A NSW doctor has been reprimanded and banned from diagnosing or treating Lyme disease after a misdiagnosed patient died of lung cancer
Dr Peter Mayne, 68, first saw Patient A in February 2012 at his rural clinic and diagnosed him with migratory arthritis.
The patient, who was also 68 years old, was a smoker suffering from COPD, ischaemic heart disease, hypertension and emphysema.
Following the first few consultations in February, Dr Mayne seemed convinced that Patient A was suffering from Lyme disease, and recorded a diagnosis of “Lyme neuroborreliosis”.
In March 2012 he commenced giving Patient A intramuscular penicillin injections for the treatment of Lyme disease, and continued to administer these several times a month over a 30-week period, until the end of September 2012.
In early 2013 Patient A relocated to another medical centre where he was treated by other doctors, who diagnosed him with lung cancer with brain secondaries. He died in mid-2013, aged 69.
The Health Care Complaints Commission (HCCC) brought Dr Mayne before the Professional Standards Committee after receiving a complaint from Patient A’s wife, who stated that her husband had ongoing symptoms including weight loss approximately one year before his diagnosis of lung cancer.
She recalled that her husband had experienced rapid weight loss, swelling in his hands and feet, and bowel problems.
While Dr Mayne was aware of these symptoms, Patient A’s wife stated: “He did not discuss with me any other possible diagnoses, and continued to attribute these symptoms to Lyme disease.”
The Committee found that the doctor had failed to consider and investigate the possibility of a malignancy in Patient A, an older male with COPD who continued to smoke.
Expert witnesses at an inquiry before a Professional Standards Committee were, in general, critical of Dr Mayne’s diagnosis and standard of treatment.
Fellow GP Dr Jeannie Ellis pointed out that Dr Mayne had failed to undertake an examination of the joints involved in the migratory arthritis, and had not examined Patient A’s musculoskeletal system nor requested any X-rays of the joints affected.
Even if the patient had Lyme disease, infectious diseases physician and clinical microbiologist Professor Miles Beaman said intramuscular penicillin for Lyme disease was “outmoded” and the length of treatment was “completely experimental”.
Based on the evidence, the Committee was satisfied that Patient A did not have verifiable Lyme disease at the time he received the injections.
The Committee also noted that there was no evidence to convince them that Dr Mayne’s diagnosis of Lyme disease was re-evaluated at any time during his treatment of the patient.
All the expert witnesses also made mention that due to Patient A’s age and comorbidities, Dr Mayne should have sought a second opinion with regard to his diagnosis and management.
Dr Mayne admitted many of the particulars in the complaint but did not accept that he was guilty of unprofessional conduct regarding his actions.
The Committee disagreed, finding him guilty of unsatisfactory professional conduct.
“We were satisfied that he engaged in conduct that demonstrated the knowledge, skill or judgment possessed, or care exercised, by him in the practice of medicine was significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience,” they found.
Dr Mayne graduated in medicine from the University of Sydney in 1973, and had been practising for over 40 years at the time of the conduct.
He is currently unregistered, having voluntarily relinquished his medical registration after suffering two strokes in 2015.
However should he regain registration at any point, the Committee has directed the following conditions be imposed:
- To practise only in an accredited group general practice… where the patients and patient records are shared between the medical practitioners and where there is always one other registered medical practitioner on site;
- Not to advise (other than refer a patient to another practitioner), diagnose or treat patients who the practitioner believes to have or may have Lyme disease or similar tick-borne diseases;
- To practise under supervision;
- To submit to an audit;
- To complete a GP prescribing course;
- To complete a course on good record keeping.
Dr Mayne is able to appeal the decision to the NSW Civil and Administrative Tribunal before the end of May.