GP censured on heart attack treatment

A DOCTOR who worked in an out-of-hours GP service in the south has been found guilty of poor professional performance by a Medical Council fitness-to-practise inquiry.

Dr Eugene Erasmus, 71, a South African physician, was the doctor on call at SouthDoc in Cork over the May bank holiday weekend last year when British tourist James Taylor attended its Skibbereen centre.

Mr Taylor, 62, from Nottingham, was on holiday in Glandore, Co Cork, when he became ill. He telephoned SouthDoc in the early hours of Monday, May 4, complaining of chest pains and saying he had had a heart attack in 1997.

The three-day hearing, which concluded on Saturday, found the doctor was guilty of poor professional performance for failing to carry out or arrange an electrocardiograph test.

Dr Erasmus claimed there was no ECG machine available in the centre or in the car used by doctors on call. He said he asked the SouthDoc driver to get him an ECG machine but was told there was none available.

The fitness-to-practise committee, chaired by Mary Culliton, accepted evidence from SouthDoc medical director, Dr Gary Stack, who said the centres and cars all had ECG machines.

The driver on call on the night, John O’Connor, also claimed the machines were available.

The committee also accepted evidence given by the council’s expert witness, Prof Colin Bradley, chair of the Department of General Practice at University College Cork, that an ECG reading was appropriate in Mr Taylor’s case.

Dr Erasmus was also found guilty of poor professional performance in advising Mr Taylor that the pain he was experiencing was caused by high blood pressure in circumstances when there was no clinical justification for that.

However, the committee found the doctor was not guilty of poor professional conduct for not advising Mr Taylor that he might have suffered a heart attack.

While the allegation was proven, it did not amount to poor professional performance as there was no diagnosis of a heart attack at the time.

The committee has recommended to the Irish Medical Council that Dr Erasmus be censured in writing.

In earlier evidence, Dr Erasmus claimed because he was advised by his employer, Locomotion, to refer all patients with chest pains to hospital, he decided to advise Mr Taylor to go to hospital in Cork for an ECG.

He said Mr Taylor refused to go to hospital because he was travelling home later the same day. Mr Taylor said he was never advised to go to hospital and would have done so if advised by the doctor.

Mr Taylor went to his own GP the day after returning to Nottingham. He was sent by ambulance to hospital where a blood test found enzyme levels that indicated there had been a cardiac incident.

At the hearing on Saturday Dr Erasmus told Nicholas Butler SC for the doctor that, in retrospect, he should have written down the advice he had given to Mr Taylor.

The doctor, who is still practising in South Africa, has come to Ireland on four occasions since 2009 to work as a locum doctor.

Prof Tom O’Dowd, a GP and public health specialist, called as an expert witness on behalf of Dr Erasmus, said he believed the doctor competently managed Mr Taylor.

Dr O’Dowd said he believed Mr Taylor suffered a heart attack after returning to Nottingham with the flight from Dublin putting pressure on an already delicate vascular system.