An expert witness told a Medical Council fitness to practise committee yesterday the system used to track medical records by the former president of the Medical Council in his private practice was not adequate.
Professor Peter Selby, consultant physician at Manchester Royal Infirmary, said he didn't quite understand how the system at Dr Colm Quigley 's private office worked.
“It does sound like it was possible to slip through the cracks,” he said.
Dr Quigley, consultant physician practising at Wexford General Hospital and The Ely Hospital at Ferrybank, Co Wexford and also formerly the president of the Irish Hospital Consultants' Association, faced nine allegations in relation to his treatment of an unnamed patient in 2009 and 2010.
Neasa Bird BL, for the Medical Council, told the inquiry Patient X, a carpenter and a smoker, first went to see the consultant, who is clinical director at Wexford general, at Ely Hospital on August 27th 2009. He had been referred by his GP as he had low sodium in the blood. After the appointment, Dr Quigley wrote to the GP and said he would be carrying out a series of tests on Patient X to investigate the cause. But the tests were never carried out.
Patient X, who also suffered from peripheral vascular disease, was referred again to Dr Quigley in December 2010 with a letter from his GP saying he was worried there was an “undiagnosed problem”. The consultant made “rudimentary notes”, Ms Bird said, and did not carry out the investigations. He did prescribe a drug called nifedipine for him, though the same drug under a different brand name had already been prescribed for Patient X.
In early 2011, the patient was very unwell and was admitted to hospital where he had his left lower leg amputated. In the course of investigations there he was diagnosed with inoperable lung cancer and died on April 16th.
The allegations of poor professional performance against Dr Quigley included that he failed to arrange for and pursue investigations,failed to take any or adequate medical history or carry out any or adequate examination, and prescribed a drug when the same drug under a different brand name had already been prescribed.
Prof Selby also said he was concerned that when Dr Quigley had an opportunity to correct the mistake and arrange for the tests to be carried out he failed to do so. He should have been asking “why on earth” he didn't have the test results. “There is no evidence that question was ever asked,” he said.
Paul Anthony McDermott BL, counsel for Dr Quigley, said his client offered his condolences to the family. Dr Quigley was "clear he should be open to scrutiny", he said. What occurred was a mistake, which can happen "when you have a paper-based system", as was the case "in this part of the country".
The doctor denied poor professional performance, Mr McDermott said.
"The mere fact mistakes occurred doesn't mean his performance is to a lesser standard than other doctors in Ireland. "
Patient X’s wife, Ms A, told the inquiry Dr Quigley wrote to her husband after he had died about a follow-up appointment. Her 18-year-old son opened the letter, she said. She subsequently wrote to Dr Quigley on three occasions asking why he had not followed through on tests for her husband. She got no response, though she acknowledged the doctor had phoned her home to offer his condolences.
Ms A said she hoped some sort of administration would be put in place so what happened to her husband “would not happen again”.
Ms B, Dr Quigley’s private medical secretary, told the inquiry the system for handling files had not changed since the incident with Patient X.
The inquiry continues on Tuesday
