Doctor defended at misconduct hearing

A consultant radiologist accused of professional misconduct conveyed “quite accurately” the findings of an MRI scan on a 23-year-old man who later died of brain damage, the Medical Council Fitness to Practise Committee heard in Dublin today.

Dr John Hanson (40), from Malahide, Co Dublin, is facing nine accusations of professional misconduct in relation to a case in which a patient died in April 2008.

Mark Haran, a DIT business graduate, from Moorechurch, Julianstown, Co Meath, died at Beaumont Hospital in Dublin on April 4th, 2008 after being transferred there from Our Lady of Lourdes Hospital in Drogheda.

Expert witness Dr Catriona Good, a senior lecturer at Brighton and Sussex Medical School, said her interpretation of an MRI scan carried out by Dr Hanson at Our Lady’s on March 24th, 2008, found “no convincing evidence of acute raised intercranial pressure”.

She said the scan indicated moderate swelling in brain ventricles but she found no evidence of a medical emergency.

Dr Hanson has been accused of failing to diagnose Mr Haran with acute intracranial pressure and/or hydrocephalus (water on the brain), after examining the MRI scan. He is also charged with failing to communicate his report on the scan “adequately or at all” and failing to furnish a written report within an adequate time.

Intern Dr Udim Damanchi took a verbal report from Dr Hanson, the contents of which were disputed.

While Dr Good said it was common for radiologists to have a clinical discussion with someone more senior after diagnosing water on the brain, she said she saw “no urgency” in this case.

“Ideally they would have discussed that but there was no clinical emergency at this stage which would have stimulated an urgent referral to a neurological team," she said. “In the context where there is no emergency then there is no absolute rule."

To produce a timely report “would have been gold standard”, she said. But, “by the very nature of our jobs that is not always possible.”

Mr Haran was discharged on March 28th and was readmitted on April 2nd with severe headache with vomiting.

When his file was examined, the report for the MRI scan taken in March was not in it. Dr Hanson had not written it up and was too busy to deal with the matter as he was about to perform a procedure on another patient.

Asked if Dr Hanson had any obligation to see to Mr Hanan’s report once he presented again, Dr Good said Dr Hansen was correct to carry out the procedure. “In the absence of clinical information it was appropriate for Dr Hanson to complete his procedure and report later - otherwise he would have put the other patient at risk.”

She said if the medical team present was concerned at the clinical condition of Mr Hanan, “they should have made that explicitly clear to Dr Hanson.”

She said the radiologist does not interact “directly” with the patient and as such it is “quite difficult” for him to get an idea of the picture unless it is very accurately conveyed.

The hearing will continue on January 13th.