The doctor is accused of professional misconduct and it is alleged he departed from accepted standards of care while treating his patient, Nikki Cockburn, for a severe skin condition between 2013 and 2018.
A hearing began yesterday in Dunedin. The doctor has interim name suppression.
He prescribed steroid ointment Dermol for Ms Cockburn’s persistent psoriasis, "often at frequent intervals and in large amounts", prosecuting counsel Lisa Preston said.
"He did so despite a written warning from another practitioner in August 2012 that care should be taken when scripting Dermol and, in early 2014, two written advices he received from a dermatologist, including that Ms Cockburn should never use Dermol again."
Other doctors also prescribed Dermol and her treatment included other potent topical steroids.
Ms Cockburn developed drug-induced Cushing’s syndrome and adrenal insufficiency.
Her primary GP was the most prolific prescriber of Dermol to her by a significant margin, Ms Preston said.
On October 9, 2013, he prescribed acitretin, known by its brand Neotigason, but did not first ensure Ms Cockburn was not pregnant, nor provide full information about risks for women of child-bearing age.
Severe foetal malformation can occur during acitretin use and the guidance at the time was for patients to continue with contraception for two years after ending use of the drug.
Ms Cockburn had just become pregnant and she felt compelled to terminate the pregnancy, as well as a subsequent pregnancy, the second occurring despite emergency contraception.
The doctor applied for a Ministry of Health subsidy.
"In doing so, he confirmed that he had ruled out pregnancy in Ms Cockburn and had provided her with all necessary information, despite having not done so," Ms Preston said.
The doctor had treated her since childhood.
"I trusted him," she told the tribunal.
"I thought he knew what he was doing."
Under cross-examination from defence counsel Adam Holloway, Ms Cockburn could not recall details of various appointments, or what medical advice she received.
She also said she continued to believe the doctor was a good person.
She at one point received a letter of apology from him, placed in her letterbox.
Ms Cockburn described Dermol as working like magic, "but it’s a Band-Aid".
Her condition would improve, but her psoriasis would later return "twice as bad".
She used Dermol like a moisturiser and people who prescribed the drug knew this, she said.
If she ran out before the next allotment was due, "the pharmacy still gave it to me".
Asked about the impact of psoriasis on her life, Ms Cockburn said it sometimes kept her away from work and she felt like her skin had been burnt.
She had longed for the day she could simply shower, avoid creams and put her clothes straight on.
Cushing’s, too, was "absolute hell".
Expert witness Dr Garry Brown told the tribunal he believed the doctor departed from accepted standards of care.
He is to be cross-examined today.
