Doctor defends treatment of elderly man

A 78-year-old man was suffering from a list of illnesses, some which were “chronic, incurable, life-threatening, but stable”, when he was admitted to Roscommon General Hospital, the Medical Council’s Fitness to Practise Committee was told today.

Dr Sadar Ali, a former consultant respiratory physician at the hospital, is facing a number of charges of poor professional performance arising out of his care of the patient, who was admitted to the hospital on March 14th, 2011, and died three weeks later.

Dr Ali, who said he would defend himself because of the potential legal costs of up to €50,000 for the hearing, said the patient – referred to only as Mr E – showed symptoms of coughing up a yellow mucous, breathlessness, weakness and lost appetite.

Dr Ali said Mr E was also suffering from modest to severe kidney disease, severe chronic liver disease, excessive amounts of iron in various organs, type two diabetes, septic arthritis and had presented many times at the hospital where the records showed he had previously suffered a clot in his leg, and gout affecting his joints.

Dr Ali prescribed antibiotics for a chest infection and ordered medical tests.

However counsel for the medical council Neasa Bird said it was alleged Dr Ali failed to give adequate consideration in a timely manner to conditions which might have caused Mr E to have a low blood platelet count.

The platelet count did not come to the forefront of Mr E’s treatment until March 29th, on the day he had a severe nose bleed.

At today’s hearing, there were sharp exchanges when Mr E’s daughter, referred to as Ms A, told Dr Ali she had asked him to carry out tests on her father. “You said he had a chest examination,” she said.

Ms A told the hearing she was accepted her father had not been a well man, and that his chest infection had initially responded to treatment with antibiotics.

But she said she was repeatedly assured by Dr Ali that her father had a chest infection and would be getting better. She also clashed with Dr Ali over his assertion that he had spoken to Mr E on April 4th, and had found Mr E to be “talking and drowsy”.

“Your own notes said he was comatose” she said.

Dr Ali, a Fellow of the Royal College of Physicians and a consultant physician in respiratory and general internal medicine denies all allegations. He said the working situation in Roscommon hospital was “dismal” with patients on trollies for up to 48 hours. He said receiving medical teams were made up of “three very junior doctors” any one of which could be on leave at any particular time. He said it was an “extremely busy but poorly resourced hospital”.

He said he had achieved “the highest qualifications” in his field and was frequently called in the middle of the night to attend cardiac patients at Roscommon, and “thanks to the almighty” he had managed to stabilise them before they were transferred to specialist hospital the next day.

The hearing is continuing and is expected to last three days.