Indian-origin doc suspended for inappropriate prescription in Singapore

Singapore, Jan 11:  An Indian-origin doctor with 35 years of experience, who inappropriately prescribed long-term sedatives to his patients, has been suspended from medical practice for three years by a disciplinary tribunal in Singapore.

Maninder Singh Shahi, a 61-year-old general practitioner at a Marine Parade clinic, pleaded guilty to 14 charges of professional misconduct in relation to his actions from 2002 to 2016, Channel News Asia (CNA) reported on Thursday.

Accepting the Singapore Medical Council's (SMC) submissions for the suspension on January 9, the three-member tribunal ordered for Shahi to be censured.

He also has to provide a written undertaking to the SMC that he will not repeat his conduct, and pay costs of the proceedings.

Of the seven patients to whom Shahi improperly prescribed long-term sedative medication, three were elderly.

The three-member tribunal heard that Shahi, who ran an “extremely busy” practice, seeing as many as 40 to 70 patients per day, inappropriately prescribed benzodiazepines, zopiclone or zolpidem.

In addition, he failed to refer patients or refer them in a timely manner to a psychiatrist or medical specialist and did not maintain sufficient details in patients’ medical records.

Benzodiazepines treat a range of conditions such as insomnia and anxiety, while zolpidem and zopiclone are non-benzodiazepine drugs that treat insomnia.

To one of his patients suffering from insomnia, Shahi prescribed benzodiazepines beyond the recommended period of four weeks, along with medication containing opioid analgesics such as codeine, CNA reported.

Where benzodiazepines are repeatedly prescribed, doctors must clearly document certain aspects in the patient’s medical records.

SMC said Shahi exposed his patients to substantial potential for serious injury or harm.

In his mitigation, Shahi said that he was not motivated by profit or greed, but wanted to help his patients by prescribing hypnotics to them.

Shahi claimed that he also tried to refer three patients to a psychiatrist but they were not keen to do so.

The tribunal considered Shahi's long and unblemished record, his plea of guilt and cooperation with the authorities but rejected his argument that he should be given a shorter sentence due to a delay in prosecution, which caused him mental anguish, anxiety and distress.

It noted that Shahi's prolonged period of offending would have exposed his patients to a “very real risk” of developing dependency on benzodiazepines, despite no evidence of actual harm being caused to the patients.