New Castle Herald
What’s up Doc: The psychiatrist, the drug addiction and the job offer
By GABRIEL WINGATE-PEARSE
Oct. 31, 2014
A HUNTER hospital offered a job in its psychiatric emergency unit to a doctor who had been deregistered over his lengthy drug addiction and ‘‘bizarre’’ treatments.
While addicted to psychostimulants, Dr Kim Street had painted the walls of his surgery black, was unable to pay bills, and exposed patients to experimental drug therapies without their knowledge.
He prescribed the wrong drugs to pregnant women and elderly patients, as well as patients with a history of psychosis, post-traumatic stress disorder (PTSD), erratic criminal behaviour, gambling addictions, major depression and social phobias.
Dr Street, who moved to Swansea in 2000, faked patient prescriptions and pretended to pick up medications on their behalf.
In September the Mater hospital offered him work in its psychiatric emergency unit under the supervision of Hunter New England Mental Health medical services director Dr Marcia Fogarty.
That was despite Dr Street’s lack of acute care experience and the fact he had been heavily addicted to prescription drugs between 2002 and 2012.
During a two-year stretch, the psychiatrist admits to being so ‘‘deeply in the throes’’ of his addiction that he was taking up to 75 tablets of dexamphetamine a day, from eight different pharmacies.
Having described his level of functioning during that time as ‘‘appalling’’, he doubts any of the clinical decisions he made ‘‘were remotely well reasoned’’.
With regard to prescribing dexamphetamine to patients suffering from PTSD, Dr Street conceded it was ‘‘bizarre treatment’’ and he would ‘‘absolutely not’’ consider prescribing the drug for patients with PTSD in the future.
This week, the psychiatrist, who previously surrendered his registration, was disqualified from practising for 18 months by the NSW Civil Administrative Tribunal.
The tribunal considered seven volumes of evidence, with complaints relating to 30 patients, in answer to a Health Care Complaints Commission request for the 61-year-old to be barred from practising for at least two years.
In handing down its decision on Wednesday, the tribunal said Dr Street’s conduct was of the ‘‘gravest kind’’.
‘‘Not only did Dr Street engage in self-abusive behaviour that affected his competence to practise, he also implicated unknowingly his patients in his pattern of deception,’’ it said.
Dr Street was diagnosed with attention deficit hyperactivity disorder (ADHD) in 1996, a condition for which dexamphetamine is used.
Over the past two years, Dr Street had shown remorse, taken proactive steps to rehabilitate himself and had won the confidence of colleagues to return to work, it found.
But the tribunal said it was still ‘‘too early’’ for him to resume practice.
In a letter to the tribunal, Dr Fogarty confirmed that Dr Street had been ‘‘very candid’’ about his circumstances and the conditions on his medical registration in a meeting with her, and mental health services director Martin Cohen.
‘‘We considered the possibilities of being able to employ an experienced Australian-trained psychiatrist measured against the risks for our patients, staff and organisation given this history,’’ Dr Fogarty said.
‘‘We have decided to give Dr Street a six-month trial …’’
Dr Street had agreed to random urine samples, and would not be assigned to any patients on prescription amphetamines, she said.
Dr Cohen said on Friday the ‘‘offer of part-time, temporary, conditional employment’’ would have been subject to a review by an internal, specialised committee, before a recommendation went to the chief executive for consideration.
Hunter New England Health acknowledged the tribunal’s findings and accepted its decision, he said.
The tribunal concluded that Dr Street had struggled with drug and alcohol addiction throughout his career.
‘‘While there are long periods when he has managed to avoid addictive behaviour they have recurred at intervals that suggest an underlying vulnerability that persists … to drug and alcohol abuse originating in a continuing ADHD condition,’’ the tribunal said.