A doctor who said he did not think falsifying his patient’s test results was “a big deal” has given an undertaking at a Medical Council fitness-to-practise inquiry not to do it again.
Dr John Stewart McKenna (28) from Co Sligo, now a senior house officer at Our Lady’s Children’s Hospital, Crumlin, was working at St Michael’s Hospital in Dún Laoghaire when the incident occurred.
Taking into account Dr McKenna’s inexperience, his immediate admission of his actions and references from colleagues, the inquiry committee yesterday decided to make no findings of professional misconduct or poor professional performance against him.
Under section 67 of the Medical Practitioners’ Act 2007, he consented to be censured by the Medical Council and gave an undertaking not to repeat the conduct complained of. The committee said it wished to emphasise that “the falsification of results by any doctor, for any reason, can never be justified”.
The inquiry in Dublin was dealing with allegations of professional misconduct or poor professional performance against Dr McKenna. His employment at St Michael’s was ended after an investigation into his behaviour.
On March 23rd, 2011, Dr McKenna falsified blood tests for a patient he was referring to the hospital’s Warfarin clinic. Explaining he thought it would be “better for the patient”, he told the inquiry: “I consciously changed the INR results hoping he’d get into the Warfarin clinic . . . I didn’t think it was a big deal . . thought it was commonplace,” he said.
Expert witness Dr Melanie Cotter, a consultant haematologist at Crumlin children’s hospital called by counsel for Dr McKenna, said “falsifying results is not something to be approved of. However I can see his motivations.”
Responding to questions from the inquiry committee, Dr Cotter said: “I’ve come across doctors who have falsified results before.” She added: “I have seen doctors produce results which are not true.”
‘A waste of time’
Dr McKenna also faced an allegation of refusing to rechart drugs required by a patient, when on March 19th he told a staff nurse it was “a waste of time and paper” and he was “refusing on a point of principle”.
“I thought the nurses were being awkward and difficult,” he told the inquiry.
When the then assistant director of nursing, Karen Sweeney, told him it was hospital policy to rechart drugs and that nursing staff could not administer the medications unless he did so, Dr McKenna still refused, the inquiry heard.
Under cross-examination by Kate Dawson, for the Medical Council, Dr McKenna said: “I still thought the nurses would be reasonable about it and would administer the drugs.”
Dr McKenna recharted the drugs 15 minutes after his conversation with Ms Sweeney.
No memory
When asked why he did not tell her he was going rechart them, he said: “I just wanted to get off the phone from her.”
In defence of his refusal to review a patient who had fallen out of bed during the night, telling a nurse, “I don’t care”, he said he did not remember the conversation and could not dispute it.
Asked why, when he was again asked to review the patient next morning, he agreed to do it but then did not do it, he said: “I just agreed with what he wanted me to say.
“I knew a new team was coming in . . . I thought the patient was going to be reviewed by their own team,” he said.
Dr McKenna who began work at St Michael’s in January 2011, said he “didn’t enjoy it” and found his supervising consultant “quite hard to get on with”. Working 40-70 hours a week, Dr McKenna said, was not compliant with the European working time directive. He said he was also getting up at 5am to train for an Iron Man competition.
“Because I was tired a lot, it had a negative effect on my interpersonal skills,” he said.
