In one weekend, Dr Trijo examined and treated (under general anaesthetic) five women with intellectual disabilities who resided in a Supported Residential Service. These patients were unable to communicate and required a ‘person responsible’ to make decisions for them concerning medical or dental treatment.
In summary, the Dental Board alleged that Dr Trijo: failed to obtain informed consent; provided sub-standard treatment and care; did not perform adequate follow-up care; had adopted inappropriate billing practices; and failed to maintain adequate clinical records.
Whilst the parties had agreed the facts and the characterisation of Dr Trijo’s conduct, there was significant disparity with respect to the proposed penalty. Although the broad penalty (reprimand and suspension) had been agreed, the Board submitted that Dr Trijo’s registration should be suspended for a period for five months and Dr Trijo submitted that her registration should be suspended for a period of six weeks.
The Tribunal held that Dr Trijo’s conduct had denied the patients a chance to have decisions made in their best interest by a person who was able to understand and weigh information about risks and anticipated benefits (noting that any such person would be someone with knowledge of the patient’s medical and dental history and able to provide vital information to inform best care). The Tribunal noted that it was necessary for practitioners to properly understand the concept of informed consent for each patient, and that the misconduct in this instance was made more serious by the vulnerability of the patients.
In making its decision, the Tribunal noted that “given Dr Trijo’s contrition and insight, the need for specific deterrence may not be as great as the need for general deterrence… but the determination must reflect the gravity of the misconduct”. The Tribunal was also cognisant of a period of suspension not being so long as to put the return to practice beyond her reach.
The Tribunal found Dr Trijo guilty of professional misconduct and (1) imposed a reprimand (2) suspended her registration for a period of three months and (3) imposed conditions on her registration requiring her to undergo further education to address informed consent.
The case Dental Board of Australia v Trijo  VCAT 558 can be read here.