GPs urged to stay vigilant following WA vaccine fraud case

GPs have been urged to stay vigilant in the wake of an alleged incidence of vaccine fraud at a general practice in Western Australia over the weekend.
 
The Perth Magistrates Court was told on Monday that a registered practice nurse had allegedly injected a patient, who was known to the accused, with a COVID vaccine but not depressed the plunger. She was then said to have disposed of the syringe with the vaccine still inside before recording the patient as having received a dose.
 
While unable to comment on the case directly, a spokesperson from the Australian Health Practitioner Regulation Agency (AHPRA) told newsGP the consequences for such an act can be significant. 
 
‘Generally speaking, in line with public health messaging, we believe vaccination is a crucial part of the public health response to the COVID-19 pandemic,’ the spokesperson said.
 
‘Practitioners providing advice on or administering vaccines should do so safely and professionally.
 
‘The consequences of providing an exemption when it is not warranted may be significant. It can undermine the public’s confidence in Australia’s COVID-19 vaccination strategy and impact community safety.’
 
The spokesperson also urged any practitioner being asked to supply exemption certificates ‘to know, understand and properly apply the advice provided by ATAGI [the Australian Technical Advisory Group on Immunisation]’.
 
‘Professional indemnity providers have also published clear advice to practitioners about when, why and how exemptions can be granted,’ they said.
 
The incident occurred on Sunday, when a father attending the Perth clinic with his 15-year-old son asked to have his child’s vaccine specifically administered by Christina Hartmann Benz.
 
The practice owner, RACGP WA Chair Dr Sean Stevens, was present at the time of the consultation and allegedly observed Ms Hartmann Benz prepare the syringe and insert the needle into the patient’s arm, but fail to depress and administer the vaccine.
 
After allegedly disposing of the still full syringe, the nurse was accused of recording that the patient had been given the vaccine, using the name of a colleague in place of her own.
 
The clinic immediately alerted WA Police to the incident and an investigation commenced, leading to Ms Hartmann Benz being arrested later that day at her home, where she was charged with one count of Gains Benefit by Fraud.
 
The RACGP issued a statement on Monday expressing its significant concern about the incident.
 
‘We are deeply concerned to hear about an incident involving a registered nurse who has been charged with COVID-19 vaccine fraud at a general practice in Western Australia, and we are providing support to the GP and practice team concerned,’ the college said.
 
‘WA Police are investigating, and we stand ready to support their investigation.’
 
The Court also heard that Ms Hartmann Benz had allegedly been approved to administer COVID-19 vaccinations to any family or friends of hers who attended the clinic over the weekend.
 
Staff later noticed up to 25 people who attended the Perth clinic had allegedly asked to see the nurse specifically and brought it to Dr Stevens’ attention, the police prosecutor said.
 
The GP then decided to stay and observe Ms Hartmann Benz administer the vaccine to the teenage patient, at which point the nurse allegedly objected to Dr Stevens’ presence, but he insisted.
 
The father of the boy later returned to the clinic, claiming his son had developed side effects to the vaccine.
 
It is suspected the nurse’s actions were premeditated.
 
‘I would say that’s highly suspicious, your honour,’ the police prosecutor told the court. ‘I would say it can be inferred there’s some level of coordination.’


Dr Sean Stevens allegedly observed Christina Hartmann Benz prepare the syringe and insert the needle into the patient’s arm, but fail to administer the vaccine.
 
The incident is the first report of a healthcare worker fraudulently recording a COVID-19 vaccination in Australia.
 
Professor Mark Morgan, Chair of the RACGP Expert Committee – Quality Care (REC–QC), said the alleged details of the case present an unusual and unique set of circumstances, albeit with the potential for far-reaching consequences.
 
‘The vast majority of practice nurses, practice administrators and GPs are absolutely focused on best patient care with dedication, with skill, with lots of knowledge – and are ideally placed to provide that care,’ he told newsGP.
 
‘Undermining a public health effort by issuing a false vaccination certificate or information actually affects all of us … and it’s something we can’t possibly condone.’
 
In addition to being a missed opportunity for a patient to be protected against COVID-19, Professor Morgan said a healthcare worker deliberately misrepresenting another person’s vaccination status could also have potential consequences for access to treatment, should they contract the virus.
 
‘They might miss their opportunity to get one of the antiviral or monoclonal antibody treatments that are increasingly in play to treat the early effects of COVID, to stop it becoming a dangerous life-threatening disease for that individual,’ he said.
 
Aside from the Perth case, there have been reports of healthcare workers issuing false vaccine exemptions, as well as instances where patients have accidentally been administered a lower dose or saline alone.
 
Professor Morgan said while it is only natural to encounter ‘a few hiccups’ when rolling out a vaccination program of this scale, knowingly undermining a public health measure cannot be condoned in any way.
 
‘We know that vaccines are there to partly protect individuals from disease, partly to protect the health system from too many individuals filling hospitals and partly to reduce spread, particularly to vulnerable people,’ he said.
 
‘So there are lots of reasons why it’s a bad look.
 
‘Most GPs and practice nurses are incredibly dedicated and trying to do the right thing.’
 
The incident involving the nurse was picked up by Dr Stevens, who was able to observe the nurse administering the vaccine, as per standard practice to have a second practitioner observe the process.
 
Professor Morgan advises that if a similar incident that could lead to suboptimal care does occur, it is vital that practices learn from the experience. 
 
‘The practice should have a set of procedures so that as an organisation it can learn from that to prevent that happening again,’ he said.
 
‘And when it’s a serious issue with an individual then it’s appropriate to report to AHPRA or even the police, depending on the immediacy and seriousness of the case.
 
‘But, otherwise, most errors seem to be not about individuals consciously doing something wrong, but more about systems … [so] you ask “why?” again and again to try to get to the root cause of what went wrong and then think about a system approach to prevent it going on again in the future.’
 
Ms Hartmann Benz has been granted bail with strict conditions, including not being permitted to work as a registered nurse or administer COVID-19 vaccines, with the police prosecutor anticipating that more charges are likely.
 
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