Disciplinary Action against
Dr. Malcomb Adams Traill
Source: March 2006 Bulletin of the
Medical Practitioners Board of Victoria
This was a complex formal hearing that dealt with the management of three patients, all of whom had malignancies and were treated by Dr Traill with one or more treatments—full body and local hyperthermia, UHF 434 Mghz treatment and lithium—which were alleged to be unproven and ineffective.
There were 23 allegations in total. The Panel separately examined, heard evidence and made a finding in relation to each allegation. The Reasons for Decision can be viewed at the Board’s website at www.medicalboardvic.org.au.
Several experts provided evidence regarding the treatment of cancer. The Panel was aware that the NHMRC was reviewing the therapeutic effectiveness and safety of microwave cancer therapy, and understood that it was not its role to undertake a similar enquiry, but rather to hear and make determinations concerning the specific matter before it and decide whether or not the allegations were made out.
The first patient, Ms SO, suffered from a small cell carcinoma of the lung and had difficulty coping with a course of chemotherapy, so she sought an alternative form of treatment. Ms SO attended Dr Traill, who allegedly recommended full body hyperthermia treatment, provided UHF 434Mghz treatment and treated her with lithium.
The second patient, Ms ST, suffered from recurrent cutaneous breast cancer. It was alleged that Dr Traill recommended full body hyperthermia treatment and provided UHF 434Mghz treatment.
The allegations regarding these two patients included that: the treatments that were recommended and offered—full body and local hyperthermia, UHF 434Mghz treatment and lithium—were unproven and ineffective; the consent obtained for treatment was inadequate; the HIC was charged for chemotherapy that was not provided; the patients were charged excessive amounts for treatment; and Dr Traill represented himself to be an oncologist to Ms SO, a position he maintained in the hearing. It was also alleged that Dr Traill’s management and monitoring of patients with serious conditions was inadequate, including his apparently experimental monitoring of uric acid in the case of Ms SO.
The third patient, Master TU, was a young child who suffered from a highly malignant and progressive brain tumour. The child’s parents had been informed by oncologists that his condition would not respond to conventional treatment with radiotherapy and surgery and, in his best interests, palliation became the primary focus. The parents sought treatment from Dr Traill and indicated that they would have travelled interstate if he did not provide the requested treatment. It was alleged that Dr Traill recommended treatment with UHF 434 Mghz treatment, which has not been demonstrated to be effective in treating the patient’s condition.
Findings and determinations
The Panel found that Dr Traill had engaged in unprofessional conduct of a serious nature in that he failed to exercise the care and skill of a competent medical practitioner in his treatment of Ms SO, Ms ST and Master TU. His professional conduct was considered to be of a lesser standard than that which the public or his peers would reasonably expect of a medical practitioner, he had engaged in professional misconduct in a professional respect and he had provided the patients with health services that were excessive, unnecessary or not reasonably required. The Panel considered that the treatments offered to the three patients were ineffective and not beneficial. The Panel believed it was therefore necessary for Dr Traill to have exercised extreme caution when offering such treatments. It was also necessary for him to have ensured he obtained the patients’ fully informed consent to the treatments, including how he administered them, and ensured the patients were fully aware of his views about the preferred treatment for their conditions and the conventional treatments available to them from other practitioners, which he did not do in relation to Ms SO. In addition, the Panel considered it was incumbent on Dr Traill to be satisfied that the treatments would have a beneficial effect on the patients, but he was not always so satisfied.
The Panel found that Dr Traill lacked insight into his patients’ needs; he did not believe that the patients were especially vulnerable, and considered they were given adequate information about his treatments and were not locked into contracts. The Panel believed that Dr Traill’s conduct was especially blameworthy also because the treatments were novel and experimental, and he charged substantial amounts for them.
A majority of the Panel determined to cancel Dr Traill’s registration and disqualify him from applying for registration for three years. It did so because there was no indication either during the hearing or after the Panel gave its findings that Dr Traill accepted he had acted unprofessionally to any extent. He did not indicate that he regarded the views of his peers, including expert witnesses, worthy of consideration. The Panel was also concerned that Dr Traill regarded it as acceptable to test his theories about treatments on patients outside the usual testing framework and to charge them for doing so. The Panel also unanimously determined to reprimand Dr Traill.
Dr Traill has applied to the VCAT for review of the Panel’s determinations regarding the cancellation of his registration and his disqualification from applying for registration for three years. On 28 October 2005, the VCAT ordered that, upon Dr Traill making various undertakings to the Tribunal (including that he not hold himself out as an oncologist, treat any patient with any form of chemotherapy or any form of hyperthermia or 434 Mghz microwave therapy), the operation of the determination be stayed pending final determination of the Application for Review.
This page was posted on March 30, 2006.