Supreme Court told of doctor’s ‘one-off error’

It was “troubling” the Medical Council was seeking to sanction an “excellent” paediatrician like Prof Martin Corbally over a “one-off error” that it accepted was not serious, the Supreme Court was told by his lawyer yesterday.

The five-judge court reserved judgment on the council’s appeal against the High Court’s decision overturning its findings of poor professional performance (PPP), and a sanction of admonishment, against Dr Corbally after an incorrect tongue-tie procedure was carried out by another doctor on a two-year-old girl.

The appeal involves the Supreme Court being asked for the first time to construe the proper meaning of poor performance in the 2007 Medical Practitioners Act. The council argues that in Dr Corbally’s case the High Court incorrectly construed poor performance as meaning it must relate to a very serious issue and must be assessed across a fair sample of the doctor’s work.

Failure

Opposing the appeal, Eileen Barrington SC, for Prof Corbally, argued the High Court correctly found a hospital systems failure, rather than an admitted single error in a note made by her client, led to the incorrect procedure being carried out on the girl, a private patient of his, at Our Lady’s Hospital, Crumlin.

The systems were “not ideal but that’s the way the Irish hospital system works” and, while Dr  Corbally had lobbied for improvements, he was told there was no funding for that, counsel said.

Dr Corbally accepted he made an error in misdescribing, on a hospital out patient note, the procedure to be carried out as an “upper lingual frenulum”  when there is no such procedure and what he meant to write was “upper labial frenulum.

Dr Corbally believed he might have been tired when he made this error as he had been on call for five out of seven nights and was seeing up to 100 patients weekly, counsel said. He had also noted Ireland has the lowest number of paediatricians per head of population in Europe.

Procedure

This was a matter of misdescription, not misdiagnosis, and Dr Corbally correctly described the procedure as an upper labial frenulum on the child’s hospital admission note, she said. Due to a systems failure at the hospital, that description did not carry through to the theatre list given to Dr Corbally nine weeks later where the procedure was listed as a tongue-tie procedure.

When Dr Corbally saw the theatre list, he was not aware it included the girl, counsel said.  The theatre list listed a tongue-tie and, because Dr Corbally was called to emergency surgery, he delegated the procedure to another competent doctor.

The  incorrect tongue-tie procedure was then carried out arising from systems issues that were not the fault of Dr Corbally, she said. He had apologised to the child’s parents, quickly carried out corrective surgery and the child made a full recovery.

Ms Barrington argued the High Court construction of poor performance was correct and the Act envisaged that issues of PPP and competence were considered as a continuum and not a one-off matter.