THE MEDICAL Council reserved judgment yesterday in a fitness to practise inquiry concerning seven allegations of professional misconduct against a trainee doctor accused of improperly changing patient notes.
Dr Samuel McManus (31) is accused of altering the notes of an Eritrean asylum-seeker after he was found hanging in the Mater hospital. The man had been taken to the hospital the previous night after he had thrown himself into the river Liffey. Within hours of admission to the psychiatric unit he was found hanging in a shower. He died two weeks later.
After the suicide attempt it was discovered Dr McManus had crossed out “high” and “risk” in the phrase “high suicide risk” in the patient’s notes, and had inserted the word “attempt”. He also entered “denied” beside “suicide ideation”.
Prof Patricia Casey, a consultant psychiatrist at the hospital, gave evidence that a nurse had drawn her attention to the alterations.
She raised the matter with Dr McManus but was unable to ascertain whether the changes were made before or after the man’s suicide attempt. She said the changes “suggested an attempt was being made to undermine the level of risk the gentleman was posing when he was seen”.
An independent expert called by the Medical Council, psychiatrist Dr Siobhán Barry, said she did not believe the changes altered the meaning of the notes but added she would have expected them to have been timed and dated.
Simon Mills, counsel for Dr McManus, said the entire case had been based on a “false premise”. He said Dr McManus had admitted from the outset that he had changed the notes, and had acknowledged he should not have done so the way he did.
Mr Mills said the changes to the notes were not inappropriate and did not alter their meaning. He said Dr McManus’s actions did not amount to a serious falling short of standards expected of a doctor and therefore he should not be found guilty of professional misconduct.
However, JP McDowell, counsel for the chief executive of the Medical Council, said the changes Dr McManus made to the notes were significant and entirely altered their meaning. He said the Mater hospital thought it significant enough to write to the Medical Council and there was enough evidence for the committee to find for professional misconduct.
After an adjournment, committee chairwoman Dr Deirdre Madden said they needed time to read transcripts and documentation related to the case; and she reserved judgment. Mr Mills objected but was overruled. Dr Madden said relevant parties would be notified of their decision.