GP faces inquiry over patient’s melon-sized abdominal mass

A GP who allegedly failed to diagnose a patient with a life-threatening abdominal infection that created a mass the size of a melon is facing allegations of poor professional performance at a Medical Council fitness-to-practise inquiry this morning.

Dr Tonya Timmons from Dublin was training at Coolock Health Centre in autumn 2011 when she treated her patient Joanne Kelly over a series of four visits. Allegations against her include that she failed to conduct an adequate examination, failed to make an adequate record of her patient’s symptoms, failed to consider any diagnosis other than nerve problem sciatica and failed to consult with her trainer in relation to her diagnosis.

The doctor denies the allegations and claims Ms Kelly did not tell her the symptoms she later complained of when she went to Beaumont Hospital.

Ms Kelly, a childcare worker, had four visits with Dr Timmons between August 2nd and October 4th and was diagnosed with a kidney infection and subsequently sciatica.

She eventually went to the emergency unit at Beaumont Hospital and was diagnosed with abdominal actinomycosis, a rare bacterial disease that created a mass in her pelvis and required surgery and intravenous antibiotics.

Giving evidence, Ms Kelly said at her last two visits to Dr Timmons she complained of symptoms including back pain, difficulty walking, dizziness, nausea, weight loss and blue lips.

She was told she had sciatica, was given prescriptions for anti-inflammatory drugs and told she needed more exercise. She was also screened for post-natal depression, having given birth to her first child four months earlier.

She said she explained she did get exercise as she had no car and also gave Irish dancing lessons to children. The last consultation, on October 4th, lasted five or 10 minutes, she said.

“I remember leaving the consultation and going to a cafe and breaking down in tears,” she said.

She went to Beaumont Hospital on October 20th after her symptoms worsened.

“Enough was enough”, she said.

Under cross-examination by Jane O’Neill BL for Dr Timmons, Ms Kelly conceded that the hospital notes taken when she was admitted did not support the timing of her symptoms which she had said she listed for Dr Timmons.

Also giving evidence, Dr Samuel McConkey, a specialist in infectious diseases from Beaumont Hospital, said actinomycosis was rare and he had only seen three cases in more than 8 years practising in Ireland. He said the abdominal mass it created was the size of a melon.

It was obstructing Ms Kelly’s urethra, the tube which drains fluid from the kidneys. This was “quite a serious problem”, he said and if left untreated could lead to death.

Dr McConkey also told the inquiry the abdominal mass was not palpable on admission to hospital.

The case continues.