A former consultant urologist at St George Public Hospital has been reprimanded "in the strongest possible terms" by the Health Care Complaints Commission (HCCC) after being found guilty of unsatisfactory professional conduct.
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The HCCC ruled Associate Professor Paul Cozzi, a urologist who has practices in Miranda, Hurstville and St Leonards and operates at Hurstville Private Hospital, had failed to properly supervise trainees who were operating at a public hospital because he was operating in a private hospital at the same time.
Dr Cozzi was also found to have "pre-signed blank count sheets and safety checklists for surgeries on patients at the public hospital, which he did not attend".
The HCCC ordered that Dr Cozzi must be subject to supervision, complete an ethics course and not supervise trainees.
Dr Cozzi has defended his actions and said he would be appealing the decision.
The HCCC prosecuted a complaint against Dr Cozzi before a Medical Professional Standards Committee.
The complaint alleged that in November 2015, Dr Cozzi "left a trainee urologist unsupervised to perform several surgeries at St George Hospital".
At the time, Dr Cozzi was operating elsewhere at the Mater Private Hospital.
"Having two concurrent surgical lists is not acceptable professional practice. Failure to properly supervise the trainee is significantly below the relevant standard," the HCCC said.
The committee also found Dr Cozzi "pre-signed blank count sheets and safety checklists for surgeries on patients at the public hospital, which he did not attend".
"The procedures for signing count sheets and safety checklists are designed to ensure patient safety. Signing sheets for surgeries when he was not present infringes basic standards of professional practice and contravenes the record keeping regulations," the HCCC said.
The committee also ruled Dr Cozzi was guilty of unsatisfactory professional conduct on the basis that:
- he made incorrect statements to investigators on five occasions;
- he was not a credible or trustworthy witness and provided contradictory information about his whereabouts; and,
- his conduct was improper, unethical and significantly below the relevant standard.
It is believed Dr Cozzi's actions came to light after concerned colleagues raised the alarm.
A spokeswoman for South Eastern Sydney Local Health District, which operates St George Public Hospital, said Dr Cozzi was employed by the health district as a clinical academic in urology on September 4, 2000.
"Following an investigation in 2016, Dr Cozzi's employment was terminated on January 24, 2017," she said.
"Dr Paul Cozzi has not been employed with the South Eastern Sydney Local Health District since early 2017.
"SESLHD made notification to the Australian Health Practitioner Regulation Agency (AHPRA), the Medical Council and the Health Care Complaints Commission (HCCC).
"SESLHD expects all medical officers to comply with the highest level of professional standards."
Dr Cozzi said providing "the best possible care for all of my patients, in both the public and private sector, is my highest priority".
He said that on the day in question, "all patients, including the cancer patients at the Mater and one who had been cancelled three times previously on the public hospital operating list were deemed to be urgent".
He said he was asked to cover the St George public hospital list "with late notice" and rearranged the Mater list accordingly "to be able to attend for direct supervision as I did not wish to cancel patients unnecessarily".
"The decision to proceed and supervise the experienced trainee both directly and indirectly to complete the list without incident was made in the patients' best interests and after careful consideration, knowing that the nature and complexity of the cases was such that they could be completed safely," he said.
"The decision was made with the full approval of the Department of Urology and the trainee."
He said he contacted the trainee "the day prior to the surgery, the day of the surgery and had my full contact details as indeed had been the case for the preceding 11 months we had worked together".
"At no stage was I uncontactable and the list was uneventful, with no adverse event to patients, staff or trainee," he said.
Dr Cozzi said he would appeal the decision on several grounds, including a lack of procedural fairness during the five-year investigation, and that "the committee's view that indirect (or remote) supervision is significantly below the accepted professional standard is at odds with common practice and the Urological Society guidelines for trainee supervision".
He said he resigned from the Mater and withdrew his accreditation there earlier this year to "focus my practice in the St George and Sutherland areas".
