Cork GP's decision to prescribe contraceptive pill to older patients 'unacceptable'
Dorota Sanocka, who practises at Our Clinic Sanocka, based at Clogheen Business Park, Co Cork, is before an Irish Medical Council fitness-to-practise inquiry to face four allegations of professional misconduct. Picture: RollingNews.ie
The decision of a Cork-based GP to prescribe an oral contraceptive pill containing oestrogen to two older women with high blood pressure was “unacceptable”, an expert witness has told a medical inquiry.
Deirdre Lundy, a GP with specialist knowledge of women’s reproductive health medicine, said the drug, Yasmin, was generally not recommended in all but exceptional circumstances for women over 35 because of the increased risk of blood clots.
Dr Lundy made her comments while giving evidence to an inquiry of the Irish Medical Council on Wednesday into four allegations of professional misconduct and poor professional performance against Dorota Sanocka, who practises at Our Clinic Sanocka, based at Clogheen Business Park, Co Cork.
Dr Sanocka, who previously operated a clinic at Woodfield, Station Road, Blarney, Co Cork, is accused of prescribing Yasmin to a 47-year-old woman with high blood pressure, known as Patient A, who was also a smoker, on March 31, 2016.
She is also accused of prescribing the same drug to treat an ovarian cyst in a 60-year-old woman, known as Patient B, who suffered from high blood pressure and high cholesterol, on November 23, 2015, and a separate allegation of failing to refer the woman for further investigation of an ovarian mass.
The fourth allegation relates to claims by Dr Sanocka posted on her clinic’s website on or around March 22, 2017, that she was a highly regarded specialist in gynaecology, obstetrics and andrology when she was not listed on the IMC’s register to conduct specialist medicine.
Dr Lundy said there were very well recognised criteria to be used in determining whether to prescribe a contraceptive pill containing oestrogen to patients as it could cause various medical problems, particularly blood clots.
She claimed it was unacceptable to prescribe Yasmin to someone over 35, especially as Patient A also suffered from hypertension and was a smoker.
She noted the risk of dying from a blood clot was most likely when a patient first started taking the medicine.
Dr Lundy said there were many other treatments available for someone with heavy menstrual bleeding like Patient A.
The IMC’s fitness-to-practise committee heard Dr Sanocka claimed she had done more for Patient A in three weeks than the woman’s own doctor had in 11 years and had regarded her condition as an emergency.
However, Dr Lundy said she disagreed completely that heavy menstrual bleeding was an emergency, “I don’t think [Patient A] was in any urgent risk and, if so, she should have been referred to hospital,” said Dr Lundy.
While it was valid for Dr Sanocka to want to get Patient A’s bleeding under control, Dr Lundy observed: “There were four other things you could have done without posing any risk to this poor woman’s health.”
She also disagreed with Dr Sanocka’s contention that the benefits of prescribing Yasmin outweighed the risks.
“It’s more concerning that instead of saying ‘O my goodness I didn’t realise how ill-advised my decision was and trying to do better’, we now find ourselves four years on having this hearing,” said Dr Lundy.
She made similar criticism about Dr Sanocka’s treatment of Patient B, noting the combined oral contraceptive bill should not be given to anyone over 50.
Dr Lundy said the GP’s action represented a serious failure which amounted to poor professional performance.
Asked by counsel for the IMC, Elaine Finneran BL, if they constituted professional misconduct, Dr Lundy replied that they were errors. “There was no malice — just ignorance,” she added.
The inquiry continues on Thursday.
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