Doctor wins nine-year legal battle to quash sanction over UHL incident
Medic cleared in High Court
A doctor who worked as an oncology registrar at University Hospital Limerick (UHL) has won a nine-year battle to quash a finding made against him by a Medical Council fitness-to-practice committee.
At a hearing in 2015, junior doctor Saqib Ahmed (43) had faced nine allegations of professional misconduct and/or poor professional performance, but was ultimately cleared of all counts bar one.
However, the finding that he showed poor professional performance by failing to request basic blood, urine and kidney function tests for a newly admitted and “extremely unwell” patient in 2012 has now been quashed by the High Court.
Mr Justice Micheál P O’Higgins said he was not satisfied a “once-off error” crossed the threshold of seriousness for a finding of poor professional performance.
The ruling came in Dr Ahmed’s second High Court challenge to the inquiry finding, which led to him having to receive “advice”, the least serious sanction available.
A previous challenge on constitutional grounds was rejected by the High Court in 2018 and the Court of Appeal in 2021.
His latest appeal was only possible following an amendment to the Medical Practitioners Act 2007, allowing for appeals in respect of minor sanctions.
Pakistan-trained Dr Ahmed was on call at UHL on November 6, 2012 when a 28-year-old patient diagnosed with widespread lymphoma was transferred from the Bons Secours Hospital in Tralee.
As the registrar on call, he was required to admit the patient and carry out an examination.
Dr Ahmed reviewed the patient, but did not write up his notes and did not undertake the tests. He was called away to see another patient who was very unwell in the accident and emergency department.
Dr Ahmed claimed that having to deal with this other patient led him to forget to write up his notes.
Locum consultant Dr Kamal Fadalla later rang Dr Ahmed as he was concerned about the lack of admission notes.
According to Dr Fadalla, Dr Ahmed became abusive and dismissed his concerns.
The court also heard there was a “heated” conversation in which Dr Ahmed was again said to have been defensive and dismissive after the issue was raised by oncology consultant Professor Rajnish Gupta.
Prof Gupta later filed complaints.
Dr Ahmed’s “unyielding position”, the court heard, was that the tests were not required.
The matter was one of a number of incidents in which Dr Ahmed’s conduct and interactions with staff and patients were called into question.
In a 60-page ruling quashing the Medical Council sanction and the finding of the fitness-to-practice committee, Mr Justice O’Higgins said the fact Dr Ahmed made no notes was “very unsatisfactory”.
But, in mitigation, the matter was “a once-off error”, “not based on a pattern” and there had been “no consequential injury or effect”, the judge said.
He said a reasonable allowance should be made for “fog of battle” considerations.
“Hospital doctors work in hectic environments. Calls and decisions often fall to be made under pressurised conditions,” the judge said.
He noted that Dr Ahmed was called away to an overcrowded accident and emergency department to deal urgently with another patient.
“As a result, he overlooked writing up the notes. In the circumstances, it may be harsh to exclude the possibility that the same pressures contributed to his error in not ordering fresh tests,” the judge said.
Mr Justice O’Higgins said “a major factor” that led to the matter developing into disciplinary proceedings at all was the way Dr Ahmed reacted to the concerns of colleagues.
He said that instead of properly listening and heeding complaints, and perhaps learning from the episode, Dr Ahmed became defensive and aggressive and refused to accept correction.