Three doctors have been censured along with attachment of conditions to their practices following their involvement in the death of a man who was admitted to Naas hospital and died three days later.
The three doctors were found guilty of poor professional performance after their patient, a 52 year old man and father of three, died in March 2014 from shock and peritonitis secondary to a perforated duodenum.
Air in Abdominal Cavity
The court heard how the man was initially admitted to hospital following chest pains, with an X-ray showing air in the abdominal cavity – an indication of a perforated duodenum (first part of the small intestine).
While this diagnosis was correctly interpreted by the emergency department registrar, one of the three doctors now facing censure disagreed that it was a surgical issue. The department registrar went over the head of this doctor to the senior consultant, who recommended that the patient be admitted to the surgical ward.
However, this did not happen and the patient was instead taken to the medical ward. Despite recognising the correct interpretation of the X-ray, another of the three doctors now facing censure did not treat the patient in a way that required transfer to the surgical ward. The doctor admitted failing to get an opinion from a radiologist about the X-ray, as well as arranging for other tests such as a CT scan to be carried out. In addition, there was also a failure to devise an appropriate management plan or ensure adequate monitoring for the patient.
The patient then finally came under the care of the third doctor now facing censure, who admitted failing to correctly interpret the result of the X-ray which had shown air in the abdominal cavity. This doctor also failed to ensure an adequate management plan was implemented, or to consult with the consultant surgeon who was on call.
Conditions on Practice
None of the three professionals contested the judgement of the Medical Council of censure and conditions on their practice.
Mr Justice Peter Kelly recommended the conditions, alongside conditions including requiring each doctor to work with a council-nominated individual in formulating a personal development plan in order to address the respective deficiencies in their practice.
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