A Cork GP has been cleared of five allegations of poor professional performance and of professional misconduct in a case which his solicitor argued, if upheld, would have led to "defensive medicine" with doctors being denied the right to their professional judgment.
Dr Mehboob Kukaswadia, a GP with the SouthDoc out-of-hours service in Cork city, was before the Medical Council Fitness to Practise Committee, in relation to his treatment of May O'Sullivan (64) in December 2008.
The committee heard Mrs O’Sullivan had been unwell for several days with diarrhoea and vomiting but felt well enough to go into town on December 11th 2008. Her daughter, Mary Daly, told the committee she got a call from town that day saying her mother had collapsed and was being sent home in a taxi. Her mother was weak that evening and she called the SouthDoc service. Dr Kukaswadia, originally from Pakistan and an Irish citizen since 1985, attended at 11.30 pm.
Five allegations were made against him: that he had failed to take an adequate medical history, had failed to take some or all of the relevant vital signs, including her pulse; had failed to undertake an adequate examination of Mrs O’Sullivan; had failed to advise or arrange for her transfer to hospital given her symptoms, and, had failed to make adequate record of his treatment or examination of her.
Mrs Daly had said that apart from taking her mother’s blood pressure and pinching her skin, he had not made any further physical examination. She said she followed Dr Kukaswadia’s instructions to keep her hydrated and had stayed with her until 4 am. Mrs O’Sullivan was found dead by her son later that morning.
Paul Twomey, BL, for Dr Kukaswadia, argued the patient’s symptoms had been “resolving” and a hospital admission had not been indicated. He said Mrs Daly also had believed her mother’s condition was improving. He said at issue was whether the doctor’s course of action would be judged reasonable on the day by his peers and not what would have been the best course given the benefit of hindsight.
To decide otherwise, he argued would be to hold doctors to an impossible standard which would lead to “defensive medicine” where they treated for every possible eventuality “just in case things might happen”.
“Really I would ask the Committee to consider this as a doctor’s judgment call and he is entitled to that.”
The Committee found only one of the allegations had been proven as to fact - that Dr Kukaswadia had failed to undertake an adequate examination of the patient, but found this did not amount to either professional misconduct or poor professional performance.
