Doctor’s use of drug on boy justified, inquiry told
Adam Jacobus Smith prescribed the 11-year-old boy with the drug Neotigason to treat his psoriasis, who was identified only as Patient D.
His barrister, Gabriel Gavigan, told an inquiry that Patient D’s mother had described her son’s hands as being like claws, that he was falling behind in school, and that his self-esteem was suffering.
Mr Gavigan was submitting his closing arguments in defence of Dr Smith, who faces more than 100 allegations of poor professional performance and professional misconduct in relation to 12 separate patients who attended his rooms at the Whitfield Clinic, Waterford, between 2006 and 2009.
The consultant dermatologist has admitted to the facts of some of the allegations before the fitness to practise committee, but disputes that this treatment of any patient amounts to poor professional performance or professional misconduct.
Yesterday, JP McDowell, counsel for the chief executive of the Medical Council, which is taking the case against Dr Smith, said an expert witness called to give his opinion on Dr Smith’s practices had two central criticisms of his treatment of Patient D.
Mr McDowell said the witness, James Clifford McMillan of City Hospital Belfast, had deemed the prescribing of Neotigason as “inappropriate and poor professional performance” because the extreme circumstances that would justify resorting to using the drug on a child did not exist.
Mr McDowell added that the expert told the inquiry that if a doctor does resort to Neotigason, blood tests and radiological tests have to be put in place to ensure there is not premature closing of the epiphyseal or growth plates.
Mr Gavigan said it was never Dr Smith’s intention to treat Patient D for a long period and once his hands were “straightened out”, he intended to treat him in another fashion.
“In essence, we are saying it wasn’t an inappropriate drug and a failure to comply with guidelines is not sufficient to warrant a finding of poor professional performance beyond a reasonable doubt,” said Mr Gavigan.
Closing submissions were also heard in respect of another teenager, identified as Patient E.
It is alleged Dr Smith recommended commercial sunbeds to the 17-year-old to treat his psoriasis.
Mr Gavigan said the committee must be mindful what the allegation against Dr Smith is that he recommended the use of sunbeds but “the one thing that cannot be said after all the evidence is dissected is that Dr Smith gave a recommendation or an endorsement”.
“He was asked to give an opinion if it was OK and he replied that it would be under limited circumstances and for a limited period of time and that was clearly not a recommendation,” said Mr Gavigan.
The fitness to practise committee are expected to retire tomorrow to consider their decision.
