A financially motivated doctor who inappropriately treated cancer patients on a machine he co-owned has been struck off.
Consultant urologist Paul Miller, 63, was said to be an "early advocate" of high intensity focused ultrasound (HIFU) – described as novel and experimental – which emerged in the mid-2000s, with trials taking place in the UK, the United States, and France.
A Medical Practitioners Tribunal Service (MPTS) tribunal, sitting in Manchester, found Mr Miller acted dishonestly in having a financial interest and motivation for eight patients to undergo HIFU treatment and did not disclose his interest to some of them.
The tribunal also concluded his recommendation and treatment with HIFU was inappropriate – either because their cancers were not of the kind for which HIFU was considered appropriate, or because standard treatments of radical radiotherapy or radical prostatectomy offered better prospects of a cure.
Five of the patients were initially treated in the NHS at East Surrey Hospital before being referred to privately run Spire Gatwick Park Hospital, while the other three were private patients of Mr Miller.
Mr Miller was also found to have failings in his care of five other patients.
Ruling Mr Miller’s fitness to practise was impaired, tribunal chair Lindsay Irvine said: "Not only did Mr Miller fail to discuss with or explain to some patients all the treatment options available to them, in the case of those to whom he recommended HIFU treatment, or treated them with Hifu he did not provide them with the level of information required for informed consent – given that HIFU was a novel, and experimental treatment.
"The Tribunal considered that depriving patients of the opportunity of receiving the right treatment because of financial motivation and concealing from patients a financial interest is a particularly serious breach of good medical practice."
"The Tribunal notes that Mr Miller has expressed no remorse, regret or apology for his actions nor has he demonstrated any insight into either his behaviour or the harm he has caused to patients."
Mr Miller has not practised since he underwent a performance assessment in 2017 and withdrew from proceedings this week.
He had denied misconduct on various dates between 2004 and 2018.
Giving evidence earlier this year, he denied wanting to make money from the machine and said he believed its use was in the patients' best clinical interests.
The consultant said he had never received a salary, a dividend or payment from the company he jointly formed in October 2005 with another clinician.
The company, Mobile HIFU Limited, purchased a Hifu machine for about £440,000 with a bank loan and subsequently rented it out to privately run Spire Gatwick Park Hospital in Surrey where Mr Miller treated patients with prostate problems, the tribunal heard.
On Tuesday, in his absence Mr Miller was erased from the medical register.
Mr Irvine said: "The Tribunal determined that given the scale of Mr Miller’s dishonesty, his deliberate disregard for patient safety, putting his own interests before that of his patients, together with a complete lack of insight and the significant risk of repetition, his misconduct was irremediable and fundamentally incompatible with continued registration."
This article contains information from PA Media.
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Cite this: Doctor who Treated Cancer Patients on Machine he Co-owned Struck Off - Medscape - Dec 15, 2021.