North Sydney doctor receives reprimand
Failed to recognize rare but serious condition and arrange emergency care for patient
A North Sydney doctor has received a reprimand from the Nova Scotia College of Physicians and Surgeons for failing to recognize a rare but serious condition and arrange emergency care for a patient.
John Kirkpatrick consented to the reprimand following an investigation carried out by the college after it received a complaint. He will also contribute to the cost of the college’s investigation.
The decision notes that the investigation committee was concerned that Kirkpatrick does not appear to acknowledge the extent of his role in missing the diagnosis.
“Despite this being an uncommon condition, Patient X’s presentation had enough classical features that the committee believes it should have been considered in the differential diagnosis,” the decision states.
The patient in the matter had complained to Kirkpatrick on a few occasions about severe lower back pain and in late 2015 was sent for scans at the Northside General Hospital where it was confirmed the patient suffered from a disk herniation. The patient saw Kirkpatrick two or three times afterward, as well as a pain specialist with Kirkpatrick, and was prescribed an anti-inflammatory drug.
On Feb. 22, 2016, the patient complained of severe pain again and Kirkpatrick prescribed morphine. Two days later, the pain had increased, the patient had difficulty urinating, his lower extremities were becoming numb and Kirkpatrick prescribed a nerve medication.
The next morning, he woke up completely numb from the waist down and called an ambulance. After undergoing a scan at the Northside General, he was sent to Halifax for emergency surgery. He was told that an extreme disk herniation had crushed his spinal nerve. He now suffers from cauda equina syndrome, which he said has “ruined his career, family life, bowel and bladder, sensation from the waist down and his sex life,” the decision states.
In his defence Kirkpatrick said he has treated the patient for more than 20 years for conditions including chronic back pain and asthma and illnesses including severe pneumonia. The decision notes that he said he treated the patient with respect and, to the best of his ability, has taken all of his medical complaints very seriously.
Kirkpatrick also said he believes his medical judgment is sound and that he provides good care to his patients. He was not aware of having ever had a patient with acute and chronic disc disease that so rapidly progressed to cauda equina syndrome.
The committee considered mitigating factors including Kirkpatrick’s long career with no past history of complaints with the college. He was also assessed as doing excellent record keeping and appropriate exams and follow up of patients and is likely being an excellent family doctor.
Kirkpatrick has been licensed to practice medicine in Nova Scotia since 1983.