GP censured over failure to refer suspected meningitis cases to hospital

When contacted by HSE the doctor got someone to translate call for her, Medical Council hearing told

A Medical Council fitness to practise hearing was told the GP  now understood the importance of referring suspected cases of meningitis to a hospital immediately and had developed a standard form for such cases. She will also enrol  in a diploma course in English.

A Medical Council fitness to practise hearing was told the GP now understood the importance of referring suspected cases of meningitis to a hospital immediately and had developed a standard form for such cases. She will also enrol in a diploma course in English.

 

A Dublin-based family doctor has admitted to a series of allegations of poor professional performance over her failure to refer two children with suspected meningitis to hospital.

Dr Albina Maksimiuk acknowledged before a hearing of the Medical Council’s fitness to practise committee on Monday that she had failed to refer a boy aged 3 and girl aged 14 to hospital in 2016 in circumstances where she believed they might have contracted the infectious disease.

Dr Maksimiuk, who operates a clinic for children on the North Circular Road, also admitted she had failed to adequately communicate to the children’s parents that they might be suffering from meningitis and that a referral to hospital was of extreme importance.

However, the GP denied that her failure to notify the HSE as soon as she became aware of suspected cases of meningitis as required by medical regulations and her poor command of the English language represented professional misconduct but accepted they constituted poor professional performance.

The hearing was told that Dr Maksimiuk, who has been working as a GP in Ireland since 2015, had no difficulty communicating with her patients as they were either Lithuanian or Russian.

The committee heard a complaint about the doctor was referred to the Medical Council by Dr Noelle O’Loughlin of the HSE’s Department of Public Health.

Dr O’Loughlin had been contacted in June 2016 by the owner of a creche who was seeking information about the appropriate action to take after a parent had handed in a medical certificate signed by Dr Maksimiuk stating her child had been diagnosed with meningitis.

Translate the call

Dr O’Loughlin said the HSE was concerned that the child had not been referred to the hospital as an emergency and that it had not been notified about the patient as it always treated such cases “with the highest priority”.

When contacted by the HSE, the fitness to practise committee was told that Dr Maksimiuk got someone to translate the call for her.

Dr O’Loughlin established that the GP had made a similar diagnosis of meningitis in several other cases in the preceding months and had written prescriptions for antibiotics without referring the patients to hospital.

She said there was “a danger to public health” if that was how Dr Maksimiuk was treating cases of the disease.

The mother of the 14-year-old girl, known as Patient A, said she had gone to Dr Maksimiuk on June 18, 2016 as she could not get an appointment with her regular GP. The woman said her daughter, who was complaining of severe headaches, had been given a full examination by Dr Maksimiuk including a blood test which showed she had an elevated white blood cell count.

Patient A’s mother said the doctor diagnosed it as a case of either flu or meningitis.

The witness said she was advised by Dr Maksimiuk in Russian to take her daughter to hospital if she wanted to be sure it was not meningitis.

“It was completely my decision not to go to hospital as I was sure it was not meningitis,” the woman said.

She said Dr Maksimiuk had phoned a few days later to check on her daughter and had done another blood test when they went back to her surgery a week later which showed normal results.

Under cross-examination by Séamus Clarke SC for Dr Maksimiuk, she said his client was a “very good doctor and very good with kids.”

Very good doctor

The mother of the three-year-old boy, known as Patient B, said Dr Maksimiuk told her that her son could be suffering from meningitis when he attended her surgery with headaches on April 15, 2016.

She told the committee that Dr Maksimiuk said they had come to her clinic on time and her son should be OK in a few days after being prescribed antibiotics but to go to hospital if his condition worsened.

The witness said her son was much better when the doctor rang her the following day to check on her son’s condition.

Patient B’s mother described Dr Maksimiuk as a very good doctor who was “easy to understand” and she attended her because they could communicate in Lithuanian.

The fitness to practice committee ruled that the case was an appropriate one for censuring Dr Maksimiuk and accepting undertakings on the doctor’s behalf to bring it to a conclusion, despite an objection by Eoghan O’Sullivan BL for the Medical Council.

Mr Clarke said Dr Maksimiuk now understood the importance of referring suspected cases of meningitis to a hospital immediately and had developed a standard form for such cases.

He said she had completed several English language courses since 2016 and promised to enrol in a diploma course in English at TU Dublin until she reached an advanced level.

The committee also required her to report annually for the next five years on meeting her obligations with regard to continuous professional development.