'Drugs turned patients to monsters': Doctor faces misconduct
A RESPECTED psychiatrist with an exclusive private practice in the heart of the Sunshine Coast stands accused of wrongly diagnosing and drugging patients who suffered catastrophic consequences.
Amid allegations he was prescribing potentially toxic doses of the speed-like drug dex-amphetamine, widely used on hyperactive children, the Australian Medical Board is pursuing Dr Phillip Bird for alleged professional misconduct - namely favouring a diagnosis of attention deficit hyperactivity disorder rather than treating a patient's primary mental illness.
A series of hearings before Queensland Civil and Administrative Tribunal will determine whether in doing so, Dr Bird exposed his most vulnerable clients to a drug that turned them into monsters unrecognisable to their loved ones, lethal weapons on the road and even homicidal maniacs.
Dr Bird disputes all the allegations and maintains a diagnosis of ADHD was available in every case based on his "clinical judgment, experience and contemporary medical knowledge".
He first made headlines when it was revealed he was the psychiatrist who had treated dex-amphetamine riddled driver Anthony Thomson before he caused a devastating car crash in 2009.
The troubled Sunshine Coast man was on cocktail of prescribed drugs when he smashed into a car, killing five-year-old twins Grace and Jessica Hornby (pictured below) and their grandmother Denise Mansell at Woombye. He also died.
The medical watchdog previously alleged the 46-year-old, who had been a patient of Mr Bird's for three years, was abusing the drug which had been prescribed in 5mg quantities up to 12 times a day despite concerns raised about his history of drug abuse and requests for excessive amounts of oxycodone.
While the Thomson case no longer falls within the scope of the pending hearings, the alleged link between dex-amphetamine and dangerous driving is again a key focus.
Evidence before the tribunal includes a letter from the wife of one of Dr Bird's patients who describes being too frightened to allow her son in the car with her husband while he is taking dex-amphetamine.
She tells Dr Bird her husband has lost control many times, running up a median strip at Buderim, speeding like "he is on a racetrack" and warns "I feel sure someone is going to be killed".
Clinical notes regarding the treatment of a late Sunshine Coast airline pilot reveal that before he took his own life in 2008, he was "risk taking" with his car and driving at dangerously high speeds which was of "great concern to his family and friends".
Another patient describes feeling guilty about being "sedated" while driving his children to school.
Expert witness Dr John Varghese, a Brisbane based medical specialist and psychiatrist, has been asked to independently review the treatment eight patients received at Dr Bird's Gosforth Clinic which he established in the late 1990s.
Having combed through what he describes as Dr Bird's "often barely legible clinical notes", Dr Varghese has recommended that on all occasions, a second opinion should have been sought and in at least three cases, nothing in the patient's history supported the diagnosis of ADHD.
Dr Bird, a psychiatrist of more than 20 years has chaired and presented educational meetings for both psychiatrists and general practitioners on ADHD in adults - his specialty field - and has been invited to speak about the condition at medical forums around the world.
He is expected to argue several of the diagnoses pre-dated revised practice guidelines which require a more extensive list of symptoms to be present.
While any retrospective recommendations about the treatment the airline pilot should have received will come too late for his family, Dr Varghese found Dr Bird's diagnosis of ADHD was made with "very little documented reasoning or justification".
He noted the man was once arrested and subdued with tear gas at a US airport, prompting concerns to be raised about his addiction to dex-amphetamine.
A file before the tribunal confirms that during the same period, Dr Bird certified "I consider there is no psychological or psychiatric reason why he should be considered unsafe to hold a firearm licence".
By 2008, the former pilot's prescription of 5mg dex-amphetamine doses had increased from six to eight times per day. He suicided that August, aged 43.
In his recommendations, Dr Varghese is particularly scathing about the treatment of a 43-year-old former Navy officer who the tribunal will hear was consumed by morbid jealously towards his wife and entertained thoughts of killing her while taking up to 40mg dex-amphetamine per day.
The medical board alleges the man's symptoms were "better accounted for by another illness" and the amount of the drug prescribed was "excessive".
Dr Varghese agreed, saying in his opinion there was "no justification for diagnosis of ADHD now or in the past" and had the man followed through on his plans while under the influence of a psycho stimulant, "there would have been little hope of Dr Bird justifying it to a coroner".
A former Sunshine Coast police officer, who it will be alleged should have been treated for post-traumatic stress disorder rather than ADHD, is also among the patients whose care the medical board has scrutinised.
In his affidavit, the retired officer, who left the force following a series of a distressing call-outs, describes losing two years of his life as a result of the ADHD diagnosis that required him to take high doses of dex-amphetamine daily.
The tribunal is expected to hear that within a month of being prescribed the drug, the officer was admitted to Nambour hospital after a suicide attempt.
In the months that followed, the husband and father, who was also drinking heavily, was hospitalised a further 11 times, became unemployable and destroyed his marriage.
The officer maintained he never displayed any symptoms or signs of ADHD and has since sought treatment elsewhere.
Dr Varghese was also critical of the treatment of a 59-year-old man who, before being treated by Dr Bird "appeared to be a reasonably functional man in a stable marriage in a well-paid senior position in a multi-national engineering company and living an independent life".
But, by the time he was referred to a NSW psychiatrist 10 years later and on a cocktail of dex-amphetamine and Xanax, it appeared that "under Mr Bird's treatment, the man's marriage broke down, he was unemployed and homeless".
He found the man was treated for ADHD when he should have been treated for anxiety and depression and prescribing high doses of dex-amphetamine to a man with a history of drug dependence was inappropriate.
An 82-year-old woman, who underwent neurological surgery and electric shock therapy during the "dark ages" of psychiatry, is also said to have been treated by Dr Bird for ADHD when she should have been treated for an eating disorder and other illnesses.
Dr Varghese has told the tribunal that while the woman's history was "exceptionally unusual and uncommon, there is limited or no history that would lead one to suspect a diagnosis of neuro-developmental ADHD (and) a psycho stimulant with its anorectic and mood altering properties could quite conceivably have had catastrophic consequences".
The care of three others - a 23-year-old Sunshine Coast University student who was repeatedly hospitalised for anorexia when she was diagnosed with ADHD, a 57-year-old woman suffering from insomnia and a 64-year-old sexually confused man from Nambour have also been referred to the tribunal.
Dr Bird has until March to respond in full to the allegations which he disputes.
A hearing date is yet to be set.
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- Dr Bird failed to take proper history of the symptoms that address the criteria for ADHD
- That he primarily diagnosed ADHD where grounds were not supported
- That he treated patients for ADHD when he ought to have treated the patient's primary disorder.
- He inappropriately prescribed the drug dex-amphetamine in excessive amounts.
What constitutes an ADHD diagnosis?
- Symptoms must have started before the patient was aged 7
- They must have resulted in or are associated with moderate or severe psychological, social and/or educational or occupational impairment.
- A confident diagnosis in an adult requires corroboration from parents, older siblings, reports of consultation and childhood/school reports
- Symptoms must be associated with at least moderate psychological, social and/or educational or occupational impairment based on interview and/or direct observation in multiple settings
- They must be pervasive, occurring in two or more important settings including social, familial, educational and/or occupational settings.
- Second opinion should be sought
* These are the practice guidelines the Royal Australian and New Zealand College of Psychiatrists considers most appropriate for the treatment of adult ADHD.