A Cork-based doctor who was the subject of a complaint for prescribing an oral contraceptive to two older, high-risk patients and advertising herself as a gynaecologist despite having no authorisation from Irish medical authorities has been cleared of charges of professional misconduct and poor professional performance.
Dr Dorota Sanocka, who practices at Our Clinic Sanocka based at Clogheen Business Park, Co Cork, was the subject of a seven-day inquiry by the Irish Medical Council earlier this year.
The council’s fitness to practise committee issued its ruling on Wednesday that three allegations of poor professional performance against Dr Sanocka over her care of two patients had not been proven beyond reasonable doubt.
Concerns about Dr Sanocka had been raised by doctors from the Owenabue Medical Centre in Carrigaline, Co Cork, where the two patients normally attend.
The inquiry heard that Dr Sanocka prescribed Yasmin, an oral contraceptive containing both oestrogen and progesterone, to a 47-year-old woman known as Patient A with high blood pressure who was also a smoker on March 31st, 2016.
She was also accused of prescribing Yasmin to treat an ovarian cyst in a 60-year-old woman, known as Patient B, who suffered from hypertension and high cholesterol on November 23rd, 2015, and faced a separate allegation of failing to refer the woman for further investigation of an ovarian mass.
Given her medical history, Patient A’s family doctor, Dr Eimear McCarthy, told the inquiry she was “surprised and concerned” for the woman’s welfare after hearing she had been prescribed Yasmin by Dr Sanocka.
Dr McCarthy said she advised Patient A to stop taking the medicine due to the fact that she was over 35 and a smoker, which placed her at an increased risk of blood clots and higher blood pressure.
Her practice colleague, Dr Caroline Wallace, outlined how she was unhappy at being asked by Patient B to transcribe a prescription for Yasmin as it was “inappropriate for someone over 50″.
Dr Wallace said Yasmin was not the right choice of treatment for cysts in post-menopausal women.
However, Dr Sanocka claimed she had prescribed the oral contraceptive as a treatment for the patient’s ovarian cysts as an alternative to invasive surgery.
Explaining its findings, the committee’s chairman, Paul Harkin, said there had been conflicting evidence between expert witnesses for the medical council and Dr Sanocka on whether it was appropriate to deviate from guidelines concerning use of the combined contraceptive pill given the circumstances of both patients.
Mr Harkin said the committee was not satisfied it could make a finding of poor professional performance in either case beyond reasonable doubt given the conflict in evidence.
He said the committee was also concerned that the guidelines were not the appropriate reference to determine the case as they were designed for the prescription of the combined contraceptive pill for contraceptive uses and not to treat heavy or prolonged menstrual bleeding.
“All the expert witnesses acknowledged that there are circumstances where it might be appropriate to deviate from the guidelines,” Mr Harkin added.
He said a departure from such guidelines could not automatically constitute poor professional performance.
On the alleged failure of Dr Sanocka to refer Patient B to see a consultant, the committee said the facts of the allegation had not been proven as it was not clear that such a referral was warranted.
Dr Sanocka was also cleared of a separate allegation of professional misconduct over a posting on her clinic’s website on March 22nd, 2017, saying she was a highly regarded specialist in gynaecology, obstetrics and andrology when she was not listed on the Medical Council’s register to conduct specialist medicine.
A Polish national who qualified as a doctor in 1987, she has been certified since October 2012 to practise in Ireland. She told the inquiry she had a degree and diploma in gynaecology and was the author of many publications used for the training of doctors in Poland.