Cork-based GP guilty of poor professional performance

A Cork-based GP has been found guilty of poor professional performance at the Medical Council for the second time in five years.

Dr Saleem Sharif, who operates a private practice at Ballyphehane, was found guilty of a single count of poor professional performance arising from his failure to diagnose a serious infection in a patient.

Dr Sharif failed to properly examine Alison Hickey when he was working as a locum doctor at the GP Now clinic in Sandyford, Co Dublin, in 2014, the fitness to practise committee of the council found.

Dr Sharif diagnosed a low-grade urinary tract infection in Ms Hickey but she was found to have suspected sepsis when she was rushed by ambulance to the Rotunda hospital a day later.

He pleaded guilty to poor professional performance and has offered to undergo a professional review. Dr Sharif has also apologised to Ms Hickey and her husband Karl.

The charges against Dr Sharif related to his failure to take an adequate history from Ms Hickey, or to carry out appropriate examinations or tests on her. She came to his clinic in October 2014, just over two weeks after giving birth to twins by emergency caesarean section.

Lack of judgement

Lawyers for the council told the inquiry he showed a worrying lack of clinical judgement and acted incompetently in jumping to the wrong diagnosis for Ms Hickey without performing the necessary investigations.

In 2011, the council found Dr Sharif guilty of poor professional performance in relation to his treatment of a cardiac patient in Cork two years previously.

Simon Mills, for Dr Sharif, said no question of "recidivism" arose in relation to the 2011 finding because there was no question about the quality of the examination he carried out on the patient in this case. What was at issue was the location where the examination was performed.

Mr Mills said his client wrote an apology to Ms Hickey in January 2015 but this was not communicated to her by GP Now until a month later, and it was this lack of response by the practice that led to Mr Hickey making a complaint to the Medical Council.

Earlier, Eoghan O’Sullivan, for the chief executive of the council, said Dr Sharif had displayed many failings during his five-minute consultation with Ms Hickey and each was an “individual act of incompetence”.

Dr Sharif displayed a “worrying level of clinical judgement” by jumping to an incorrect conclusion about the condition of the patient without carrying out examinations or tests, he said.

Mr O’Sullivan said Dr Sharif, who trained in Pakistan, deserved credit for admitting to poor professional performance.

The patient, Alison Hickey, told the inquiry on Monday she was feeling very unwell and could barely walk when she went to see Dr Sharif.

Mr O’Sullivan said the significance of Dr Sharif’s various clinical failings could only be appreciated by reference to Ms Hickey’s circumstances. She had given birth to twins three weeks earlier, delivered by emergency caesarean section after she suffered pre-eclampsia.

Clinical failings

In a five-minute consultation, Dr Sharif’s clinical failings were numerous, counsel said. He didn’t take a detailed history of the patient, physically examine her or carry out tests. The shivers Ms Hickey was experiencing were indicative of a systemic infection, not the urinary tract infection he diagnosed, Mr O’Sullivan said.

“To jump to that conclusion and form that impression in the absence of taking a history and carrying out investigations displays a very worrying lack of clinical judgment.”

Mr Mills said there was no evidence Ms Hickey’s outcome was made worse by what happened at the appointment with his client.

Pleading for mitigation, Mr Mills said it would be disproportionate for the council to take any action that would affect his client’s professional registration. It would also be an error in principle to take into account the previous inquiry as evidence of recidivism.