Brian McLean, who at the time worked for McLeay Valley House, a Thompson Health Care Residential Aged Care Facility in Frederickton, NSW, said he could not explain why he removed Risperidone from one patient’s Webster pack and gave it to other patients. The NSW Civil and Administrative Tribunal heard that McLean took the antipsychotic medicine from the Webster Pack of Patient A and gave one tablet to each of Patients B, C and D on 23 October 2014. Patients C and D were charted for the drug “as needed” but Patient B was not charted for it at all. When cross-examined, McLean said that there was no occasion for Patient B to be administered Risperidone. He did not record that he had taken the tablets or given them to Patients B, C or D and said he had no recollection as to whether he had done it or not. On 24 October, he took three more Risperidone tablets from Patient A’s Webster pack – which had been supplied and correctly labelled by a pharmacist – and put them into Patient B’s medication pouch. He also inappropriately pre-prepared, on 11 occasions, medication pouches for administration to residents not in accordance with MVH Guidelines, the court heard. When asked directly why he took the drugs from Patient A, McLean said he could not explain, that “they were there”, and asked the cross-examiner “what you want me to say?” The tribunal noted that on 24 October “he was not acting in accordance with MVH protocols, made no assessment of the patient, did not administer the medication from the appropriate container, did not check the relevant medication charts and took it upon himself to dispense medication against policy and good clinical and medical practice.” “When asked why he acted in this way, and whether it was easier to have less disruptive patients, the respondent said that there were some residents with an ability to reason, but others did not.” When asked whether he had inappropriately given medicines on previous occasions over a six and a half month period, McLean said that he was not denying it. He said that between April 2014 and 24 October 2014, it was his usual practice to make such decisions about administering Risperidone and gave Patient A’s medications to each of Patients B, C and D on a number of occasions. He agreed that he did not seek advice or guidance from a medical officer in relation to the administration of the drugs as alleged, saying he “should have but didn’t”. McLean said in a letter that it “was never my intention to cause harm to any resident, only to ensure safety to my colleagues. I know that what I did was wrong + unprofessional + I sincerely regret my conduct.” He was asked why he administered Risperidone without authority and replied: “I was concerned for the safety of my colleagues. A few of the residents could be quite aggressive when being attended.” After colleagues noticed that medicines packs had been tampered with, they confronted McLean in the medication room and he admitted that Patient A’s Risperidone tablets were in Patient B’s medication pack. McLean was dismissed from his place of employment on 24 October 2014 and a letter to him dated that day from his employer read in part: “Your actions in dispensing and administering the Risperidone medication without appropriate documentation, clinical indication or in [Patient B’s] case, without a prescription was unlawful and totally incomprehensible. “You have unnecessarily jeopardised the health and safety of residents in your care.” The tribunal ruled that McLean was guilty of unsatisfactory professional conduct and professional misconduct, and he was publicly reprimanded. While McLean did not renew his registration, the tribunal said that it would have cancelled his registration were it still current. He may not apply for a review of this decision for a minimum period of two years.
