A Queensland doctor has been banned for working in hospitals after a tribunal found he performed an incompetent neurological examination on a patient in an emergency department and tried to overturn the diagnosis of a specialist neurologist.
Among the allegations aired at a hearing of the Queensland Civil Administrative Tribunal was that the doctor – whose name has been suppressed – did an unnecessary and prolonged neurological examination on a patient who had already been diagnosed with functional neurological disorder, after which he announced that he had worked out a diagnosis of a rare neurodegenerative condition.
The patient complained about being subject to a unnecessarily rough and painful examination that went on for hours, during which the doctor inappropriately used the needle from a hypodermic syringe to perform multiple pin prick tests on the patient’s hands and feet, penetrating the skin.
The tribunal found the doctor lacked the skill and experience to be able to carry out a competent neurological examination and had incorrectly diagnosed the patient with a rare condition, Cerebral Autosomal Dominant Arteriopathy with Sub-cortical Infarcts and Leukoencephalopathy, (CADASIL).
The doctor, in his 50s, was suspended from his position as a Principal House Officer and the tribunal heard that he had been the subject of previous complaints about his poor communication style and professional behaviour and had restrictions put on his practice.
A psychiatrist concluded the doctor was a high functioning individual with an autism spectrum disorder (ASD) and the tribunal was told: “concerns about him at work were his being too autonomous, being impolite and disrespectful, and losing his temper with staff, poor communication, arguing with consultants or not following their advice, acting without speaking to consultants, and showing impatience and a lack of empathy.”
At the hearing witnesses said the doctor appeared to have little insight into his limitations and inappropriate behaviour.
“There was simply no reason for him to be trying to work out what [patient] B was suffering from, when that had already been determined by a consultant neurologist,” it noted.
“When the [doctor] thought he had identified the relevant neurological condition, he disclosed this to B in the middle of the night with an air of triumph, and left some pages about the condition, printed from Wikipedia, on B’s bed. B did not have that condition, which was serious, but the thought that he did have it would have caused a good deal of distress to B.”
The tribunal noted that the doctor had shown a consistent pattern over about ten years of difficulty in working as part of a hospital team.
It concluded that his professional conduct had been unsatisfactory and his impairment required restriction on his registration.
Noting that he appears to be performing adequately in his current general practice position, the tribunal required that the doctor must not practise in any position in a hospital setting, must not work alone and must work under supervision of another doctor.