Plastic surgeon guilty of professional misconduct

 

A PLASTIC surgeon was yesterday found guilty of professional misconduct in relation to his treatment of a 33-year-old Dublin woman who attended him for a breast augmentation operation.

A three-person fitness to practise inquiry team of the Irish Medical Council found six of 12 allegations made against Italian Dr Marco Loiacono in relation to his treatment of Catherine McCormack, from Swords, Co Dublin, proven beyond reasonable doubt.

They have recommended a number of conditions be attached to the retention of his name on the medical register including that he undertake an appropriate professional development programme. Their decision will now have to be ratified by a meeting of the full medical council.

It was found proven that Dr Loiacono failed to arrange for adequate post-operative treatment for Ms McCormack when he became aware her left breast had become infected some days after her surgery at an Advanced Cosmetic Surgery (ACS) clinic in Dublin in October 2006. It was also found proven that he failed to remove her left breast implant in a timely manner when an infection set in or when he saw her on November 9th or 17th, that he failed to treat the infection appropriately, failed to maintain adequate medical records, and failed to apply adequate standards of clinical competence or judgment in her case.

Ms McCormack, a receptionist and mother of three, told the inquiry last December that while she was initially happy with her surgery, one breast implant eventually had to be removed when an infection set in and she was left disfigured. She claimed her outcome after the surgery, which was to bring her from a B bra cup size to a D/DD cup, would have been much better had she received proper post-operative care.

Dr Loiacono, who now works mainly in Italy and Brazil but was operating on patients at Clane Cosmetic Clinic in Kildare and at Cosmedico in Wicklow up to late last year, denied all the allegations and conducted his own defence.

Before the fitness to practise committee reached its decision yesterday it heard evidence from Dr Peter Meagher, a reconstructive breast surgeon at Dublin’s St James’s Hospital. He said the management of Ms McCormack was “fundamentally flawed” and “suboptimal”. He said on November 9th she was clearly “in very real trouble” when Dr Loiacono reviewed her. Nursing notes from the day before referred to her left breast being red, tender and oozing. She had a severe infection and should have been admitted to hospital and put on intravenous antibiotic therapy. Infected implants must be removed, he said, as antibiotics will not work on them as they have no blood supply.

It was “reckless”, he added, to operate where there were no proper post-operative facilities to admit patients to at the ACS clinic, which has since gone into liquidation. Furthermore he said it was “unwise” of Dr Loiacono to stitch Ms McCormack’s wound when it was coming apart and oozing when he saw her again on November 17th. He regarded this as poor clinical practice. If a locum for him did this he would ensure he never worked in the same institution as him again.

He also criticised that Dr Loiacono did not see Ms McCormack for 20 days after her surgery, or for a further eight days thereafter even though she had an infection.

In his own evidence Dr Loiacono, whose contract said he would get 8 per cent commission if he earned the ACS clinic more than €25,000 a day, said Ms McCormack only had a mild infection when he saw her on November 9th and he put her on antibiotics. If he had sent her to hospital she would be in danger of picking up MRSA, he said.

He said she could have been admitted to the ACS clinic if necessary. He stressed nurses from the clinic saw the patient in the days after her operation and he was available to see her within 24 hours if required.

He added that he had carried out over 450 breast augmentations and only in three cases had infections set in. Were he to treat Ms McCormack again, he would not do anything differently.