Locum doctor failed to complete referral for woman who was later diagnosed with cancer, inquiry told

The doctor whom Dr Christova had been hired to cover told the fitness to practise inquiry she was called back from her annual leave by the clinic’s concerned staff after just three days, who were of the opinion it was 'not wise' for Dr Christova to be left there alone. File photo

A locum doctor failed to refer a woman with lumps in her breast — who was subsequently diagnosed with breast cancer — for urgent consultation, a fitness to practise inquiry has heard.

The 72-year-old woman in question presented at Shannon Medical Centre in Co Clare on October 17, 2019, with a series of lumps on her breasts. However, despite noting the lumps, the GP who heard her case Dr Theodora Christova began, but failed to complete, a consultant referral for her condition.

The woman subsequently presented at the same practice four days later to a different doctor, and was then referred for further consultation. On November 1 she discovered she had breast cancer, a diagnosis which was followed by surgery and chemotherapy.

That patient's case is one of several issues being considered by a Medical Council fitness to practise inquiry following a series of complaints regarding the performance of Dr Christova, a Greek national, who worked briefly for Shannon Medical that month.

Dr Christova was not present at the hearing after failing to respond to “extensive” attempts to contact her over the past three years, counsel for the Medical Council Lorna Lynch SC said.

She faces allegations that the manner in which she carried out her duties at the time amounted to poor professional performance and that her alleged conduct constituted “disgraceful or dishonourable behaviour”.

Dr Christova had worked at Shannon Medical for from October 15- 19,  2019.

It is alleged that on one occasion she consulted with an elderly patient who was trying to obtain a certificate of driving competence, which she granted, while failing to take into account that the man — who had late-stage terminal cancer and attended the surgery without his family’s knowledge, and who died six months later — had been prescribed sleeping tablets and steroids at the time and would have presented as being “frail and not a well man”.

With regard to a teenage girl presenting with an accelerated heartrate, the inquiry heard that a nurse had flagged concerns regarding Dr Christova after she allegedly reached into her bag and gave the girl an unidentified tablet to take to help her to “calm down”. 

It is also alleged that she failed to diagnose that the girl was displaying the symptoms of thyrotoxicosis, a condition which can lead to symptoms, including a rapid heartbeat and anxiety.

GP's testimony

GP at Shannon Medical Dr Yvonne Williams — whom Dr Christova had been hired to cover — told the inquiry she had been called back from her annual leave by the clinic’s concerned staff after just three days, who were of the opinion it was “not wise” for Dr Christova to be left there alone.

She said that the situation with Dr Christova was “unprecedented”. 

“I met with the staff and they said they didn’t feel it was appropriate for her to return to the practice,” she said.

She said that when she got to the practice she found the waiting room “overflowing and chaotic” while Dr Christova was making a cup of tea in the canteen. 

“If I had been locuming for someone who had had to return from a day off I don’t think I would have been so relaxed about it,” she said.