Judgment was reserved this afternoon in a fitness to practice inquiry concerning seven allegations of professional misconduct against a trainee GP.
Dr Samuel McManus (31) is accused of altering the patient notes of an Eritrean asylum seeker who was found hanging in a shower at the Mater hospital’s psychiatric unit.
The man had been taken to the hospital’s emergency department the night before after he threw himself into the river Liffey. Hours after his admission to the psychiatric unit he was found hanging in the shower. He died two weeks later.
After the man’s suicide attempt it was discovered that Dr McManus had crossed out the words “high” and “risk” in the phrase “high suicide risk” and added the word “attempt”. He also entered “denied” beside “suicide ideation”.
Prof Patricia Casey, a consultant psychiatrist at the hospital, gave evidence that a nurse had drawn her attention to alterations to the patient’s notes.
She raised the matter with Dr McManus but wasn’t able to ascertain whether the changes were made before the man’s suicide attempt or after it. She said the changes to the notes “suggested an attempt was being made to undermine the level of risk the gentleman was posing when he was seen”.
However, an independent expert called by the Medical Council, psychiatrist Dr Siobhán Barry, said it was not unusual for entries in medical notes to be made retrospectively when people were busy.
Dr Barry said she did not believe the changes altered the meaning of the notes but added that she would have expected the changes to have been timed and dated.
Simon Mills, counsel for Dr McManus, said the entire case had been based on a “false premise”. He said Dr McManus had admitted changing the notes from the outset and had acknowledged that he should not have done it the way he did.
Mr Mills said the changes to the notes were not inappropriate and did not alter their meaning. He said Dr McManus’s actions did not amount to a serious falling short of the standards expected of a doctor and therefore he should not be found guilty of professional misconduct.
J.P. McDowell, counsel for the chief executive of the Medical Council, said the changes Dr MacManus made to the notes were significant and entirely altered their meaning. He said the Mater hospital thought it significant enough to write to the Medical Council and that there was enough evidence for the committee to find for professional misconduct.
After an adjournment of an hour and a half, chairwoman Dr Deirdre Madden said the committee needed time to read transcripts and documentation related to the case and reserved judgment. Mr Mills objected but was overruled. Dr Madden said relevant parties would be notified of their decision.