A doctor who admitted he should have carried out an examination on a patient concerned about a possible internally lodged tampon has told a fitness to practise hearing his performance was not influenced by gender.
Dr Herbert Taute treated the woman during a consultation in November 2019 but did not carry out a physical examination despite her requests for one. Instead, believing it more likely to be an infection, he offered antibiotics and later prescribed an antifungal medication.
A Medical Council hearing on Monday heard Dr Taute had conceded he should have carried out an examination and he had apologised. However, in response to a belief set out in the complaint, he denied gender had played any role in his performance.
He faced four allegations including that he failed to document in his notes the history of a potentially retained tampon, and failed to have due regard to the patient’s presenting complaint. It was also alleged he failed to carry out an adequate clinical examination, and that although his medical notes stated he had carried out chest, cardiovascular and abdominal examinations, he had not done so. Dr Taute disputed the final allegation.
Expert reports submitted on behalf of Dr Taute and the complainant differed on whether the first three allegations amounted to poor professional performance. Neither offered a view on the final allegation.
The fitness to practise committee of the Medical Council heard the patient had attended Centric Health on the Navan Road in Dublin over concerns she had a retained tampon, with symptoms including a discharge, pressure around the groin and odour.
However, Dr Taute told her the cause was more likely an infection, a diagnosis she was surprised by given her lack of symptoms. In her complaint, the patient said that although she was slightly relieved that a physician was not overly concerned, she nevertheless felt “unheard”.
Her symptoms subsequently became enhanced, the committee heard, and she became embarrassed by the odour both at work and at home. The tampon later dislodged, four weeks after the consultation.
“I believe that this was a case of complete clinical mismanagement,” the complaint to the Medical Council set out.
In his initial response, Dr Taute said he appreciated why his patient would have felt he was being dismissive but that that had not been his intention and he apologised. He said he had examined her to rule out infection.
He also conceded that, whether requested or not, he should have carried out a physical exam.
Barrister Rory White, representing Dr Taute, made an application that the committee deal with the case by way of specific undertakings given by his client, and noted that in over 20 years of practice this had been the only complaint made against him.
Mr White told the committee that as well as undertaking not to repeat the conduct, he would also complete further upskilling, namely in abnormal menstrual bleeding and screening for cervical cancer. Dr Taute would also consent to formal censure by the Medical Council.
Committee chairman Paul Harkin accepted the application. He noted Dr Taute’s early acknowledgment of his conduct and said that while it was a singular event in an otherwise unblemished career, the matter could not be regarded as trivial.