Doctor 'talking nonsense', hearing told

A consultant dermatologist who is facing more than 100 allegations of poor professional performance or professional misconduct was accused of talking “absolute and utter nonsense”, at a Medical Council fitness-to-practise hearing this morning.

The accusation was made by solicitor for  medical council JP McDowell, who told the hearing Dr Adam Jacobus Smith's evidence did not make sense.

Reviewing a case where a disabled woman had developed blisters and hair loss during treatment by Dr Smith in March 2011, Mr McDowell said the patient had been given an antibiotic as well as an immune suppressant, which appeared to be contradictory approaches.

Mr McDowell also asked Dr Smith whether he would agree that his recall of the patient's condition was "at odds" with evidence given to the committee by the patient's sister.

Specifically, Mr McDowell recalled the patient's sister had claimed the patient had "blisters the size of golf balls".

Dr Smith said the patient, who attended his clinic at the Whitfield Clinic, Waterford, in January and March 2011, came in with a rash and diagnosis of cellulitis. He said he did not see blisters on the patient's skin at an examination on March 8th, and where a rash was evident it was where she was interacting with her wheelchair.

He determined she did not have cellulitis and diagnosed psoriasis. He then prescribed a series of injections of a powerful biological agent, Stelara. Asked about this drug, Dr Smith said it was registered for use in Ireland in 2010.

A few days after taking Stelara, the woman's condition worsened and she was sent to Waterford Regional Hospital, where she was diagnosed with pemphigus vulgaris (PV), a rare auto-immune disease.

The inquiry has previously been told the woman required large doses of steroids, auto-immune suppressants and antiviral drugs to bring the condition under control.

Afterwards the patient developed cold sores all over her body and needed further hospitalisation.

The case continues.