Cork teen had testicle removed after GP failed to diagnose well-known condition, medical inquiry told

The locum doctor is accused of failing to have adequate regard to the symptoms of two patients and failing to directly refer them to an emergency department or escalate their care appropriately.

SouthDoc is an out-of-hours GP service based in Cork and Kerry. File  Picture: Eddie O'Hare

A Cork teenager had to have surgery to remove a testicle after a GP at SouthDoc allegedly failed to diagnose a well-known emergency condition relating to a swelling of the area, a medical inquiry has heard.

Dr Alicia Marton Martinez is accused of a series of allegations of professional misconduct and poor professional performance in relation to her treatment of two young patients while she was working as a locum GP with SouthDoc — an out-of-hours GP service based in Cork and Kerry — three years ago.

They include that she failed to refer a three-week-old baby with a fever and mottled skin, who was subsequently diagnosed with viral meningitis, to an emergency department.

An expert witness claimed the baby boy might have died but for the persistence of his parents.

Dr Marton Martinez, who qualified as a doctor in Spain in 1988, did not attend the fitness-to-practise inquiry and is not legally represented at the hearing being held by the Medical Council.

The GP gave a voluntary undertaking to the High Court in September 2023 not to practice medicine until further notice after the Medical Council had sought an interim suspension order against her.

She is accused of failing to have adequate regard to the symptoms of both patients as communicated by their parents and failing to directly refer them to an emergency department or escalate their care appropriately.

Patient A

The mother of the Cork teenager — identified only as Patient A — said her son, aged 14 at the time, had complained early on October 10, 2022, of a swollen testicle and being in a lot of pain and discomfort.

The witness said she had looked up the symptoms on the internet and had packed a bag for hospital because it looked like her son might have a testicular torsion — a medical emergency where the blood flow is cut off to a testicle.

The woman gave evidence of contacting South Doc and receiving a call back about an hour later from Dr Marton Martinez, who said her son’s condition was normal for a teenage boy.

The inquiry heard that the locum advised that the boy should place “a cold compress” and take Ibuprofen three times daily for a week.

The woman replied that she would prefer if he could be examined by the GP, who seemed “brisk and impatient” on the phone.

She told counsel for the Medical Council, Brian Gageby BL, that she had not mentioned a testicular torsion to Dr Marton Martinez as she did not want to come across as “a Google doctor”. The inquiry heard that the teenager was examined a short time later at the SouthDoc clinic in Midleton, Co Cork, by the locum, who repeated her earlier advice.

His mother said the examination only lasted about two minutes, but she felt relieved that he did not have a testicular torsion.

The woman said she was outside of Ireland a week later when she heard her son had been referred to Cork University Hospital where he had a testicle removed after being “bowled over with pain”.

Patient B 

The father of the three-week-old baby — known as Patient B — gave evidence of calling SouthDoc on November 12, 2022, as his son had a fever from the previous night and was very irritable, while also making a lot of grunting noises, feeding slowly, and having pale and mottled skin.

The man said they felt his son’s symptoms were worrying.

However, he said Dr Marton Martinez said they did not sound very severe, and asked if the baby had been given Calpol.

Patient B’s father said that the GP said a baby under two months could be given Calpol, despite him stating a number of times that he did not think that was the case.

He told the inquiry that Dr Marton Martinez accepted that he was correct after she checked the issue.

The witness said he had lost confidence in her at that stage, and asked to be referred to another doctor.

The inquiry heard another GP, Dr Anas Matar, believed the baby’s symptoms were “red flags” and immediately gave them an urgent referral to Cork University Hospital.

Patient B’s father said his son was diagnosed with viral meningitis and spent several days in hospital.

The man rejected claims by Dr Marton Martinez that he had been aggressive on the phone or that he had suggested his son was nine years old.

GP response to Medical Council

In correspondence with the Medical Council, the GP said Patient A did not tell her he was hurting in the genital, area but did feel “a bit uncomfortable”, which she claimed was “a very difficult symptom to interpret or to understand”. 

Dr Marton Martinez said she had a “bit of a misunderstanding” about Patient B with the baby’s father as her English was “not perfect”. 

The GP said she does not know why, but she believed the patient was nine years old instead of nine days old, which is why she had asked if the young boy had been given Calpol.

An expert witness, Tom O’Dowd, told the inquiry that there would have been a 90% chance of salvaging Patient A’s testicle if he had been referred to an emergency department by Dr Marton Martinez.

Prof O’Dowd observed that the teenager was left with a lifelong disability that was ”entirely preventable”. He said it was “incompetent practice” by the locum to instruct the teenager to apply a cold compress and take pain relief for a week.

Prof O’Dowd said there was a serious failure by the GP to meet the standards of competence and knowledge expected of doctors.

He said testicular torsion was one of a few emergencies widely known in general practice.

Prof O’Dowd said it was “indefensible” that Dr Marton Martinez had diagnosed the patient as having “orchitis” (a swollen testicle), but had not escalated the care.

In relation to Baby B, he said the baby had alarming symptoms and was “on the verge of circulatory collapse”. Prof O’Dowd said doctors have to be particularly vigilant with the care of babies and infection because of the risk of things like meningitis.

He claimed Dr Marton Martinez had disgraced the profession and dishonoured the patients in both cases.

The inquiry was adjourned and will resume tomorrow.