Doctor defends claims he failed to diagnose patient’s heart attack

A DOCTOR has defended claims that he missed a heart attack when a patient came to him complaining of chest pains.

The Irish Medical Council is investigating the case of a British tourist who claims he was only given a prescription for high blood pressure by a doctor on call at SouthDoc in Cork.

James Taylor, 62, from Nottingham, said that when he went to his own GP the following day he was informed he had had a coronary incident.

Before the Council’s Fitness to Practise Committee is South African physician, Dr Eugene Erasmus. He claimed yesterday that he did not expect that Mr Taylor had suffered a heart attack as there were no symptoms.

Dr Erasmus faces allegations of poor professional performance.

Two of the six allegations, including one of failing to adequately examine Mr Taylor on May 4, 2009, and failing to consider that he may have suffered a heart attack, were withdrawn yesterday.

The outstanding allegations include one that the doctor advised Mr Taylor that he may have been suffering from a chest virus, and the pain he was experiencing was caused by his high blood pressure in circumstances where there was no clinical justification.

He is also accused of failing to carry out, or to arrange, a full appropriate investigation, including an electrocardiograph (ECG) and of failing to refer him to a qualified practitioner.

Dr Erasmus, 71, a GP, worked two night shifts over the May bank holiday weekend and saw Mr Taylor in the early hours of Monday, May 4, at SouthDoc’s Centre in Skibbereen. He took his medical history and examined him. He decided he could not make a specific diagnosis, other than pointing out that his blood pressure was high and he had a lung infection.

Earlier, Prof Colin Bradley, chair of the Department of General Practice at University College Cork, had said in expert evidence that it was the responsibility of doctors to ask the right questions when a patient’s history was taken.

Dr Erasmus said Mr Taylor, who told him he suffered a heart attack in 1997, was complaining of pain across his chest and in the right side his neck. He also said that he had contracted a viral infection two weeks previously.

He told Mr Taylor that because he had a previous heart attack he wanted him to have an ECG. He also told him that he worked for the Locomotion Agency and that they advised that a patient with chest pains should be sent to hospital.

Nicholas Butler SC for the doctor asked Dr Erasmus if he had expressed any view as to whether or nor Mr Taylor was suffering from a heart attack. “Well, I didn’t actually expect it to be a heart attack because there were no symptoms of that,” he replied. “I told Mr Taylor that the classical signs of a heart attack were absent.”

Dr Erasmus said he asked the SouthDoc driver to get him an ECG machine but was told there was none available.

Dr Erasmus claimed Mr Taylor had looked for medication to treat his blood pressure which he prescribed.

The hearing has adjourned until October 16.