Czech-based GP accused of changing nursing home patient’s pain medication without consultation

A Czech-based GP has appeared before a fitness-to-practise committee accused of changing the pain relief medication dosage of a female patient in a nursing home without consulting in advance with her or her consulting physicians. Dr Jan Österreicher, with an address in the Czech Republic, appeared before the Medical Council committee on Monday regarding allegations of professional misconduct and poor professional performance relating to services he provided to the patient, Mary Gleeson, at Castle Gardens Nursing Home, Drumgoold, Enniscorthy, Co Wexford, from June 20th to June 27th, 2022. William Martin-Smith, barrister for the chief executive of the Medical Council, Dr Maria O’Kane, told the committee that Gleeson died last year. Österreicher faces one allegation of professional misconduct relating to a meeting between him, Gleeson and members of her family at the nursing home on June 27th, 2022, concerning a reduction in her Gabapentin prescription.READ MOREGabapentin is used to treat symptoms including nerve pain and neuropathic pain caused by diabetes.It is alleged that Österreicher stated at the meeting that he had considered test results which indicated that the original higher dose of Gabapentin at 2,700mg daily had impacted on Gleeson’s liver and liver toxicity levels. The chief executive alleges that this statement was inappropriate, not supported by test results available to Österreicher at the time, and caused stress and anxiety to Gleeson. O’Kane further alleges that this was conduct in which Österreicher seriously fell short of the standards expected among doctors. The remaining 10 allegations that Österreicher faces are of poor professional performance. These include that on June 20th, 2022, he prescribed Gleeson a reduced dose of Gabapentin of 900mg daily and that he failed to consult in advance with Gleeson and her consulting physicians. It is further alleged that he failed to advise Gleeson of the possible side-effects of such a reduction, and that the amount by which the medication was reduced within a short timeframe was not appropriate and was not warranted by any change in her condition. Martin-Smith told the committee that Gleeson was discharged from St Vincent’s University Hospital in April 2022 with a 2700mg daily prescription for Gabapentin, and was brought to the nursing home for respite care, where she stayed until the end of July 2022. On May 20th, 2022, after suffering a fall, she was brought to Wexford General Hospital where a compression fracture of a vertebrae in her lower back was identified. She was discharged on May 25th, 2022, with a 3600mg daily prescription of Gabapentin. She returned to the nursing home in serious pain and was initially treated by another GP, and then by Österreicher. It is alleged that on June 22nd, 2022, Österreicher further reduced Gleeson’s prescription for Gabapentin to 600mg daily, where he failed to consult in advance with Gleeson and her consulting physicians, and that such a reduction was not appropriate or warranted. It is further alleged that during the period of June 24th to June 27th, 2022, Österreicher failed to appropriately respond to Gleeson and her family’s concerns in relation to the change in the Gabapentin prescription. Österreicher, who qualified from Charles University in Prague in 1996, has been registered with the Medical Council since March 14th, 2017. The committee will reconvene on Tuesday to hear further evidence on behalf of the chief executive.