A Sydney GP who is banned from treating females has been found guilty of professional misconduct for carrying out dozens of clandestine consultations with women in a matter of months.
The Medical Council of NSW (MCNSW) prohibited Mustafa Jamnagarwalla, who works in Sydney's north west, from seeing any female patients after reports that he inappropriately touched a 12-year-old girl he treated for an ear infection in 2018.
It was alleged that while examining her ear at the Rouse Hill Town Medical & Dental Centre, Dr Jamnagarwalla touched the girl on her bare upper thigh, about 12 centimetres from her genitals, with no clinical reason for doing so. The NSW Civil and Administrative Tribunal (NCAT) has now concluded this incident did occur.
The allegation prompted the MCNSW to place a condition on Dr Jamnagarwalla's registration that he not see female patients unless it was an emergency.
But just four days after that condition was imposed, he started seeing women again while trying make the appointments undetectable by authorities, the NCAT found.
It found Dr Jamnagarwalla breached his medical registration by treating 29 female patients (some on more than one occasion) over a period of nearly 10 months.
For the vast majority of these consultations, he didn't bill the women so auditors couldn't trace the consultations through Medicare, the NCAT found.
The tribunal panel also said Dr Jamnagarwalla would deliberately not make notes in patient files to suggest he had not seen them.
This often meant there were no details about patient history, examinations, treatment plans or scripts.
"The seriousness of these deliberate omissions is obvious. Any doctor taking over that treatment could only guess as to the reason for the script and whether any diagnosis that was made justified the medication prescribed," the NCAT judgement said.
During two consultations for a female patient in October 2019, Dr Jamnagarwalla put full stops in certain sections of the file.
"[He] deliberately failed to record essential information in the patient’s clinical notes to give the impression that he had not consulted the patient," the tribunal members found.
Only one of the 29 women was treated for an emergency, after being bitten by a wasp, but Dr Jamnagarwalla said he "forgot" to notify the Medical Council about the consultation.
He argued he didn't have a clear understanding of the conditions and didn't believe he was in breach if he was just writing scripts for women, as long as he didn't physically examine them.
"On the occasions I wrote prescriptions for the above patients, as I did not consider I was conducting a consultation with the patients, I did not think I needed to record the information I would ordinarily include in the medical records," he said in a statement.
However, the tribunal rejected this, concluding it wasn't believable that a practitioner with almost two decades of experience could misunderstand what the conditions meant.
Doctor identified male patients as females
The NCAT found that, in November 2019, the MCNSW became aware of what Dr Jamnagarwalla was doing.
A letter was sent to the doctor advising him that the council had reviewed data from Medicare and it appeared he was treating female patients.
A list of patients was provided and in his response, Dr Jamnagarwalla incorrectly told the council that 52 people were male, despite eight people on that list being female.
In a statement, the doctor said he wasn't trying to be misleading and was simply rushing and not paying sufficient attention to the patients' names.
He said at the time he was under "significant stress" as his wife was subject to longstanding criminal proceedings and his brother was sick in Tanzania.
But NCAT said the mistake was "significant" and many of the first names of patients were typical female names.
"Dr Jamnagarwalla provided false and misleading information to the Medical Council ... he did not exercise reasonable care when making that response," the NCAT found.
"Dr Jamnagarwalla cannot have been so naive as to think he would get away with making such a claim."
Protective orders will be decided on at a later hearing but for now Dr Jamnagarwalla is still treating patients at the Rouse Hill Town Medical & Dental Centre.
