A JUNIOR doctor gave a patient an injection of salt and water to “placate” a nurse who wanted him to administer intravenously a prescribed antibiotic which he didn’t feel was needed, a Medical Council fitness to practise inquiry was told yesterday.
The inquiry heard Dr Lee Seng Khoo later tried to cover up what he had done and when asked by a consultant at Sligo General Hospital for the vial from which he had taken the solution he injected into the patient, he produced a “counterfeit” one which did not originate in the hospital.
The incident happened on August 14th last year after Dr Khoo had worked a 28-hour shift. The hospital subsequently dismissed him and lodged a complaint with the Medical Council.
The council’s three-person fitness to practise committee chaired by Mary Culliton yesterday found the allegations against Dr Khoo proven beyond reasonable doubt and found him guilty of professional misconduct. They fined him €2,500, ordered that his name be suspended from the medical register for three months and that he be censured in writing.
Ms Culliton said the committee took into account the fact that Dr Khoo admitted 13 of the 14 allegations against him. What he did amounted to “serious dishonesty” and he also failed to deliver appropriate care to a patient, she said.
Giving evidence, nurse Elaine Gorman said the elderly patient was about to go to theatre for investigation of gallstones and a medical registrar had ordered the antibiotic ciprofloxacin be given in advance. As the woman was nauseous, she asked Dr Khoo to give it intravenously.
She said he administered it quite quickly in a single push, when normally it would take time to administer the antibiotic. She questioned him and he said he had consulted a medical guide.
As he walked away she told him she needed to know what he had given the patient. He seemed quite agitated. She admitted she had previously taken the doctor, who was from Malaysia but trained at the Royal College of Surgeons in Ireland, to task over the way he cannulated a patient.
In evidence by video link from Malaysia, Dr Khoo said when he looked at the patient’s chart he saw she had already got 500mg of antibiotic orally, felt this was adequate and there was no point in giving her more. He admitted not asking the nurse about this chart.
He said the nurse had been rude to him before and so he gave the patient an injection to placate her.
Dr Khoo, who had started work in Sligo as a senior house officer on July 1st 2008, admitted he had a lapse of judgment and said what he did, in hindsight, was highly inappropriate.
He said he subsequently tried to cover up what happened because he was scared.
He is currently lecturing in surgery at the University of Malaysia and writing a book. He does not intend to return to work in Ireland, he said.
Iftikher Ahmed, a consultant surgeon at the hospital, said the patient who was given the saline solution came to no harm but without the antibiotic which she was due to get, she was at risk of septicaemia and renal shut down.
He said when he asked Dr Khoo to produce the vial from which he had taken the solution he administered to the patient he produced one which clearly did not originate in the hospital. It appeared he had got it from a friend abroad.
The fitness to practise committee’s decision will now have to be ratified by a meeting of the full Medical Council in September.
Yesterday’s inquiry was the second into the fitness to practise of a doctor to be held in public since new legislation was introduced.