Inquiry told doctor did not read report in full

WHEN Pauline Dorney asked her family doctor if her husband would be around to see his son graduate from college, he could not answer.

In his evidence to a Medical Council inquiry yesterday, Superintendent Martin Dorney said his wife had put it to their GP that his son and their son were in the same year and she asked him if he hoped he’d be around for his son’s graduation.

“But when she asked him if I’d be there, he could not answer,” the clearly distraught Superintendent said.

Superintendent Dorney’s GP, Dr Patrick Joseph Lee, was the subject of a Fitness to Practice committee hearing which took place in Silversprings Moran Hotel in Cork yesterday. Dr Lee has already admitted to concealing from his patient the full contents of a report which he had failed to read in full. His failure meant that the surgical follow-up recommended following the removal of a mole from Superintendent Dorney’s right knee in August 2003 did not happen.

In 2009, Superintendent Dorney, a fit and active man who played underage football with both Cork and Tipperary in the ‘70s, was given a diagnosis of metastatic malignant melanoma. He is now in stage four of the disease and his prognosis is poor.

Yesterday the inquiry heard the two men had met when Superintendent Dorney was based in Ballincollig and Dr Lee, who graduated from University College Cork in 1988, provided services to the gardaí such as taking blood samples from those suspected of drink driving.

“The relationship I had with Mr Dorney was a very friendly, open relationship,” Dr Lee told the inquiry.

“If I went to the waiting room and he was there, I would look forward to seeing him; after the medical issues, we would have easy conversation.”

After he removed a mole from Superintendent Dorney’s knee in 2003, Dr Lee said he remembered reading a report which indicated “a lack of any malignancy” but not, “unfortunately”, a recommendation that further surgery be carried out.

Prof Colin Bradley, Prof of General Practice at University College Cork, gave his opinion to the inquiry as to which of the 15 allegations against Dr Lee amounted to professional misconduct and poor professional performance. A number of the allegations were withdrawn on the basis that legislation existing in 2003, and since changed, did not cater for a finding of poor professional performance.

Prof Bradley said Dr Lee’s note-taking in relation to surgical procedures was not met. He also said for a doctor to be involved in taking steps to conceal information from a patient was “disgraceful”.

Prof Bradley said the appropriate action for Dr Lee would have been to make Superintendent Dorney aware in 2003 that he had a suspicious lesion and that a report which read “not malignant” was not the same as saying “benign”.

In February 2009, Superintendent Dorney attended Dr Lee after noticing a lump on top of his groin. “He told me it was nothing nasty and gave me some cream,” the Superintendent told the inquiry. He re-attended 10 days later for a review, as arranged with Dr Lee, who took blood samples and sent them to a consultant in the Bon Secours Hospital in Cork for analysis. On foot of this, Superintendent Dorney, whose three children range in age from 14-23, was admitted to the Bon Secours for surgery and was advised on March 30 that the lump was malignant.

“Naturally enough I was devastated when he told me that particular news,” Superintendent Dorney said. He and his wife then decided to call to Dr Lee and ask him about the 2003 mole. The Superintendent contends Dr Lee read from a report written on a yellow sheet. He said he “couldn’t see what was written on it but I could see it was on a yellow sheet, and he closed the report, and told me it was fine. He was confident because of my physical fitness at that time that I would get through it”.

Dr Lee subsequently admitted concealing some of the report during that consultation when he realised he had not read it fully in 2003. He later altered the report to hide his negligence before showing it to the Dorneys at a subsequent consultation. However Superintendent Dorney said he later twigged that the first time Dr Lee had read from the report it was on yellow paper, while the report he showed them at a subsequent meeting was in black and white. Superintendent Dorney said he knew then there was something amiss. He was not convinced by Dr Lee’s claim that the negligence was an administrative error.

“I mentioned to him I was almost 30 years in the Garda Síochána and I knew...that he was keeping something from me,” Superintendent Dorney said.

At one stage, the Superintendent was so upset after a meeting with Dr Lee that while driving into the city to collect his son from school, he drove through a roundabout without stopping “and very nearly caused an accident”.

Finally, on April 30, 2009, Dr Lee confessed his actions to the Dorneys during what both sides described as a “very emotional meeting”.

“Sometimes in my profession, you’ll get a confession straight away, sometimes you go through a process and during that you get a confession,” Superintendent Dorney said.

Superintendent Dorney, who lives in Ballinora, Waterfall, Cork, was a member of the Robert Holohan murder investigation team and the Sheola Keaney murder investigation team.

Dr Lee admitted his actions were an attempt to “deflect and dilute” attention away from himself. He said he now “purposely flips back” over previous consultations with patients to see if he could have missed other diagnoses.

A psychiatrist who gave evidence on Dr Lee’s behalf said he believed the GP had “learned a hard lesson” and that he “would certainly be of the opinion that he does his best from his patients”. The psychiatrist was asked if a “serious traumatic incident” at Dr Lee’s practice a number of years ago could have contributed to the way he reacted when he discovered his error. He said he “couldn’t say” if there was a link. The incident occurred in 2002 when a man from whom Dr Lee had taken a blood sample during the Rachel Kiely murder investigation turned up at his surgery with a butcher’s boning knife and attempted to stab him. The blood sample had linked him to another crime.

Dr Lee told the inquiry he “knew the Dorney’s were going to uncover my mistake, they’re intelligent people”. It was put to him that he only came clean “because the Dorney’s pursued you doggedly”.

Dr Lee replied that he “couldn’t live with his action”. “I had to get this mistake, this lie of mine out of the way...I couldn’t live with my deception,” he replied.

The FTP committee failed to reach a conclusion at yesterday’s hearing which lasted almost 10 hours. Its chair, Dr Deirdre Madden, said the conclusion will be published on the Medical Council’s website in due course.

A range of sanctions are open to the Council from advice and admonishment up to revoking a licence to practice and erasure from the register.