File Number: Med19/446P
Practitioner: Medhane Hagos Mesgena
Hearing Start Date:
Hearing End Date:
Examination - inadequate/inappropriate (Established)
Note taking - inadequate/inappropriate (Established)
Failure to record (Established)
Records - inappropriate storage (Established)
Name Suppression to Practitioner
Practitioner granted interim name suppression
Precis of Decision:
On 4 December 2019, the Health Practitioners Disciplinary Tribunal (the Tribunal) considered a charge laid by a Professional Conduct Committee against Dr Medhane Hagos Mesgena, medical practitioner formerly of Napier (the Doctor).
The particulars of the charge alleged the Doctor failed:
- to adequately assess a 12 year Patient with a developmental impairment; to take adequate notes during the consultation; and to record his notes in a timely manner;
- to document any record of consultations; to note consultations in a timely manner; and that he made retrospective entries in records without any annotation of that fact;
- to adequately document the care provided on 22 occasions; and
- to take reasonable steps to ensure that patient health information was safe and secure in respect of a period he was away from New Zealand which was 23 November to 2016 and 10 February 2017.
Charge Details and Background
The 12 year old Patient had a developmental age of about 6 years and she attended the surgery with her social worker. She was under the care and protection of Child Youth and Family Services at the time and was living in a family group home. On arrival at the surgery the Patient was triaged by a nurse who established that the Patient was most likely sexually active and she complained of vaginal discharge and other symptoms.
It was alleged the Doctor did not adequately examine the Patient as he did not do a pelvic examination. His notes were inadequate and were not made in a timely manner.
The Doctor’s practice management software automatically generated a notification to staff at the end of each day, in respect of each patient when a consultation is marked on the system, but no consultation notes were entered into a patient record. In the period set out in the charge 77 notifications were sent to the Doctor warning him that there were no notes entered in respect of consultations completed.
- In respect of 3 of the 77 notifications the Doctor created patient notes for those consultations on the same day as the notification.
- In respect of 13 of the 77 notifications, he did not create any patient notes at all in respect of the consultations
- In respect of 55 of the consultations of the 77 notifications, the Doctor entered notes more than 24 hours after the consultation.
- On 27 occasions the Doctor entered notes more than 24 hours after the date of the consultation without any annotation indicating that his notes had been entered after the date of the relevant consultation.
On 22 Occasions the Doctor failed adequately to document the care he provided. His notes did not provide sufficient information to determine a baseline from which to review a patient’s progress.
On 23 November 2016 the Doctor parked his car at Hawke’s Bay Airport. He left New Zealand that day and returned to Auckland 31 January 2017. He left his vehicle unlocked in a short-term public car park with miscellaneous items in his car including documents containing private health patient information and a laptop.
The Doctor accepted that his conduct amounted to professional misconduct and the hearing proceeded on the basis of an Agreed Summary of Facts. The only issue of contention was that the PCC submitted that each of the particulars separately amounted to professional misconduct whereas the Doctor submitted that the conduct only amounted to professional misconduct when the four particulars were considered cumulatively.
The Tribunal found the Doctor did not adequately assess the Patient, by a majority of four to one. The majority found that this conduct separately warranted disciplinary sanction. The minority member was not satisfied the Doctor did not adequately assess the patient. On the balance of probabilities the minority member accepted the Doctor may have intended to examine her further. Therefore, the minority member did not consider this part of Particular 1 was established.
The rest of the Charge was found to be established by the full Tribunal in all its particulars and sub-particulars with each cumulatively and separately warranting disciplinary sanction.
- censured the Doctor;
- fined the Doctor $2000 in respect of Particular 4;
- imposed three conditions on the Doctor’s practice which will apply for a period of three years, following his commencement of practice in New Zealand;
- ordered the Doctor pay costs of $40,000; and
- ordered publication of the decision.