Surgeon guilty of professional misconduct in 2006 death

A CONSULTANT surgeon has been found guilty of professional misconduct in a case arising from the death of a woman in a Dublin hospital four years ago.

Colette Donohoe (54), from Crumlin, Dublin, died of multiple organ failure, sepsis and severe infectious colitis at St James’s Hospital in August 2006.

The Medical Council’s Fitness to Practise Committee yesterday held standards of care and monitoring set by Dr Jarvaid Ahmad Butt had fallen seriously short of standards expected of doctors.

The committee is to recommend that the Medical Council formally admonish Dr Butt.

The committee had been told Ms Donohoe was admitted to the hospital on Thursday, August 17th, 2006, and was seen by Dr Butt the next day, when he prescribed “conservative management” of her condition.

Counsel for the Medical Council, JP McDowell, said Dr Butt’s registrar Dr Dervesh Singh had apologised that, though he examined Ms Donohoe on Saturday 19th, “no notes regarding the patient” were made over the weekend of August 19th/20th.

Mr McDowell said the committee may have to resolve whether Dr Butt saw Ms Donohoe on the morning of Monday, August 21st as he claimed, and why there were also no notes to support that claim. Ms Donohoe’s condition deteriorated that afternoon and she died the following day, August 22nd.

Mr McDowell said the absence of medical notes was totally unacceptable, but the real issue was Dr Butt’s failure to apply adequate standards of clinical judgment or competence. He recalled the evidence of two independent medical experts who, he said, had expressed serious concerns about the standard of care.

Counsel for Dr Butt, Conor Halpin, told the committee the independent experts had agreed the response to the clinical diagnosis, that of “conservative management”, was the correct one. He said it was only on the Monday that complicating factors had been triggered, and the expert advice was these complications were very rare and were a surprise.

He said the lack of note-taking was “less than ideal and nobody is denying that”, but said it was not a serious falling short which should lead to a finding of medical misconduct.

In its decision, the committee said it had found as proven the failure to make adequate clinical notes. But while it had concerns about the making of clinical notes generally, in this case it did not find the failure amounted to professional misconduct.

The committee said it was “clear from the expert evidence that careful monitoring of conservative management” was essential to patient care. Dr Butt had seriously fallen short of the standards expected of doctors in this and it had amounted to professional misconduct.

The committee also found Dr Butt had failed to employ an adequate standard of clinical judgment and competence.

In recommending admonishment as a sanction for Dr Butt, the committee said it was aware of the adverse impacts which would accrue from the finding of professional misconduct.