A family doctor has been censured by the Irish Medical Council over his failure to carry out a proper examination of a female patient who suspected she had a tampon stuck inside her body.
Herbie Taute was charged with four counts of poor professional performance over his treatment of the patient at the Centric Health clinic on the Navan Road in Dublin on November 12, 2019.
An inquiry by the Irish Medical Council heard Dr Taute was accused of failing to record details of the patient’s concern about a tampon lodged in her vagina in his medical notes of the consultation as well as failing to have due regard for what she had told him.
The IMC fitness-to-practise committee was told Dr Taute was also charged with failing to carry out an adequate clinical examination of the patient.
Dr Taute, a South African national who has worked in Ireland since 2018, was also accused of recording in his medical notes he had carried out various examinations of the patient, including her chest and abdomen when he knew it was untrue.
Counsel for the IMC, Caoimhe Daly BL, said the allegations, if proven, amounted to poor professional performance as he had failed to meet or apply the skills and knowledge expected of a GP.
Ms Daly said the inquiry arose from a complaint filed in January 2020 by a female patient who had attended Dr Taute because she suspected she had a tampon lodged internally after her menstrual cycle but claimed she had received “complete clinical mismanagement.”
In a statement, the patient said: “I felt pressure in my groin area and was experiencing some brown discharge and a strange vaginal odour.”
The woman said Dr Taute had said it was highly unlikely she had failed to remove a tampon after she responded to his query that she had had sex in the interim which was not painful.
Instead, she said the GP had claimed it was probably an infection and he offered to prescribe her antibiotics on at least three occasions during the consultation.
“He made no attempt to confirm his assumptions with an internal examination,” she added.
The patient expressed surprise at his immediate diagnosis as she had limited symptoms of an infection such as increased urination, pain, a high temperature or itchiness.
She said she requested a vaginal swab sample should be sent off for tests after a urine sample had been found clear.
The woman said she was “slightly relieved” the doctor wasn’t overly concerned about her situation but was “uneasy” her concerns had gone unaddressed.
She said she was given a prescription to treat a fungal infection which made no difference to her condition and her symptoms subsequently became worse and were “becoming psychological as well as physical”.
“The odour was so pronounced that it was causing me extreme embarrassment both in work and at home,” she said.
The woman said she cancelled a follow-up appointment with another doctor at the clinic a month later as the tampon eventually dissolved itself.
However, she believed she had been at high risk of toxic shock syndrome because of the treatment by Dr Taute.
The inquiry heard Dr Taute, who has worked as a locum with Centric Health since June 2019 and is now based at its clinic in Newbridge, Co Kildare, accepted he should have offered the patient an internal examination to determine if there had been a retained tampon.
Ms Daly said the doctor had apologised to the woman and accepted his failure to carry out an internal examination led her to believe he was being dismissive of her concerns.
The IMC counsel said there had been “a failing in his judgement at the time”. Dr Taute informed the IMC that gender was not an issue in his failure to offer an internal examination as he carried them out regularly but he did not wish to put the patient through one unnecessarily during the consultation.
The inquiry heard he believed there were a number of factors which pointed away from a tampon being responsible for the patient’s complaints.
Dr Taute also asked the FTP committee to take into account it was a single clinical incident which did not result in any adverse outcomes for the patient.
Ms Daly acknowledged there was a dispute between Dr Taute and the patient over whether he had carried out an examination of her chest and abdomen.
A report by an expert witness for the IMC, Professor Susan Smith, said Dr Taute’s belief the patient had a vaginal infection was “not a reasonable assumption” given what he had been told by the woman.
An expert witness for Dr Taute, Dr Stephen Murphy, said the doctor’s failure to record the patient’s concern about a tampon was not a serious omission as “nothing of any consequence” occurred and did not constitute poor professional performance.
The FTP committee granted an application by counsel for Dr Taute, Rory White BL, under Section 67 of the Medical Practitioners Act 2007 to stop the inquiry on the basis his client would give an undertaking not to repeat the conduct and to complete further training to strengthen his competence.
Mr White said Dr Taute also agreed to be censured by the IMC.
The barrister said the case was an appropriate one for a Section 67 application as Dr Taute had apologised for his shortcomings and had shown insight into his actions.
Mr White also outlined a testimonial from Dr Liam Power who had worked with Dr Taute at Centric Health which described him as “respectful and attentive to patients under his care”.