Failure to seek consent for an examination and failure to offer the opportunity to have a chaperone present

A complaint was received by the Medical Council from the General Manager of a hospital concerning the treatment afforded by an NCHD to a female patient.

The patient, who was diabetic, attended the hospitals outpatients for an appointment. She was called by the NCHD into a consultation room. During the consultation the NCHD conducted an examination of the patient by pulling up her bra and exposing her breasts in order to listen to her heart and lungs. She was left in this position while the rest of the examination was carried out which included palpations of her stomach.

The patient was not asked for her consent to the examination nor was the necessity of the examination explained to her. She was not advised of the opportunity to have a chaperone present. During the consultation the NCHD asked the patient about her private life including her boyfriend and her marriage intentions. He sent text messages and telephoned her mobile phone (he had obtained the details of her mobile phone from the hospital chart) and took the opportunity to take a photograph of her using his mobile phone.

No notes or records were made of the consultation in the hospital chat. At the hearing of the Fitness to Practise Committee inquiry the NCHD did not attend nor was he represented. The inquiry heard evidence from the patient and from a number of other witnesses from the hospital. The inquiry also heard that the NCHD had left the hospital without giving notice.

The inquiry found the allegations against the NCHD proved and that they amounted to professional misconduct. The inquiry found that the NCHD had breached the inherent trust in the doctor patient relationship and recommended that his registration be cancelled.

Subsequently the Council decided to cancel his registration and that decision was confirmed by the High Court.