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Psychiatrist's patient care questioned

KIM ARLINGTON COURTS June 11, 2010

WHEN she saw psychiatrist Yolande Lucire on July 5, 2007, she had a feeling " of

impending doom … that something dreadful would happen " .

Within hours, the 25-year-old had stabbed her father and 15-year-old sister to

death at the family home.

She was tried for murder but found not guilty on mental health grounds. The

Supreme Court heard she had a psychotic illness.

This week Dr Lucire faced the Medical Tribunal, defending claims of

unsatisfactory professional conduct and/or professional misconduct over the

woman's treatment. The Health Care Complaints Commission alleges she failed to

give the patient or her parents enough information to make informed decisions

about her illness.

Known as Patient A, the woman first saw Dr Lucire in November 2006 after her

admission to hospital with schizophrenia. During a consultation with Patient A

and her parents on July 3 - her first in more than two months - Dr Lucire failed

to obtain a proper history of the patient's recent state and inappropriately

advised her to stop taking antipsychotic medication, the commission says.

On July 5, Dr Lucire allegedly spoke to Patient A for 15 minutes in a cafe

before telling her parents to ''bring her back next week''.

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Dr Lucire disputes elements of the commission's complaint. Her counsel,

, SC, said it was based on a number of false assertions and assumptions.

Patient A's father, a Scientologist, believed antipsychotic medication was

harmful, the tribunal heard. Dr Lucire told police that interference by Patient

A's parents made treating her difficult.

Patient A's mother, Mrs A, was also stabbed during the attack and is pursuing a

compensation claim against Dr Lucire.

She told the tribunal her daughter ''bashed'' her while waiting to see Dr Lucire

at her Edgecliff practice on July 5. Patient A would not attend Dr Lucire's

rooms and the psychiatrist took her to a Gloria Jeans coffee shop.

''Did Dr Lucire … ever tell you [your daughter] was profoundly mentally ill?''

counsel for the commission, Mark Lynch, asked.

''We didn't really talk about it and didn't talk about her treatment on the 5th

of July,'' Mrs A said. ''[Dr Lucire] just said to come back next week.''

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Believing the illness was more than the depression and panic disorder diagnosed

by Dr Lucire, Mrs A saw her daughter's GP, Carolyn Greenhalgh, on the way home.

''We needed help,'' she said. ''I didn't feel safe around [our daughter].''

Dr Greenhalgh told the tribunal that when she phoned Dr Lucire during the July 5

consultation, the psychiatrist said that if Patient A returned to Bankstown

Hospital, they would ''pump her full of antipsychotics again''.

The tribunal heard that soon after the stabbings, Dr Lucire advised police that

Patient A suffered from a religious mania, but it was her " adverse reaction " to

her mental illness medication that might have caused her to kill.

On July 10, Dr Lucire allegedly expressed concern to a detective about her

" inaction " , saying Patient A was profoundly mentally ill. Referring to the July

5 visit, she said she should have called the police and asked if she would be

struck off, the tribunal heard.

In November 2006, when a magistrate was considering whether Patient A's

medication should be continued under a community treatment order, Dr Lucire said

she was having ''a severe adverse reaction'' to her medication and that

''increasing depression and psychosis … are side-effects of all her drugs''.

The hearing continues.

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