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Sarah Simpkins A PATIENT who argued that a psychiatrist had to let him record a consultation has been rebuffed after an appeal with a Supreme Court declaring it could harm him . Former police officer Michael Hollingsworth is suing the state of NSW alleging false imprisonment , assault and battery during his arrest by police in January 2018 , which he claimed exacerbated his PTSD .

A psychiatrist appointed to assess Mr Hollingsworth for a medicolegal

report refused to let him record video and audio of the consult .

In a letter to Mr Hollingsworth , the psychiatrist said paper notes were acceptable but the “ presence of electronic recording devices has the potential to adversely affect the interview ”.

Mr Hollingsworth attended the appointment with his wife , where both attempted to make recordings with their smartphones .

The psychiatrist then ended the appointment .

In patients with Heart Failure

‡

As an adjunct to standard of care therapy . 1

LVEF ≤40 % 1 , 2 vs placebo on top of standard of care *

IN COMPOSITE OF CV DEATH OR HHF

HR = 0.75 ; 95 % CI : 0.65 , 0.86 ; p < 0.001 ARR = 5.2 % NNT = 19

* Adult patients with chronic heart failure ( NYHA class II , III , or IV ) and reduced ejection fraction ( LVEF ≤40 %) on top of standard of care ( including ACEi / ARB or ARNI , beta blockers , MRAs , diuretics and cardiac devices [ as indicated ]). 2

Boehringer Ingelheim Pty Limited , ABN 52 000 452 308 . 78 Waterloo Road , North Ryde , NSW 2113 Australia . Copyright © 2023 . BOEH1780 . PC-AU-103519 . Prepared July 2023 .

LVEF > 40 % 1 , 3 vs placebo on top of background therapy †

IN COMPOSITE OF CV DEATH OR HHF

HR = 0.79 ; 95 % CI : 0.69 , 0.90 ; p < 0.001 ARR = 3.3 % NNT = 31

†

Adult patients with chronic heart failure ( NYHA class II , III , or IV ) and preserved ejection fraction ( LVEF > 40 %) on top of background therapy ( including all appropriate treatments for HF or comorbid conditions that could be initiated or altered at the discretion of the clinician ). 3

BEFORE PRESCRIBING , PLEASE REVIEW THE FULL PRODUCT INFORMATION AVAILABLE AT WWW . BOEHRINGER-INGELHEIM . COM . AU / PI

Eli Lilly Australia Pty Limited , ABN 39 000 233 992 Level 9 , 60 Margaret St Sydney NSW 2000 .

Copyright © 2023 .

The next six psychiatrists approached for the report also refused to let Mr Hollingsworth record them .

One argued that patients who wanted to record medicolegal assessments “ usually have either a paranoid condition … or are affected by a high level of interpersonal sensitivity ”.

“ An insistence on recording the interview introduces a hostile element into the assessment and adversely affects the development

PBS Information : JARDIANCE ® : Heart Failure with Reduced Ejection Fraction ( LVEF ≤40 %): Authority Required ( STREAMLINED ). Code 12477 . Refer to PBS Schedule for full Authority Required Information . Heart Failure with LVEF > 40 %: JARDIANCE ® is not listed on the PBS . Refer to PBS Schedule for full Authority Required Information .

JARDIANCE ® ( empagliflozin ) 10 mg film-coated tablets . INDICATIONS : JARDIANCE is indicated in adults for the treatment of symptomatic heart failure ( HF ) independent of left ventricular ejection fraction , as an adjunct to standard of care therapy . CONTRAINDICATIONS : Hypersensitivity to empagliflozin or any of the excipients ; rare hereditary conditions of galactose intolerance , e . g . galactosaemia . PRECAUTIONS : Patients with type 1 diabetes ; ketoacidosis ; surgery ; not recommended when eGFR is below 20mL / min / 1.73m 2 ; monitoring of renal function is recommended ; consider discontinuation in patients with recurrent complicated urinary tract infections ( UTIs ); necrotising fasciitis of the perineum ( Fournier ’ s gangrene ); patients for whom a drop in BP could pose a risk ( e . g . those with known CV disease , on diuretics , have a history of hypotension , or aged ≥75 years ); pregnancy ; lactation ; children (< 18 years ). INTERACTIONS : Diuretics - may add to diuretic effect of thiazide and loop diuretics ; insulin and sulfonylurea ( SU ) - may increase the risk of hypoglycaemia ; interference with 1,5-anhydroglucitol assay ; lithium - may decrease blood lithium levels . ADVERSE REACTIONS : Very common : hypoglycaemia ( combination with metformin and an SU ; insulin - patients with type 2 diabetes ( T2DM )); volume depletion ( patients with HF ). Common : hypoglycaemia ( combination with metformin ; pioglitazone with or without metformin ; metformin and linagliptin - patients with T2DM ); hypoglycaemia ( T2DM patients with HF ); UTIs ; increased urination ; vaginal moniliasis , vulvovaginitis , balanitis and other genital infections ; thirst ( patients with T2DM ); pruritis ( patients with T2DM ); serum lipids increased ; constipation . Others , see full PI . DOSAGE AND ADMINISTRATION : JARDIANCE can be taken with or without food . The recommended dose is 10mg once daily . No dose adjustment is necessary for patients based on age , patients with eGFR ≥20mL / min / 1.73m 2 or hepatic impairment . December 2022

References : 1 . Jardiance ® Product Information . 2 . Packer M et al . N Engl J Med 2020 ; 383:1413 – 24 . 3 . Anker SD et al . N Engl J Med 2021 ; 385:1451 – 61 . 4 . Sindone AP et al . Med J Aust 2022 ; 217:212 – 17 . Abbreviations : CV , cardiovascular ; HHF , hospitalisation for heart failure ; HF , heart failure ; HFpEF , heart failure with preserved ejection fraction ; LVEF , left ventricular ejection fraction .

of rapport ,” she said . She added that Mr Hollingsworth ’ s condition could worsen if he repeatedly listened to a recording of them discussing a stressful event in his life , especially with his PTSD .

She was also concerned about Mr Hollingsworth publishing the recording on social media , “ potentially damaging the reputation of the expert who has no right of reply ”.

Mr Hollingsworth said he was anxious about the risk of misspeaking or being misinterpreted . “ Thinking about participating in an interview that is not recorded makes me feel stressed , anxious and frustrated ,” his affidavit stated .

“ I feel like my disability is not being taken seriously .”

The state sought orders from the District Court of NSW that Mr Hollingsworth had to undergo a psychiatrist ’ s assessment without recording it .

A district court judge sided with Mr Hollingsworth , saying any forensic psychiatrist appointed by the state should let him make a recording .

However , the state won its appeal against the ruling .

In the Supreme Court of NSW , three judges said the district court had “ erred ”.

‘ Recording a psychiatrist ’ s medicolegal assessment may have adverse effects .’

The district court ’ s judgement had described Mr Hollingsworth ’ s “ right to make a recording ” but the Supreme Court declared that no such legal right existed in NSW .

Under the Surveillance Devices Act , Mr Hollingsworth could not record the consult without the doctor ’ s consent , the Supreme Court ’ s judgement said .

“ The recording of a consultant psychiatrist ’ s medicolegal assessment may well have significant adverse effects upon that assessment and potentially may also give rise to risks of harm to Mr Hollingsworth himself ,” it added . “ The judgement of numerous other psychiatrists is that they are unwilling to perform a medico legal assessment in circumstances in which that assessment is recorded by audio or audiovisual means .”

It continued : “ There may well be disputes as to what was or was not captured by the recording and as to the significance of what was or was not so captured in the context of the assessment as a whole .

“ Thus , whilst there is a possibility that a recording may assist in resolving such disputes , there is equally a possibility that it will lead to greater disputation and … a focus upon the recording and transcript rather than upon the psychiatrist ’ s impression and observations at the assessment itself .” Supreme Court of NSW ; 4 July 2023 . bit . ly / 3K2dCaJ