Three doctors censured over care of man who had chest pains, and later died

Three doctors censured over care of man who had chest pains, and later died
File photo of Naas General Hospital

The president of the High Court has confirmed the censure of three doctors and attachment of conditions to their practices over their involvement in the care of a man who died three days after being admitted to a hospital.

The three doctors were found guilty of poor professional performance when they dealt with father-of-three Seamus Kavanagh (52) who died on March 10, 2014, at Naas General Hospital of shock and peritonitis secondary to a perforated duodenum.

Following the results of the post mortem, his widow made a complaint to the Medical Council which had an inquiry carried out by a Fitness to Practice Committee (FtPC) into the three: Dr Syed Quadri, Dr Muhammad Azam, and Dr Michael Arotiowa.

Doctors Quadri and Azam admitted poor professional performance charges, while Dr Arotiowa did not attend the FtPC inquiry but was found guilty in his absence. The court heard the other two doctors continue to work in the profession, while Dr Arotiowa no longer practises and is in business in Nigeria.

None of the three appealed the Medical Council recommendations of censure and conditions on their practice when the matter came before Mr Justice Peter Kelly today.

The judge confirmed the recommendations but expressed concern that doctors could continue working at the same time as they have yet to meet new conditions of practice, including that they undergo a personal management plan.

The court heard Mr Kavanagh was admitted to Naas accident and emergency on Friday, March 7, 2014, suffering from chest pains.

An X-ray showed air in the abdominal cavity – a sign of a perforated organ - and it was correctly interpreted by the emergency department registrar. However, Dr Arotiowa disagreed it was a surgical issue, Neasa Bird BL, for the Medical Council, said.

The department registrar went over the head of Dr Arotiowa and contacted the senior consultant who directed he be admitted to the surgical ward.

However, this did not happen and he was moved to the medical ward where Dr Quadri, despite recognising the correct interpretation of the X-ray, did not treat him in a way that required transfer to the surgical ward. This was also in spite of the fact Mr Kavanagh had undergone an X-ray four days earlier and the March 7 X-ray would have shown the changes which had occurred, the court heard.

Dr Quadri admitted failing to get an opinion from a radiologist about the X-ray, to have other tests such as a CT scan carried out, and to devise an appropriate management plan or ensure adequate monitoring for Mr Kavanagh.

Mr Kavanagh then came under the care of Dr Azam who admitted failing to correctly interpret the X-ray and to diagnose the presence of air in the abdominal cavity or to ensure appropriate investigations were carried out or to consult with the consultant surgeon who was on call.

Mr Justice Kelly said he was satisfied to confirm the censure recommendations of the Medical Council in all three cases along with conditions primarily including that they each must work with a council-nominated individual to formulate a personal development plan to address deficiencies in their practice.

"It has to be said the unfortunate Mr Kavanagh and his family were ill-served indeed over that weekend which resulted in his untimely death," he said.

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