Director of Proceedings v Dr N

Health Practitioners Disciplinary Tribunal  Decision No. 535/Med12/225D (8 May 2013 and addendum of 3 July 2013)

Dr N is a registered medical practitioner whose practice consists of minimally invasive appearance medicine. In July 2009 he provided care to an elderly patient visiting from Australia. The patient had concerns about the appearance of her cheeks. Dr N explained that he could perform a malar/cheek lift by injecting a dermal filler for the purpose of adding volume and fullness to the cheeks. That procedure is ordinarily undertaken with the use of an approved dermal filler.

When performing the procedure that day Dr N used a product named Novielle Gel Plus. Novielle Gel Plus was an unapproved medicine in New Zealand in terms of the Medicines Act 1981. Novielle Gel Plus had been developed by its manufacturer Coapt Systems Inc for use in vocal cord augmentation, a purpose for which it had been approved by the United States Food and Drug Administration. However, it had never been approved for use as a dermal filler in the United States.

Dr N failed to obtain his patient's informed consent prior to administering Novielle Gel Plus in that he failed to advise her that Novielle Gel Plus was an unapproved medicine. He also failed to advise her that there was a risk of granuloma forming when dermal filler is applied. Dr N also failed to ensure that the product he used was safe for that purpose and failed to comply with applicable legal and professional standards when he elected to use the product as a dermal filler.

When his patient subsequently suffered an adverse reaction to the procedure, Dr N then failed to refer her for specialist care in a timely manner. He prescribed further medication and provided further treatment that was without adequate clinical justification. Dr N also failed to adequately document the care he provided his patient.

In acting as he did the Tribunal found Dr N guilty of professional misconduct and ordered that Dr N be censured, that he pay a fine of $8,000.00, that conditions be imposed on his practice and that he pay a proportion of the Tribunal's and the Director's costs. The Tribunal ordered that Dr N's name be permanently suppressed.

The Tribunal's decision can be viewed at: https://www.hpdt.org.nz/Charge-Details?file=Med12/225D


Last reviewed February 2019