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Consultant to carry on despite misconduct

Dr Ken Graham

A SENIOR consultant at Lerwick’s Gilbert Bain Hospital is to be allowed to continue to practice despite admitting misconduct over the death of an elderly Shetland woman in 2005.

A General Medical Council fitness to practice panel has decided that Dr Ken Graham had expressed “genuine regret” about the death of Eileen Peterson and learned enough lessons to be allowed to carry on working as a consultant physician.

After the determination was announced, Mrs Peterson’s family said Dr Graham and NHS Shetland have a period of “quiet reflection” over the matter.

After four days of evidence and submissions, the panel on Friday told Dr Graham there was “no doubt that the gravity of your misconduct would have resulted in a finding that your fitness to practice was impaired at the time”.

However they said that he had been through “what can only be described as a chastening learning experience” over the ensuing six years, including three inquiries into Mrs Peterson’s death, and had subsequently improved his own and the hospital’s standards of practice.

the late Eileen Peterson

The 84 year old woman was admitted to Gilbert Bain Hospital on 8 March 2005 with a chest infection and released the following day with a prescription for oral amoxicillin. She died five hours later from pneumonia.

A fatal accident inquiry in 2006 cleared Dr Graham and NHS Shetland of any responsibility for her death, however in 2009 the Scottish Public Service Ombudsman decided Mrs Peterson had been let down following a two year inquiry. They demanded the health board apologise to the family.

During this week’s fitness to practice hearing in Manchester, Dr Graham admitted that he had failed to provide adequate care for Mrs Peterson during her 24 hours in hospital, and that his discharge notes were inadequate as they failed to mention any chest infection or pneumonia.

However he was cleared of deliberately misleading the fatal accident inquiry when he told Sheriff Principal Sir Stephen Young that he had diagnosed pneumonia and this had been incorrectly recorded in her medical records.

On Friday the panel took account of a “glowing testimonial” for Dr Graham from NHS Shetland’s director of public health Sarah Taylor, along with many positive comments from fellow medical practitioners, notably west side GP Helen Ward.

They also noted that in his role as medical director with NHS Shetland from 2006 to 2010 the consultant had to review and scrutinise complaints against other clinicians, which provided “an opportunity to reflect on your failings and to learn from them”.

Dr Graham told the panel he had made several improvements to clinical systems within the hospital, including ensuring high standards of note keeping, an early medical warning system, reliable discharge letters and fortnightly meetings to analyse critical incidents including deaths on the ward.

“The panel is satisfied that you have demonstrated substantial insight and remedied your clinical failings,” it said in a statement on Friday morning.

“The panel is of the view that these proceedings have had a salutary effect upon you and that it is highly unlikely that you would repeat such behaviour in the future.

“It is clear to the panel that you are a highly regarded physician who has contributed significantly to the development and implementation of clinical standards locally.

“The panel has carefully considered all the evidence placed before it and in the circumstances of your case has determined that allowing you to resume unrestricted practice would not place patients at risk, nor would it damage the public’s confidence in the profession.”

The panel has also decided that there is no need to impose a warning on Dr Graham’s registration as a doctor, saying it would be disproportionate and unnecessary.

Speaking after the determination was announced, Mrs Peterson’s son Michael said: “Contrary to what he claimed at the fatal accident inquiry in 2006, Dr Graham has now admitted that he failed to adequately assess my late mother’s hydration, the nature and extent of her infection and that his decision to continue to treat her with an oral antibiotic and to discharge her were inappropriate.

“The panel has found that his conduct was unacceptable and would be regarded as deplorable by fellow practitioners and I welcome that it has determined that Dr Graham’s conduct was serious and amounted to misconduct.

“This should properly now be a time of quiet reflection for both Dr Graham and the board and at the moment I am anxious that any dialogue should not be conducted through the press.”

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