Findings

Charge Characteristics

Additional Orders

Commonly
Cited Cases

Precis

Charge:  

A CAC charged that Dr Curtis was guilty of conduct unbecoming a medical practitioner which reflects adversely on his fitness to practice medicine. In particular that Dr Curtis:

1. Failed to make appropriate arrangements for the aftercare of his patient following an operation on 10 September 1993.
2. Failed to take appropriate care at the time of removal of the patient's splint on 12 October 1993.
3. Failed to consider whether further investigation or a second opinion should have been sought before proceeding with further operations on the patient.

Background:

The patient suffered a fall in March 1993. He was referred to Dr Curtis who first saw him on 16 August 1993. On 10 September 1993 the patient underwent a left rotator cuff tendon repair. His left arm and shoulder were put in an aeroplane splint. A nurse incorrectly told the patient the splint would remain on for three weeks. The patient rang Dr Curtis' surgery after three weeks but was informed Dr Curtis was out of the country. The splint was removed on 12 October 1993, some five weeks after surgery. The patient claimed Dr Curtis removed the splint and let the patient's arm drop causing him considerable pain. After the operation the patient's left shoulder was very painful and had a very limited range of movement. Over the next 2 years the patient underwent physiotherapy, two manipulations of the shoulder under anaesthetic, and three further operations. The pain and stiffness continued. On 6 March 1995 Dr Curtis advised he could do nothing further. Subsequently the patient was referred to another orthopaedic surgeon. On 7 May 1998 the patient underwent further surgery. Following that surgery the patient regained a functional range of movement and the pain in his left shoulder ceased.

Finding: 

The Tribunal found Dr Curtis was not guilty of conduct unbecoming a medical practitioner which reflects adversely on his fitness to practice medicine.

When considering particular 1, the Tribunal found that a misunderstanding did occur as to the length of time during which the aeroplane splint would be in place. The Tribunal was satisfied that it was always Dr Curtis' intention to leave the splint on for five to six weeks. The Tribunal considered that period was not excessive and was principally a matter of surgical preference. The Tribunal did not make an adverse finding with regard to Dr Curtis' failure to lower the shoulder and arm joint progressively and gradually, considering it was largely a matter of professional judgment. In this particular case the rotator cuff was subsequently demonstrated to be intact, and thus the way in which the arm was lowered in fact did no harm.

The Tribunal found particular 2 was not established. The Tribunal was unable to resolve the conflict in evidence as to the manner in which the arm was lowered following the splint's removal. However the Tribunal accepted that in whatever way the procedure was undertaken, the patient suffered severe pain.

The Tribunal found the evidence fell short of establishing particular 3.