A DOCTOR STANDS accused of multiple examples of poor professional performance and professional misconduct while working at three Irish hospitals, a Medical Council Fitness to Practice committee heard today.
It is alleged that Dr Omar Hassan misidentified an x-ray image of an ankle as being one of an elbow at a teaching session on 17 February 2014 at University Hospital Galway (UHG).
This allegation is one among more than 30 alleged examples of professional misconduct and displaying a lack of professional knowledge bordering on the “disgraceful and dishonorable”, in the words of Frank Beatty, appearing on behalf of the Medical Council Chief Executive Officer.
Among the allegations against Dr Hassan, who in a highly unusual move has chosen to represent himself rather than seeking legal advice, are the following:
Today’s hearing was delayed by five hours as Dr Hassan initially chose to appear at the hearing via Skype video call.
When it was ascertained that Dr Hassan was currently in Dublin, the hearing committee instructed him to make himself available to the hearing for 2pm this afternoon as he had provided no grounds as to how his appearance would be prejudicial against him.
The hearing had been delayed multiple times from late last year as Dr Hassan had failed repeatedly to provide himself with legal representation.
At the three hospitals that Dr Hassan worked in Ireland between July 2012 and February 2014 – Portlaoise, Galway, and Mayo General Hospital – his tenure was cut short on each occasion on grounds of concern over his clinical performance.
Prior to today’s hearing Dr Hassan was subject to a Section 60 order under the Medical Practitioners Act 2007 under which his medical registration was suspended by the Council. Such an order can be made if the Council considers that the suspension “is necessary to protect the public”.
The hearing
Today’s delayed evidence dealt with specific issues relating to Dr Hassan’s performance at Midland Regional Hospital Portlaoise in late 2012.
From the beginning Dr Hassan asserted that he was unhappy at the nature of the allegations against him.
“I think I have been treated unfairly in this case, for reasons that I am not totally aware of, I think the material used and incidents used are very vague, there are a high degree of vague terms,” he said.
Dr Hassan further stated his displeasure at having to carry the core book of evidence against him with him to the hearing.
“I shouldn’t have to carry all these documents with me. I will not hold those documents for a long time,” he said.
I have an issue with how fitness to practice panels work. I think there is a conflict of interest that they are handled on the Medical Council premises. I think they should be held in a neutral building.
“It is intimidating hearing things about you that are not entirely true,” he said.
Mr Beatty for his part expressed dismay that Dr Hassan had initially chosen to represent himself via Skype on the basis that he was in Sudan. “But he is not in Sudan, he is in Dublin,” he said.
Dr Hassan found himself frequently at odds with the hearing committee, chiefly as he tended to ask questions of witnesses that were not in discussion of factual evidence, but rather in more subjective terms as to how he was perceived by other staff at Portlaoise Hospital. He was also repeatedly admonished for speaking out of turn.
Witnesses
Mr Beatty called four witnesses regarding specific incidents at Portlaoise Hospital.
One of these, staff nurse Caitríona Brennan, had compiled an incident ‘near miss’ report on 24 September 2012 on the occasion of Dr Hassan attempting to apply an intravenous line unsuccessfully to a patient three times which resulted in the patient asserting that they did not wish to have the line applied again.
It is alleged, and the incident report states, that Dr Hassan returned to the patient, having been instructed by Brennan not to attempt to apply the line again, and attempted to insert the line for a fourth time.
According to nurse Brennan it is not normal for such a procedure, known as cannulation, to take more than two attempts. She asserted that it was her recollection that the patient had been left “hurt, with bruising” following Dr Hassan’s attempts at cannulation.
In his cross-examination of Brennan, Dr Hassan persisted in a line of questioning regarding what the medical staff in Portlaoise had thought of him at the time.
“All these allegations stem from when I was on the day wards, which was one day in five. No incidents were reported from the general wards,” he said.
Did you find my behaviour aggressive, do you think that was the case?
Ms Brennan asked whether or not she had to answer the question. The committee replied that if she felt she could answer it she was allowed to do so, but that it did not relate to the evidence on which she was asked to bear witness.
“I didn’t have any issues with you,” she said. “I didn’t have any with you either,” Dr Hassan replied.
“The incident in this case was that the patient wasn’t happy, it is not a reflection of your ability to cannulate. Respect was not maintained,” Brennan said.
Brennan conceded that she was not aware as to whether or not a registrar may have asked Hassan to try to cannulate the patient once more. Dr Hassan said that since he could not remember the incident he did not know if that was the case either.
“I think there is a degree of unfairness as to the allegations I am being asked to answer,” Dr Hassan said.
“Do you think the staff had positive views of me?” he asked.
“We are all colleagues. That is a subjective question. I can’t answer that,” Brennan replied.
“You are the one who came to give a statement against me,” said Dr Hassan. “I was legally obliged to be here,” Brennan replied. “I am here on my day off.”
Legal Counsel for the committee Patricia Dillon then asked Dr Hassan: “are you trying to suggest there was discussion against you among nurses there?” “Yes that is the case,” he replied. “Ask that question then,” said Ms Dillon.
Delays
A staff theatre nurse, Jane Wallace, then testified as to an incident report she filed citing failings on Dr Hassan’s behalf regarding a delay of admission of theatre patients on 1 October 2012.
It is alleged that Hassan failed to respond to being paged by nursing staff on that date and that he failed to admit patients in a timely manner.
“How many minutes did I delay?” he asked Wallace.
“I don’t have a specific recollection as to how many minutes,” she replied.
The incident related to the impact on my running of the surgical list that day. Minutes are irrelevant.
“How do you know it was me? You don’t mention who the other doctors on duty were,” said Hassan after rebuking Wallace for interrupting him. Hassan stated that four doctors were required in order to admit a patient to theatre in Portlaoise at that time.
“We don’t have time to be questioning things, we are busy, as I know you are aware,” she replied. “You just hope everyone is doing their jobs.”
Someone should have been in your role doing their job at that time. If you were discommoded perhaps you should have gotten someone to aid you.
“I don’t recall this particular incident,” said Hassan.
“Was I difficult to work with?” he asked.
“I can’t recall you so I can’t give you an answer,” replied Wallace. “I don’t recall much about you at all.”
“I don’t recall you either. I recall your colleague (Nurse Brennan) but not you,” Hassan replied.
I don’t think it is good that you can not recall the exact time frame. I reject your allegation, it was three years ago and I have no recollection of it.
The number of minutes is not specified. She [sic] is not very specific, if you are talking about delays and standards you should be specific about the number of minutes.
Dr Hassan then asked Wallace as to whether or not she had any questions for him.
“No, I have no questions for you,” she replied.
Unpleasant
A nurse Nicola McGlynn, who managed the operating theatre list on 5 October 2012 when it is alleged Dr Hassan also failed to answer pages from nursing staff when on duty, then testified. McGlynn filed the incident report citing Hassan regarding that date.
When Hassan asked her what she thought of him she replied “you are not one of the most pleasant people I worked with” in what was a testy exchange.
But there is nothing specific that I can recall.
“It was my impression that you did not like being instructed by nurses, or being told where to go or what to do,” she said.
“I must apologise, English is not my first language,” said Dr Hassan earlier in the session.
My attitude and relations with patients have improved hopefully.
The hearing continues.
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