Galway fertility doctor cleared of poor professional performance

A Galway fertility doctor has been cleared of poor professional performance at the Medical Council despite a finding that he did not adhere to the consent provided by a patient whose fallopian tubes he clipped.

Dr Declan Egan clipped both of Lorna McKeogh's tubes in circumstances where this was not consistent with the consent form she signed, the council's fitness to practise committee found.

However, the committee found this did not amount to poor professional performance.

Chairman Michael Ryan said the case raised a number of issues of concern. He said communications between the patient and the medical practitioner were “deficient” and the handover and referral process between other doctors and Dr Egan was “flawed and unsatisfactory”.

The consent process was unclear and unsatisfactory, Mr Ryan said. He described the sending of literature about IVF by Dr Egan’s private fertility clinic to Ms McKeogh after the procedure as “insensitive”.

The allegation against Dr Egan is that he performed a clipping of both left and right hydrosalpinges (fallopian tubes) “in circumstances where this was not consistent with the consent form dated June 2nd, 2010”.

He acknowledges he should have sought the consent of Lorna McKeogh before he clipped both her fallopian tubes but argues his action was medically justified.

Ms McKeogh, a sales executive from Mountbellew, Co Galway, says the decision by Dr Egan to clip both of the tubes, rather than just one, has rendered her infertile.

As a result of Dr Egan’s actions, she has been deprived of the opportunity to bear children naturally and may only be able to conceive using IVF, an option that involves a great deal of stress and expense.

Earlier, the hearing was told Dr Egan had acted in the best interest of his patient.

Dr Egan clipped both tubes during a procedure with the aim of enhancing the woman’s fertility and in view of delays in the health service, his barrister Eileen Barrington SC, told the hearing.

Ms Barrington was making final submissions in the fitness to practise hearing into Dr Egan, a consultant obstetrician/gynaecologist who practised until recently at University Hospital Galway and runs the private Galway Fertility Clinic. He faced a single allegation of poor professional performance.

Ms Barrington said the allegation against Dr Egan must be proven beyond reasonable doubt. Dr Egan believed that what he had done was covered by a general clause in the consent form.

This stated: “I also consent to such further or alternative operation measures or treatment as may be found necessary during the course of the operation or treatment and to the administration of general or other anaesthetics for any of these purposes”.

She said practitioners who gave evidence during the hearing were unclear as to the meaning of the clause or else said that, at the time, it covered what had happened.

What had happened was in large part the result of a communications deficit, and this could not entirely be laid at the door of Dr Egan as he was not dealing with the patient when it would have been most appropriate to discuss consent, she said.

JP McDowell, for the chief executive of the Medical Council, said that while there was some divergence among authorities in relation to the clause, a doctor was required to act in the best interests of the patients and it could not be relied upon to in relation to what had happened in this case.

None of the expert witnesses who gave evidence had said they would have done the “additional major procedure” performed by Dr Egan, he said.

Seamus Woulfe SC, legal assessor, said the clause cited by Ms Barrington should be given a relatively narrow interpretation. It primarily related to situations where was a danger to the life or health of the patient, though it could go “a little further”.

This was the sixth day of the hearing into Dr Egan, which began last September.