A&E doctor warned over ‘fatigue’ rant

AN A&E doctor has avoided being struck off after an “aggressive” and “derogatory” rant at a colleague.

Dr Sebastian Johns’ outburst came after he turned up for work at Haverfordwest’s Withybush Hospital in a sleep-deprived state, a medical tribunal heard.

Dr Johns, who qualified in 2007, took up a locum post as an emergency doctor at Withybush in November 2020 and worked regular shifts there until the following May when the incident took place.

Tribunal chairwoman Becky Miller said Dr Johns had worked “an additional set of night duty on four consecutive night shifts”, finishing at 9.30am on May 14, 2021. The next day he arrived two hours late for his 9am shift after being phoned four times by a colleague, named only as Dr A, who was the consultant in charge of the A&E unit.

Dr Johns apologised for being late and said he had slept through six alarms.

Dr A asked him to make up the two hours that day so he finished his shift at 11pm. He sent Dr A an email at 2.30am raising concerns over the rota and telling her he was sleep-deprived. Dr Johns was scheduled back in work at 9am that day but arrived around 15 minutes late, according to Dr A.

Mrs Miller said: “Dr A noticed that Dr Johns was walking differently and seemed to be losing his balance and staggering. Sister Catrin Wyn Griffiths, the nurse in charge of the department, also described him as ‘wobbly.’ Sister Griffiths noticed that Dr Johns looked tired, was pale and sweaty, and looked unkempt.”

The tribunal heard that during the morning handover Dr Johns was “writing things on the whiteboard despite this typically being the role of the consultant”.

Dr A asked if he was all right and he replied: “Sleep deprivation. I haven’t slept.”

The consultant took Dr Johns into an office and asked if he had been drinking, which he denied. The tribunal chairwoman added: “Dr A asked again and said she would rather know if Dr Johns had been drinking, so she could keep the floor safe, but Dr Johns again interrupted and repeatedly stated: ‘Sleep deprivation.’ Dr Johns then became angry and told Dr A that he was sleep-deprived because of her as he had been working nights and only had one day off before starting the weekend day shift on the rota.

“Dr Johns stood up and spoke to Dr A in an aggressive manner, raising his voice and pointing at her. Dr A informed Dr Johns that he was clearly unfit for work and suggested he go home.

“However, when Dr A stood up, Dr Johns stated: ‘So fire me then’ several times and called Dr A obnoxious.

The panel concluded that Dr Johns had turned up to work while unfit and “behaved aggressively”.

They then considered whether he was fit to continue practising.

Mr Donoghue, representing the GMC, said Dr Johns’ conduct had led to Dr A breaking down in tears at work and having to take time off. But Mr Day, representing Dr Johns, argued that “like many doctors” his client was suffering with exhaustion. The panel concluded that his fitness to practise was not impaired but a warning has been placed on his registration.

Hywel Dda University Health Board did not answer whether changes had been made to the hospital’s working patterns since the incident.