Doctor who altered notes after patient committed suicide denies misconduct

A DOCTOR who altered the notes of a man after he had committed suicide in the Mater hospital, Dublin, has been charged with seven counts of professional misconduct by the Irish Medical Council.

A fitness to practise hearing yesterday was told Dr Samuel McManus (31), now a GP, altered and added to the notes of Mr W, an Eritrean asylum seeker, who died in April 2008.

Mr W was admitted to the Mater hospital on the night of April 12th, after being pulled from the river Liffey. The 47-year-old had been in Ireland 12 days and was resident at Balseskin Reception Centre in Finglas. He was estranged from his wife and daughter. He had also been diagnosed with HIV. When he was admitted to the Mater, he told staff at A&E he “did not want to live in the world anymore”. Dr McManus, who was then a senior house officer as part of his GP training, saw Mr W on April 13th. Mr W told him “I have a voice in my heart, one good, one bad, telling me to hurt myself.”

After consulting by phone with psychiatric consultant Prof Patricia Casey, Dr McManus admitted Mr W to St Aloysius ward, in the hospital’s psychiatric unit, at 2pm. His belt was removed. The doctor told staff to observe him every half-hour.

He was given anti-psychotic drugs, and at 3.30pm he went for a shower. He was checked at 3.40pm. When he was checked again at 3.50pm there was no response. He was found hanging from the shower frame by his shoelace. He died, in the presence of his wife, on April 28th.

JP McDowell, solicitor for the Irish Medical Council, said on April 14th it was discovered Dr McManus had altered his notes. In a different pen, he had crossed out the words “high” and “risk” in the phrase “high suicide risk” and added the word “attempt”. He also entered the word “denied” beside the phrase “suicide ideation”. Dr McManus also added retrospectively his patient plan for Mr W and changed the time of one of his notes.

Counsel for Dr McManus, Simon Mills, said his client accepted he had made retrospective changes to his notes, but did not accept that amounted to misconduct. He also did not accept criticism of his treatment of Mr W.