Panel hearing summary 2012.0158

Decision of the Medical Board of Australia

Performance and Professional Standards Panel

Jurisdiction: Victoria

Date of Hearing: 22 August 2012

Date of Decision: 14 November 2012

Classification of Notification:

• Clinical care – Inadequate or inappropriate treatment
• Clinical care – Inadequate or inappropriate follow up or review

Allegations

The patient visited the doctor to have a number of skin lesions assessed, resulting in the doctor surgically removing a small lesion the same day. It was alleged that the doctor behaved in a way that constituted unprofessional conduct under section 191(1)(b)(ii) of the National Law in that they:

1. inadequately performed the surgical procedure
2. did not adequately plan the surgical procedure
3. provided inadequate post-operative management.

Finding

The panel found that the doctor had behaved in a way that constituted unprofessional conduct in the ways alleged.

The surgical procedure took almost three hours and was not conducted with nursing assistance or in a fully sterile environment. The procedure resulted in an unreasonably large wound which became infected, bled excessively and left the patient with a scar. The panel found that while infection does not necessarily mean that the procedure was performed incorrectly or inadequately, these things did suggest that the procedure was poorly planned, executed and beyond the doctor’s level of expertise.

The doctor failed to provide adequate post-operative management. They did not see the patient when the patient arrived for the removal of stitches as they had instructed, despite the patient waiting three hours. They instructed the patient to dress the wound themself but failed to tell them how or consider that the patient could not do so single handed. The doctor also failed to monitor any complications, including the treatment of the infection.

Determination

The panel decided to reprimand the doctor for their failure to have adequate assistance for a procedure which was carried out without adequate planning and for their failure to provide adequate post-operative care.