Gynaecologist rejects patient’s account of disputed consultation

Joanne Hunt

A Dublin gynaecologist and obstetrician denies having a consultation with a patient who three days later was treated for an ectopic pregnancy. The woman and her husband say a consultation took place.

Dr Patrick Gerard Rafferty, a consultant at Mount Carmel Hospital and Landscape Clinic, both private facilities in Churchtown, faces 10 allegations of professional misconduct relating to two patients.

Michelle Howe, a 35-year-old mother of one and a patient of Dr Rafferty attended the Landscape Clinic in June 2008. Allegations against Dr Rafferty include that he failed to diagnose ectopic pregnancy, failed to advise her of the significance of the results of two blood tests and failed to make arrangements for her admission to hospital.

Ms Howe attended the clinic on Wednesday June 4th for a scheduled scan but had bleeding and pain. In evidence, Dr Rafferty said he was on holiday that week and did not have a clinical appointment with her. He said he dropped into the clinic however and saw Ms Howe and her husband.

“I said ‘great to see you, good luck with your scan’,” he said. “My recollection and my true belief is that I then left and went to get my daughter [from crèche].” The Howes contend a consultation took place.

Dr Rafferty said the sonographer later phoned him and said the scan was “inconclusive” but that an ectopic pregnancy “could not be ruled out”. To Ms Howe’s claim that he later that day told her the pregnancy was “non-continuing and looks like an ectopic”, he said that was not his recollection. He said he told her this on Friday evening, on receipt of the results of two blood tests.

Dr Rafferty said that when he told Ms Howe that Friday that she would have to attend hospital for a laparoscopy, she said she’d rather not come in.

Solicitor for the Medical Council JP McDowell asked him if he thought it was “extraordinary” that a mother of one would decline to attend for treatment if she understood she had an ectopic pregnancy, a possibly “life threatening” condition.

“If I’m at fault, I did not convey the seriousness of an ectopic,” Dr Rafferty said. “If she is angry that I didn’t make her come to the hospital on Friday night, she has a fair point.”

Ms Howe attended Mount Carmel Hospital the following evening, having collapsed in the car en route. She underwent surgery and lost one of her fallopian tubes.

Dr Rafferty also faces four allegations in relation to his treatment of a woman who lost the function in one of her kidneys after he performed a hysterectomy on her.

In 2007, he treated Cathy Coyle, from Terenue, a then 56-year old woman. The allegations include that he should have treated her more conservatively and also that he failed to have a surgeon assisting him during the procedure.

Responding to an allegation that he failed to refer Ms Coyle for a urological opinion, he said, “My thinking was erroneous”.

“I’m really sorry that she suffered what she suffered.”

The hearing continues in April.