A senior nephrology registrar who engaged in “deceptive, dishonest, harassing, intimidating and threatening behaviour” towards a junior female colleague has convinced a NSW tribunal that he should be allowed to continue his training.
The NSW Civil and Administrative Tribunal found that Dr Dilshan Ariyarathna’s actions, including stalking a junior colleague (Person A), illegally accessing hospital personnel records and sending insulting emails under an assumed identity, constituted professional misconduct.
“The conduct was directed at a fellow medical professional, it was conducted from the privileged position which the respondent had as the supervisor of a more junior professional; it was calculated and carried out deliberately,” the tribunal said in its September 30 ruling.
Dr Ariyarathna was found guilty on three conduct breaches brought by the NSW Health Care Complaints Commission. But the tribunal rejected the HCCC’s assertion that he was not a fit and proper person to practise medicine and should be subject to a further suspension.
The tribunal heard that Dr Ariyarathna became infatuated with Person A late in 2018, when she was posted to John Hunter Hospital in Newcastle as a basic trainee in general medicine. The final-year registrar had recently been admitted as an RACP Fellow and was her supervisor.
After she declined his advances, he waged a secret campaign to pursue her and find out if she was involved with anyone else.
To this end, he created email accounts under fake identities purporting to be fellow trainees and contrived to impersonate a doctor he saw as a rival by luring him away from his computer.
“He believed that Person A was seeing another person (Person B) who worked at the hospital. The respondent decided to try to send a sham message from the office of Person B to Person A,” the tribunal said.
“To carry out such purpose the respondent:
“(a) on the 15th of January 2019, sent a fake sms message to Person B informing him that his car lights were left on. Person B knew that this was incorrect as he had ridden his bicycle to work. He assumed the message was sent to him in error.
‘(b) because this first ruse was unsuccessful, the respondent then sent Person B an email dated 15th of January 2019 from “Anette Read” informing Person B that some urgent forms were left for him by the Head of Medicine and were available for collection and requesting that he “spare 5 min” to collect them at 3:30 PM Tuesday, from the Department of Medicine.
“(c) knowing that Person B would be attending to collect the forms at that date and time, and that the computer of Person B would be unattended, the respondent gained access to Person B’s computer.
“(d) the respondent then sent a message (dated 15 of January 2019) from Person B’s computer to Person A purportedly from Person B.
“(e) the message was sent, using the hospital’s email service, in the most derogatory terms regarding Person A. It made insulting personal remarks concerning her appearance and it was written in a way to belittle and demean Person A.
“The email stated (in part): “that’s the real reason I asked you out, for sex, you aren’t special. You remind me of her [a fictional new girlfriend] … except the unsightly skin lesions, pronounced chin and wide shoulders… but the cheaper option. there is a farewell bar party for the leaving regs/fellows, I might take my new GF to it, will you be there… You might meet her!!. You may then see what attractive looks like. So there, that’s last thing [sic) I wanted to get off my chest. You won’t hear from me again and don’t contact me!”
Previously, the respondent had used a fake gmail account in Person B’s name to send similarly abusive and derogatory emails to Person A, the tribunal said.
In evidence, Dr Ariyarathna said he had hoped that if Person A believed that Person B was no longer interested in her, he would have a chance of securing her attention and affection. In another email, he had falsely alleged that Person B had had a child by another fictional person (“Jules”).
In “another level of deviousness”, he tracked down Person A’s mother by accessing next of kin details in hospital records, again using a work computer logged in under another colleague’s name, the NCAT said.
In this ruse, he bought a new mobile phone under his own mother’s identity and sent text messages posing as “Alice”, saying a “secret surprise dinner” was being planned for Person A, and asking who should be invited.
Ultimately, after Person A was transferred to another regional hospital and Dr Ariyarathna drove the 400km distance to a leave a note and a DVD on her car, she called police.
He was suspended firstly by the Hunter New England Local Health District in January 2019 and subsequently by the Medical Council of NSW in April that year, with a finding that he had engaged in “deceptive, dishonest, harassing, intimidating and threatening behaviour”.
The Medical Council revoked the suspension order in June 2020 with conditions, allowing Dr Ariyarathna to pursue ongoing training towards qualifying as a dual renal and gerontology physician.
In the latest proceedings, the HCCC argued for a further three-month suspension to “denounce” the doctor’s conduct and serve as a deterrent to others.
“The issue of a suspension is one the tribunal debated extensively,” the NCAT said. “The inappropriate conduct of the respondent was of an extremely serious nature and inconsistent with the standards expected of a medical practitioner. Such conduct rendered him unfit for practice.
“However, the counterbalancing factor is that the reasons underlying such conduct have been explained to the tribunal, have been addressed through professional treatment and continue to be addressed through such treatment.”
It accepted the conclusions of two psychiatrists and a psychologist that a recurrence of the conduct was “most unlikely” and that it had arisen solely from “particular circumstances which were foreign to him”.
Specifically, the circumstances were “being relocated to a place where he was away from his family and friends (and experiencing social isolation and limited emotional support), combined with the fact that he was immature and lacking experience in the development of romantic relationships…”
The tribunal accepted that the conduct had also arisen from the fact that he needed psychiatric help, which had received and continued to receive. It noted his “genuine remorse and contrition” and his recognition of the hurt he caused Person A.
Among conditions imposed, Dr Ariyarathna is not allowed to undertake solo medical practice, or act as the sole supervisor of any junior practitioner, and will need to attend supervision meetings and courses to focus on issues such as professional boundaries and responsible communications.