An incident with a racist patient helped a locum GP recall the details of a subsequent house visit that is the subject of a disciplinary inquiry, he has told the Medical Council.
Dr Salaheldin Ahmed, with an address in Cavan, faces six allegations of poor professional performance over his treatment of the late Louis Kinsella in April 2017. He denies he failed to properly examine or take an adequate history of Mr Kinsella during his visit.
The doctor said immediately before he was due to visit Mr Kinsella, he was scheduled to make a call to a woman patient in south Dublin.
However, he said when the driver of his Mediserve car phoned that patient to say the doctor was coming, she asked ‘Is he Irish? Is he white?’
The driver contacted their office to say they would not be seeing this woman and they went to the next patient on the list, Mr Kinsella.
Dr Ahmed told his barrister, David Dodd, that his clear memory of the incident helped him recall the details of the subsequent visit to Mr Kinsella after Anna Kinsella, the patient's wife, filed a complaint.
“I didn’t recall [THE DETAILS]but when I went back to the notes and talked to the driver everything dawned on me,” he said.
He had earlier been accused by Eoghan O’Sullivan, barrister for the Medical Council, of giving a “completely inconsistent” account of events in evidence compared to what he had said when initially responding to Mrs Kinsella’s complaint three weeks after his visit to her house.
‘Making up’
Mr O’Sullivan accused the witness of “making this up as you go along” in relation to Mr Kinsella’s condition. Dr Ahmed denied this and said his memory of the Kinsella visit had been jogged by the incident that occurred that morning.
Mr Kinsella later died of lung cancer but the allegations at the Medical Council relate solely to the out-of-hours consultation in his house on that date and not his ultimate cause of death.
In earlier evidence to the inquiry, Mrs Kinsella said she called the out-of-hours GP service when her husband, who had Alzheimer’s, became very ill. She said Dr Ahmed, in a brief visit, failed to examine her husband, take his blood pressure or pulse, or test a urine sample she had ready.
Mr Kinsella’s condition continued to worsen and the following day his family called an ambulance. He was admitted to hospital, where an x-ray showed evidence of lung cancer and treatment was discontinued. He died in May 2017.
In his evidence on Wednesday, Dr Ahmed said when he arrived, Mrs Kinsella opened the door, showed him some immodium and said her husband had been using it for three days. She said he had improved and was sleeping upstairs.
Mrs Kinsella guided him upstairs; he did not go before her, as Mrs Kinsella has claimed, as this was “not my culture”.
“She requested me not to disturb her husband because this was the first time had had rest or sleep in the last three days. She did not want him disturbed.”
Comfortable
Dr Ahmed said he went to see the patient, and he asked questions about symptoms and past medical history. He found the patient appeared comfortable and did not look dehydrated other than his lips were dry.
“I agreed with Mrs Kinsella’s request not to disturb and said he would benefit from dialoryte. She was satisfied with that and I left.”
Dr Ahmed agreed that he had not had physical contact with the patient, but said that after 35 years of practice he was able to assess patients by inspection. He said there was no mention by Mrs Kinsella of her husband having a cough, as she had claimed.
In the afternoon, a row broke out between the legal teams over the submission by Dr Ahmed’s lawyers on Wednesday of an expert report asserting there was no poor professional performance involved in his attendance on Mr Kinsella.
After an adjournment, fitness to practise committee chairman Joe O’Donovan ruled evidence would be taken from the author of the report, Prof Colin Bradley of UCC, in the presence of the Medical Council’s expert witness Prof Tom Fahey of RCSI, who has previously given evidence. Prof Fahey, who supports the Medical Council’s contention of poor professional performance, may then be called to give further evidence.
The hearing will resume next week.
