose after an amended AML consolidation chemotherapy protocol with errors was introduced in 2014.

In a case heard by the Health Practitioners Tribunal of South Australia, Dr Lewis admitted unprofessional conduct in relation to a charge that he failed to discharge his responsibilities concerning the introduction of the new protocol.

He also admitted professional misconduct in relation to his response after the  protocol under-dosing error was discovered, in that he failed to take appropriate action to address the issue of incorrect dosing of patients at the Royal Adelaide Hospital.

Lawyers representing of the Medical Board said that in his position, Dr Lewis should have ensured that the protocol accurately transcribed the revisions and presented it to his peers and relevant specialist medical practitioners before the protocol was distributed.

The Medical Board also alleged that when he became aware of the chemotherapy underdosing error after returning from holiday in January 2015, Dr Lewis did not take action to determine the stage of treatment for the affected patients; took no action to identify or notify clinicians responsible for treatment of those patients and took no action to identify and notify patient’s clinicians at any other hospital affected by the error.

The tribunal also heard that there was no process put in place to notify the affected patients until 18 February 2015, and no appropriate action taken by Dr Lewis to communicate with management in relation to the error and remedial action. He also took no appropriate action to ascertain his obligations to lodge an incident report with the South Australian Safety Learning Incident Management System and the report was not submitted in a timely manner.

The tribunal found that the conduct “was substantially below the standard reasonably expected of a registered health practitioner of Professor Lewis’s level of training or experience; namely, his role as a specialist haematologist and the AML lead clinician at the RAH his role as clinical director.”

In addition to the reprimand, Dr Lewis was ordered to pay a fine of $10,000 to the Medical Board and their costs of $25,000.

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