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Consultant cleared of dishonesty

A SENIOR consultant physician has been found not guilty of deliberately misleading a fatal accident inquiry into the death of an elderly Shetland woman six years ago.

A fitness to practice hearing of the General Medical Council is currently considering whether Dr Ken Graham should continue practicing as a consultant physician following the death of  Eileen Peterson on 9 March 2005.

This week Dr Graham admitted failing to provide adequate care when Mrs Peterson was admitted to Gilbert Bain Hospital with a chest infection from the Lerwick care home Taing House where she had lived for four years.

The 84 year old died from pneumonia just five hours after she had been discharged from hospital, even though the hospital discharge note made no mention of any chest infection.

A fatal accident inquiry 15 months later found Dr Graham and NHS Shetland could not be held responsible for Mrs Peterson’s death.

However three years after the inquiry, the Scottish Public Services Ombudsman concluded that the hospital had failed the patient on four counts and insisted the health board apologise to the family.

Before the hearing this week, Dr Graham has admitted failing to adequately assess Mrs Peterson’s level of hydration or the nature and extent of her infection.

He also admitted his decision to continue treatment with oral amoxicillin was inappropriate, as was his decision to discharge her from hospital 24 hours after she was admitted.

However the charge that he deliberately misled the fatal accident inquiry by giving evidence that he had diagnosed pneumonia and that this had been incorrectly recorded in her medical records was found not proven.

The hearing accepted that Dr Graham had diagnosed a chest infection, even though this was not recorded in the clinical notes.

The panel noted that the doctor had told Shetland’s procurator fiscal death had been caused by a “chest infection superimposed on dementia and immobility” the day after her death, prior to the results of a post mortem.

They did however decide that the consultant had misled the fatal accident inquiry by failing to draw a distinction between the terms “chest infection” and “pneumonia”, though they accepted that the doctor viewed the two terms as “interchangeable”.

In deciding he had not been acting “dishonestly” at the inquiry, the panel told Dr Graham they “weighed in the balance your previous good character and the positive testimonials from several close professional colleagues who attest to your honesty and good character”.

The panel also found Dr Graham not guilty of failing to communicate with Mrs Peterson’s family or staff at Taing House, as it was not his responsibility to do so but that of the discharge liaison nurse, who told the inquiry she had made an effort to make contact.

Now the panel is inviting the lawyers acting for the GMC and Dr Graham, Craig Sephton QC and Abhijeet Mukherjee, to make further submissions on whether his fitness to practice is impaired by reason of misconduct. A decision is expected by 2 June.

Dr Graham, a kidney specialist, joined NHS Shetland in 1998 and was promoted to medical director in 2006, two months after the outcome of the fatal accident inquiry. He stood down from the post in August last year.

In 2009 it was reported that Dr Graham earned almost £180,000 a year, making him one of the highest paid NHS professionals in Scotland, having received a pay increase of almost £40,000 the previous year.

An NHS Shetland spokeswoman said they would not comment on the fitness to practice hearing until it had been concluded.

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