A grieving family is calling for changes to the Irish Medical Council after a consultant who they accused of mistreating their late mother left the country when an investigation into his practice was to be launched.
Eileen Hyland, 68, was refused a potentially life-saving treatment for thyroid cancer, called radioactive iodine therapy (RAIT), in Cork University Hospital in 2016.
She died in CUH on May 5, 2017.
Her family believes that her life may have been cut short and her suffering intensified because of alleged failures in her care.
The Hylands pushed for an investigation into her consultant following her death.
But they were horrified when they learned that the Irish Medical Council (IMC) had dropped the investigation after the consultant voluntarily removed himself from the Irish medical register and moved to another country in Europe.
Now, the Hylands want to protect other patients from falling victim to a system where doctors can so easily escape investigation.
They have called for the High Court to examine the IMC’s decision and a judicial review is due in October.
Ms Hyland’s son, James Hyland, believes that changes now could protect other patients in the future.
“A doctor [should not be able] to remove themselves from the register to basically avoid investigation,” Mr Hyland said.
“He’s in Europe, retired, but still registered as a medical practitioner.
"If a doctor makes a mistake they should not just be able to remove themselves from Ireland to go and practice elsewhere."
Their call for a judicial review is not the first time the family has had to turn to the High Court to address grievances with their mother’s care.
Jim Hyland Snr and his three children, including James, previously sued the HSE claiming there was an alleged failure to treat Ms Hyland’s cancer with RAIT.
They settled with the HSE out of court for an undisclosed sum but with no admission of liability.
But their case did lead to the introduction of RAIT for cancer patients on dialysis in CUH this year - the first hospital in the State to do so.
In a letter read out in the High Court last year, CUH said that it sincerely regretted the “untimely death” of Ms Hyland.
Ms Hyland, a 68-year-old grandmother of six, suffered from end-stage renal failure and was undergoing dialysis when she was diagnosed with thyroid cancer in July 2016.
She had a total thyroidectomy at CUH a few months later.
In October 2016, it was recommended that she be treated with RAIT.
But Mrs Hyland was essentially refused RAIT because she was on dialysis. Her family was told by Mrs Hyland’s consultant that RAIT was not available to a patient on dialysis.
“Mum was diagnosed with thyroid cancer,” Mr Hyland said.
“She was told she would start radioactive iodine therapy which is the standard treatment for thyroid cancer.
“But when she went to see her radiation oncologist he said that was not an option for her because she was a dialysis patient.
“We took his word for it. But the cancer progressed so my sister and I started investigating.
“We thought mum couldn’t be the only person in the world who had thyroid cancer and was also a dialysis patient and we found a facility in Liverpool that did the treatment and we connected Cork and Liverpool together.”
But Mr Hyland alleges that emails then sent to him by the oncologist in CUH still inferred that it was impossible to treat his mother with RAIT because she was on dialysis.
After his mother’s death, Mr Hyland discovered that hospitals in Liverpool and Manchester had offered to help make RAIT available to Ms Hyland, either locally in CUH or in the UK.
“So that consultant in Cork was aware that that treatment was available but yet was telling us constantly that it wasn’t available,” Mr Hyland said.
He said that his mother’s condition quickly deteriorated after she was prescribed a drug that he believes was unsuitable.
“She went into A&E within 24 hours of being on this drug and she had 31 side effects across seven days, life-threatening side effects,” he said.
“However the oncologist didn’t turn up to see her for seven days. By that time, the drug had caused catastrophic liver failure and she died.
“It was pretty horrific. We still think we should have fought more for her but our trust is meant to be in the medical system and the doctors to do their best.
“You hear plenty of people say at a funeral after someone passes if someone was sick ‘everything that could have been done was done.’ We would love to have those words.”
More than four years after his mother’s death, Mr Hyland said that he and his family are “still fighting every day” for her.
“Our mum was a very caring person. She always put other people first, so this is a nice legacy for her if we can fight for changes to help other patients in the future.
“But you don’t get time to grieve when you’re still fighting for that person every day.”
Mr Hyland said that he has been hugely disappointed by the slow pace of progress addressing the issues raised by his mother's death.
RAIT was only introduced to CUH four years after Ms Hyland’s death and after the High Court had sanctioned the settlement.
The adversarial nature of the HSE’s legal defence was also unnecessary and upsetting, Mr Hyland said.
“They dragged us through the gutter. It’s just crazy to put any family through that.
“I work in media, I organise tours around the world [with artists including Lady Gaga] and we’re talking to a director about doing a potential documentary for Netflix about this.
“You shouldn’t have to fight like this as a family.
“It’s hard. You put your trust in these people because they’re the professionals. That is their job and duty.
“But there are plenty [of doctors] for whom you are just a number. I feel that’s what happened to my mum.
“It’s upsetting to think about that.
“We had a horrific ordeal but the ultimate goal for us now is to make sure this doesn’t happen to any other family.”
Lawyer Lyndy Cantillon who has won landmark medical negligence cases, securing millions of euros for people catastrophically injured by doctors, said that problems with Medical Council investigations were unfortunately not new.
A Partner at Cantillon’s Solicitors in Cork, Ms Cantillon said that although medics are occasionally held accountable by the system there are “serious flaws.”
Penalties for those who are found to have done wrong range from a “warning” to a fine to being struck off the register, but the bar for the latter is “extremely high”, Ms Cantillon said.
And once a doctor is found guilty of professional misconduct it is not necessarily public knowledge so may not be known by their current or prospective patients.
Another potential problem is that the Medical Council investigates its own colleagues - the committee that investigates complaints is formed mostly by other medics.
"Once a complainant makes a complaint to the Medical Council the complaint is considered by a Preliminary Proceeding Committee (PPC). It is the role of the PPC to investigate a complaint, decide whether it warrants further action, and provide recommendations to the Medical Council. The PPC is made up of mostly medical professionals. Out of 16 people on the committee, 4 of them are “non-medics”, however, the “non-medics” are usually involved in the medical field, e.g. working in HSE.
“This strikes me as another flaw in the system,” Ms Cantillon said.
The Medical Practitioners Act 2007 does grant some protection to patients, dictating that the IMC must decide whether a doctor may be removed from the register or not - which could be denied if a complaint was pending.
"This is helpful in that it does provide some protection to the patient if the application to remove from the register is denied due to a pending complaint," Ms Cantillon said.
However, a doctor can apply to remove themselves from the register prior to a complaint being lodged or the Medical Council can decide to grant the application for removal from the register despite a complaint being lodged.
And once a doctor has been removed from the register the Medical Council appears not to have jurisdiction to investigate the matter further, she said.
The Irish Medical Council was contacted for comment.