A specialist doctor conceded he prescribed risky drug combinations of anabolic androgenic steroids, human growth hormone and other substances for bodybuilding purposes
Dr Anish Dwarka Singh, a WA medical practitioner with 25 years’ experience under his belt, was brought before the State Administrative Tribunal of Western Australia in late 2016 by the Medical Board of Australia in relation to his prescribing patterns.
According to the West Australian, Dr Singh was director of the Metabolic Medicine Laboratory clinic until it went into receivership last year.
He had also advertised himself as “a world leader in specialist and diagnostic services in obesity and clinical medicine”, according to the publication.
But in contrast to his professional reputation, the Medical Board alleged Dr Singh had prescribed drugs or other treatments when there was no therapeutic basis, and in some cases with potential adverse effects putting a number patients at risk of harm.
The Board’s supporting evidence included the dispensing histories of several local pharmacies including a compounding chemist, in addition to clinical patient notes, Dr Singh’s testimony and expert witness testimony.
While Dr Singh’s witness statements included “barely a hint” that he was prescribing drugs for physical conditioning and/or bodybuilding purposes, the tribunal found strong evidence that this was in fact the case.
It pointed to a particular patient whom it said represented the “clearest example” of Dr Singh prescribing drugs for bodybuilding purposes.
Patient 71, who had initially consulted Dr Singh for obesity, had a prescription history with the doctor dating from January 2008 to April 2013. Photographs of the man reveal a bodybuilder who is not obese.
During the treatment period, the already “very developed bodybuilder” was prescribed Stanozolol, Methandrostenolone, Primoteston, Sustanon, Deca-Durabolin, Oxandrolone, as well as the complementary bodybuilding drugs Clenbuterol and Clomid, in large quantities through 2008 to June 2013.
The Board alleged that from early 2008 Dr Singh had engaged in a general practice of prescribing to patients who consulted him seeking weight loss, physical conditioning and/or bodybuilding:
- Anabolic androgenic steroids including Oxandrolone, Stanozolol, Methandrostenolone, Primoteston Depot and Methenolone;
- Ephedrine and capsules containing Ephedrine, Aspirin and Caffeine (EAC).
In addition, he was found to have engaged in a general practice of prescribing:
- Human growth hormone;
- Sibutramine (after it had been withdrawn);
- Erythropoietin; and
- Clomid – in contravention of the Poisons Act.
These drugs had been prescribed in circumstances in which there was no proper therapeutic indication and unnecessarily exposed patients to adverse effects.
Indeed, doses of Oxandrolone were prescribed up to nine times higher than Dr Singh’s witness statement suggested.
He had also engaged in a general practice of ordering the infusion of iron for patients who did not suffer from iron deficiency, and/or in circumstances in which the infusion of iron was contraindicated for patients due to haemochromatosis or beta thalassaemia trait.
While Dr Singh denied that he prescribed drugs for non-therapeutic purposes, tribunal notes say Dr Singh eventually “crack[ed] in the witness box”.
“It is rarely that a witness cracks in the witness box and concedes the other party’s case. But crack, Dr Singh did,” read the hearing notes.
After a string of questioning, he conceded that he was supplying steroids for bodybuilding for a large number of patients.
“There is overwhelming evidence that Dr Singh was prescribing androgen anabolic steroids to his patients for use in physical conditioning and bodybuilding,” the tribunal found.
It accepted the evidence of expert witnesses that there was no therapeutic basis for his prescription of these drugs.
An expert witness stated his opinion that at least “some harm” to a number of patients would be potentially attributable to the treatments administered, with evidence of potential “severe harm” to a further three patients.
He had also failed to keep proper records, and had written a “derogatory”, “offensive” and “totally inappropriate” letter to a hospital doctor who had notified the Board of Dr Singh’s prescribing patterns, the tribunal found.
In a decision handed down last week, the tribunal determined that Dr Singh had acted “carelessly, incompetently and/or improperly … in a way that constitutes professional misconduct”.
The doctor now awaits a second decision regarding the appropriate penalty and costs for his behaviour, which should be passed down within the next few months.