Consultant fined for directing further step be carried out during a gynaecological procedure without patients' consent

The sanction against Professor Raymond O’Sullivan also includes a letter of censure over the procedure carried out during an internal examination with a camera at St Luke’s Hospital, Kilkenny.

St Luke's Hospital, Kilkenny.

A consultant gynaecologist found guilty of professional misconduct for directing a further step be carried out during a diagnostic gynaecological procedure on four different women without obtaining their consent is to be fined €5,000.

President of the High Court Mr Justice David Barniville today confirmed the Medical Council sanction against Professor Raymond O’Sullivan, which also includes a letter of censure over the procedure carried out during an internal examination with a camera at St Luke’s Hospital, Kilkenny.

The allegations related to a direction to insert an abdominal rectal pressure catheter to measure intravaginal pressure while carrying out a hysteroscopy on four different women on September 4-5, 2018, at St Luke’s Hospital.

It was also found that Prof O’Sullivan failed to produce advance approval from the local research ethics committee or to comply with professional guidelines about the use of the catheter.

Counsel for the Medical Council, Nessa Bird, told the court that there were three separate complaints, including from solicitors representing two of the women.

At the start of the inquiry, Prof O’Sullivan admitted the allegations and that they amounted to professional misconduct. The High Court heard that it was professional misconduct of the type to represent a serious falling short of the standards of conduct expected of medical practitioners.

The Fitness to Practise Committee had heard that Prof O’Sullivan, who had a research idea, had the honest belief that the added step did not require the consent of the patient. It was accepted that the motivation behind the step was benign and there were a number of mitigating factors, including that the consultant had apologised to the women.

In the High Court, Mr Justice Barniville said he saw no good reason not to confirm the sanctions, and he also granted costs to the Medical Council.

The chairperson of the Medical Council inquiry, Jill Long, earlier this year said the fitness-to-practise committee also noted that medical records contained no reference to any consent having been obtained from any of the four female patients in advance of the procedure.

Ms Long said the committee’s conclusions were also based on a systems analysis review of what happened by the Ireland East Hospital Group, of which St Luke’s Hospital in Kilkenny is a part.

She also observed that the issue arose while Prof O’Sullivan alone had taken the decision to conduct a feasibility study of using the catheter to measure intravaginal pressure while performing a diagnostic hysteroscopy.

Ms Long said the purpose of the research on the four patients was to see if a future proposed study was even possible.

She explained that the research was to determine if there was a better alternative that could be developed to the traditional method of carrying out such an examination, as the use of a speculum caused “so much more discomfort”. 

The three-member committee concluded that the proven allegations represent professional misconduct insofar as they represented a serious falling short of the standards of conduct expected of medical practitioners.