Doctor craved ‘euphoric’ drug

BORDER surgeon Roland Von Marburg has been disciplined by the NSW Medical Tribunal after it was found he self-medicated with pethidine.

The ear, nose and throat specialist has this month been found guilty of professional misconduct after admitting he self-administered pethidine between April and August 2008.

Mr Von Marburg, who has been drug free for 3½ years, told the tribunal he first used pethidine in 2001 to deal with headaches.

He turned to the drug again in 2008 to handle migraines and personal and professional stresses.

But after some time he started taking the drug for recreational use as he had become addicted to its “euphoric experience”.

Mr Von Marburg was suspended from practising in NSW and Victoria for a month in October 2008 as a result of two complaints made by the Health Care Complaints Commission.

The suspension was conditionally lifted in November 2008 and he has since been in an impaired doctors’ rehabilitation program, subject to random drug screening.

Mr Von Marburg must continue to not prescribe, possess, supply, administer, handle or dispense any drug of addiction.

He is not to prescribe for self-medication and must continue to undergo treatment for his drug addiction.

The tribunal found Mr Von Marburg hid his addiction within false medical records of his patients and some of the doses prescribed to patients would have otherwise attracted a finding of inappropriate treatment.

During March and August 2008, Mr Von Marburg would self-administer pethidine on Friday and Saturday nights, hiding his addiction by over-prescribing for patients and collecting the prescribed medication himself.

When he began getting frequent migraines in 2001, Roland Von Marburg self-prescribed pethidine during the lead-up to a case that had been brought against him by a former patient.

Mr Von Marburg told the NSW Medical Tribunal he had taken four or five ampoules of the drug over four or five weeks but he stopped using pethidine when the migraines were relieved.

By 2008, the surgeon had established a busy practice over almost a decade.

His personal and professional stresses had again built up and the migraines had returned.

The tribunal decision of May 8, 2012 notes that Mr Von Marburg “complains of multiple stressors and some poor coping skills during this period”.

In response, he began using pethidine to relieve the severe pain of the headaches in late March to early April 2008.

The tribunal was told Mr Von Marburg continued taking the pethidine for his own recreational use, having “become addicted to the ‘euphoric’ experience” of the drug.

“It was his practice, instead of discarding excess vials that he prescribed for a patient’s relief of pain, often post operative, to keep some of that prescribed for a patient for his personal use on a Friday or Saturday night,” the tribunal decision says.

“Initially this would involve two vials over the weekend but it quickly rose to the doctor using four or five vials.”

A local pharmacist reported Mr Von Marburg was picking up a large number of prescriptions for pethidine himself, in contrast with regular practice where a patient would take a prescription from their doctor to the pharmacy and take the drug back to the doctor for intramuscular injection.

But when Martin Power, of the pharmaceutical services branch of NSW Health, contacted the doctor in August 2008, he denied his use of pethidine.

Overwhelming documentary evidence, including the falsification of his drug diary and clinical records, was offered in the investigation that followed, forcing Mr Von Marburg to concede his addiction to the NSW Medical Board.

He was placed in an impaired registrar’s program in late 2008 and his practice has since been monitored.

He has been drug tested at random and given psychiatric support.

Since October 2008, Mr Von Marburg has not been able to prescribe opiates and other Schedule  8 drugs and he has been drug free.

Another ear, nose and throat specialist, John Carotta, undertook an audit of the clinical records of seven of Mr Von Marburg’s patients, concluding the treatment offered to six of the seven patients, fell “significantly below the standard reasonably expected of such a highly qualified and experienced practitioner”.

The tribunal expressed “serious concern not only as to the doctor’s breaching his ethical responsibilities to himself as a leading member of the medical profession but the dishonest way in which he then denied and deceptively hid his addiction”.

Mr Von Marburg’s counsel, Mark Lynch, said his client’s conduct over the past 3½ years, including his record keeping, had improved following orders and discussions with a number of other practitioners.

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