Doctor became tearful when confronted about changing medical notes

Medical Council hearing told the notes related to delivery of baby who later died

 Róisín and  Mark Molloy who lost their son Mark Molloy leaving a fitness to practice hearing at the Medical Council.  File photograph: Gareth Chaney/Collins

Róisín and Mark Molloy who lost their son Mark Molloy leaving a fitness to practice hearing at the Medical Council. File photograph: Gareth Chaney/Collins

 

A doctor broke down crying after being confronted by managers about altering his notes on the delivery of a baby who died shortly after being born at Midland Regional Hospital, Portlaoise, an inquiry has heard.

The obstetrics registrar, referred to as Dr A and accused of wrongdoing at a Medical Council fitness to practice hearing, was questioned after the tragic death of baby Mark Molloy on January 24th, 2012.

Parents Róisín and Mark Molloy, from Killeigh, Co Offaly, were told their boy was stillborn but later found out he had been born alive and died about 22 minutes after unsuccessful attempts to resuscitate him.

One of a three panel team in an internal hospital investigation, who also cannot be named, said he noticed Dr A had changed a note saying a heart rate printout during delivery was satisfactory to unsatisfactory.

The word “non-reassuring” was also added retrospectively, the hearing was told.

“When Dr A admitted that the change had taken place he was very upset and I was very disappointed,” the manager said.

“I was very disappointed that he had made an addition.

“I felt he had let himself down and if he was going to significantly alter the meaning of what he had entered, he should have documented it with an explanation and signed it.

“He was changing it knowing what the end result was, probably after discussions with people. It was really only changed to his own advantage.”

The manager said he interviewed Dr A on February 19th - almost four weeks after the delivery, which he called a “catastrophe” - as part of an “in-house risk management” assessment.

Dr A became “tearful” during the interview, he told the inquiry.

The manager said there is an internationally recognised standard for altering medical notes, so any subsequent changes are made clearly, showing what had been changed and why along with time and date and signature.

“Record keeping and note amendment is something you take for granted for someone who goes through medical school,” the manager said.

“It is not something you feel you would need to reinforce.

“That is why I was so disappointed on the day, that someone would do that. When you alter the note like that you are turning everything around to your own advantage.”

He added: “It is not acceptable practice.”.

Dr A, who had only started working in the hospital two weeks beforehand, said he had sought advice from colleagues before changing his notes “but I couldn’t get any”.

“I know you can always change your documentation if you make an error,” he said.

Dr A told the inquiry he became tearful during his interview with managers because he felt he was not getting the support and advice from the hospital that other colleagues were getting.

The manager said there was “debriefing” for those involved but that Dr A was on preplanned leave overseas from the day of the delivery.

He was offered access to an employee assistance scheme, which includes counselling, during the February 29th interview.

But Dr A said he was not debriefed at all, and only had conversations with the consultant involved in the delivery when they met passing in the corridor.

The manager said he got the impression those conversations were about how the delivery was managed.

“There was probably anger on both sides at the outcome and how the delivery had been managed from the time that Dr A was called in at 7:55am that morning,” he said.

The manager said the case was escalated to the HSE’s serious incident management team after the internal hospital review was completed.

Dr A, who is accused of professional misconduct, denies the majority of seven separate allegations against him.

The inquiry was adjourned until March 12th.