Mr Rafael Ramirez – registration as a nurse cancelled by Nursing and Midwives Tribunal

27 July 2011

The Health Care Complaints Commission recently prosecuted Mr Rafael Ramirez, a registered nurse, before the Nurses and Midwives Tribunal of NSW.   The prosecution related to Mr Ramirez’s care and treatment of a number of patients and his failure to follow instructions.

The Commission argued that Mr Ramirez was guilty of unsatisfactory professional conduct, and was not competent to practise nursing as he did not have sufficient mental capacity, knowledge and skill.

The particulars of the Commission complaints against Mr Ramirez related to repeated medication administration errors and his failure to follow instructions, such as:

  • twice failing to administer Lasix to a patient in accordance with a medical order
  • failing to commence IV Heparin for a patient and/or failing to ensure appropriate medical review
  • administering 12.5mg Ramipril instead of 1.25mg to a patient
  • administering Parvolex to a patient in circumstances when the medication had already been received
  • failing to commence cardiac monitoring of a patient for more than one hour after the patient had arrived in the ward
  • failing to comply with an instruction from a nursing unit manager not to administer any medication unsupervised.

The Commission also argued that Mr Ramirez has a mental impairment, namely a paranoid personality disorder and/or psychotic illness, which detrimentally affects, or is likely to detrimentally affect, his mental capacity to practice nursing. 

In its decision of 21 July 2011, the Tribunal found Mr Ramirez guilty of unsatisfactory professional conduct and that he was not competent to practise nursing as he does not have sufficient mental capacity, knowledge and skill.  It also found that Mr Ramirez suffered from an impairment that detrimentally affects, or is likely to detrimentally affect, his mental capacity to practice nursing.

The Tribunal noted

Mr Ramirez has already placed the safety of the public at risk through, for example, overdosing patients in different ways, failing to follow instructions in relation to cardiac monitoring, taking a a patient off a cardiac monitor, being unable to cooperate with others, follow the directions of superiors and learn from his mistakes.

The Tribunal ordered that Mr Ramirez’s registration as a nurse be cancelled.  The Tribunal did not set a period of disqualification as “Mr Ramirez’s impairment was likely to be long term and because his lack of competence as a nurse was going to be difficult to overcome".

Further Information

The full decision is available at AUSTLII

For further information, contact the Executive Officer of the Health Care Complaints Commission on 9219 7444 or send an email to

The information in this media release is correct at the time of publication. Orders may change; for example, conditions may no longer apply. For current information regarding the status of a registered health practitioner, including any conditions that currently apply, please check the National Register at