A DUBLIN-BASED surgeon is facing two allegations of poor professional performance at a Medical Council fitness-to-practise committee after a patient did not receive his results of a biopsy for skin cancer until 15 months after the test was carried out.
Mr S, a 58-year-old man from Knocklyon, Co Dublin, had a biopsy in August 2008, but did not find out until November 2009 that he had malignant melanoma. He died the following month.
Consultant surgeon Mashood Ahmed, originally from Pakistan, worked at the time at St Columcille’s Hospital, a public hospital in Loughlinstown, and at the Beacon Hospital, a private facility in Sandyford.
He allegedly failed to ensure the results of his patient’s biopsy were pursued or to ensure there was a follow-up appointment made for Mr S.
JP McDowell, solicitor for the Medical Council, told the committee the surgeon initially saw Mr S at his private practice in the Beacon in July 2008. He had been referred by his GP with a mole growing above his right nipple. He had asked for a private referral after waiting six months for an out-patient appointment at Tallaght Hospital.
Mr S told Dr Ahmed he could not afford to have the mole removed privately and the doctor agreed to carry out the procedure at St Columcille’s, where he was working as a locum consultant.
On August 14th, Mr S attended St Columcille’s as a day patient. The mole was removed by surgical registrar Faisal Nazir and a tissue sample was sent for testing.
Mr S was given a letter for his GP to have his stitches removed and, Mr McDowell said, was told by the staff nurse Hilda Finnamore that he would need to be seen for a follow-up six weeks later. However, he was not given a follow-up appointment and did not make one.
A report with the results of the biopsy was filed on August 21st and showed Mr S had malignant melanoma.
Mr McDowell said histology department records showed the report was sent to four parties including Dr Ahmed and the hospital’s cancer liaison nurse, though Dr Ahmed denied he received it.
Mr S went back to his GP in September for a diabetes-related appointment. He had removed the stitches himself. He was not given the results of the biopsy until he attended the emergency department at Tallaght hospital in November 2009 complaining of pain and a lump under his arm. He was told his cancer was incurable.
Counsel for Dr Ahmed, Oisín Quinn SC, said Mr S should have been given a public patient appointment at the outpatient department in St Columcille’s. His client never received the biopsy report. Dr Ahmed was a locum consultant and depended on the hospital’s systems to function, Mr Quinn said.
“It was a multifactorial set of circumstances that caused the problem here,” he said.
The wife of Mr S told the committee she believed her husband was a public patient in St Columcille’s. He could not afford private health insurance. He was not anxious about the biopsy results, and believed if there had been bad news he would have been told. Her husband was “quite astonished” when he was told in Tallaght he had cancer.
Ms Finnamore said it would have been “quite clear” to Mr S that he was to make a follow-up appointment himself to see Mr Ahmed at the Beacon. She said his file showed he had signed into St Columcille’s as a private patient. If he had been public, an outpatient appointment would have been made for him.
Cancer liaison nurse Loretta Keane said she was sent a copy of the biopsy report, but she did not become involved in the case as she had not received a request from the consultant to do so.
The case continues.
