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DISCIPLINARY INQUIRIES
OF THE VETERINARY SURGEONS BOARD
TABLE OF CONTENT
| Disciplinary
Inquiry held on 2 November 2000 (Case Summary) |
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Summary of the charge(s): The veterinary surgeon was charged with
an offence alleging misconduct or neglect in a professional respect
by failing promptly to notify the owner of the death of a cat
following post-surgical treatment.
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Disciplinary
Inquiry held on 12 October 2000 and 22 November 2000 (Case Summary) |
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Summary of the charge(s): The veterinary surgeon was charged with
an offence alleging misconduct in a professional respect by hitting
a dog on the head several times when examining it in his capacity
of a registered veterinary surgeon.
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Disciplinary
Inquiry held on 21 March 2001 (Case Summary) |
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Summary of the charge(s): The veterinary surgeon
was charged with the offence of committing a misconduct in a professional
respect by (a) failing to properly advise and refer the owners
of an injured dog to seek timely treatment from a better equipped
clinic; (b) failing to provide the owners with a written referral
letter or to use other means to provide the receiving veterinary
surgeon with all pertinent information of the injured dog; and
(c) suppressing and/or advising the owners to conceal the fact
that the dog had received treatment from him.
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Disciplinary
Inquiry held on 19 and 20 June 2001 (Case Summary) |
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Summary of the charge(s): The defendant veterinary surgeon was charged
with the offence of committing misconduct in a professional respect
by performing a sterilization operation on a female grey and white
Persian cat, which was not up to the standard expected of a registered
veterinary surgeon, in particular:
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| (a) |
only about one third of the
abdominal muscle wound had been stitched; |
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| (b) |
the left ovary had only been partially
removed; |
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| (c) |
both uterine horns had been inadequately
double ligated; |
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| (d) |
the right ovarian stump was inadequately
ligated; and |
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| (e) |
massive abdominal haemorrhage and blood
clotting was present. |
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Disciplinary
Inquiry held on 24 April 2002 (Case Summary) |
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Summary of the charge(s): The defendant veterinary surgeon was
charged with a charge alleging misconduct in a professional respect,
the particulars being that he, being a registered veterinary surgeon,
on 2 June 2001, at his clinic, behaved in a disgraceful or dishonourable
manner towards the client in relation to her request for the refund
of HK$500 deposit.
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Disciplinary
Inquiry held on 25 March and 14 May 2002 (Case Summary) |
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Summary of the charge(s): The veterinary surgeon
was charged with the offence of committing a misconduct in a professional
respect in that she, being a registered veterinary surgeon, during
the period from 26 December 2000 to 2 January 2001 at her clinic,
in relation to treatment given to the complainant's dog for an
injury to its proptosed left eye, failed to provide proper care
and treatment for the said dog
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Disciplinary
Inquiry held on 17 March, 19 June and 4 July 2003 (Case Summary) |
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Summary of the charge(s): The defendant veterinary surgeon was
charged with the offence of committing a misconduct in a professional
respect in that he, being a registered veterinary surgeon, on
a date unknown but prior to about 13 June 2001, he,
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| (a) |
obtained or caused or instigated the obtaining
of confidential information, including information relating
to the names, contact telephone numbers and addresses of clients,
from another clinic; and |
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| (b) |
made use of the said confidential information
to solicit and/or canvass business from clients of the said
clinic. |
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Disciplinary
Inquiry held on 21 - 22 October 2003 and 18 November 2003 (Case Summary) |
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Summary of the charge(s): The veterinary surgeon was charged with
the offence of misconduct or neglect in a professional respect
by failing to remove completely the ovaries of two dogs referred
to him by their respective owners for sterilization operations.
The inquiry involved two separate complaints and complainants.
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Disciplinary
Inquiry held on 6 and 12 February 2004 (Case Summary) |
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Summary of the charge(s): The defendant veterinary surgeon was
charged with the offence of misconduct or neglect in a professional
respect by failing to provide proper care and treatment for the
complainant's rabbit, in particular, (a) failing to diagnose or
correctly diagnose the medical conditions of the rabbit; and (b)
giving inappropriate treatment and/or failing to give appropriate
treatment to the rabbit.
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Disciplinary
Inquiry held on 18 May 2004 (Case Summary) |
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Summary of the charge(s): The defendant veterinary surgeon was
charged with the offence of misconduct or neglect in a professional
respect by, being a registered veterinary surgeon, in or about
October and/or November 2002, seeking to acquire an unfair personal
advantage over or at the expense of another veterinary surgeon
("Complainant"), in particular, (a) by targeting the
Complainant's clients and canvassing business from them by distributing
name cards and offering discounts outside the Complainant's clinic;
and (b) by advertising through distributing name cards and offering
discounts outside the Complainant's clinic.
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Disciplinary
Inquiry held on 22 - 24 November 2004 (Case Summary) |
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Summary of the charge(s): The defendant veterinary surgeon was
charged with the offence of misconduct or neglect in a professional
respect by failing to provide proper care and treatment for the
complainant's dog. In particular, she, being a registered veterinary
surgeon, during the period between 19 February 2002 and 18 March
2002, in relation to treatment given to the complainant's Pekingnese
dog,:
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| (a) |
failed to offer further diagnostic testing
and/or pursue differential diagnosis when the dog's medical
conditions failed to improve; |
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| (b) |
adopted inappropriate treatment methods
for the dog in that: (i) by prescribing human cold preparations
in the treatment of productive coughing which indicates lower
respiratory disease; and (ii) by prescribing dexamethasone
in a case where the drug is contra-indicated; and |
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| (c) |
compounded different medications together
without due or any regard at all to the risk that the efficacy
and safety of each of the drugs prescribed might be compromised. |
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Disciplinary
Inquiry held on 6 - 7 January and 18 February 2005 (Case Summary) |
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Summary of the charge(s): The Defendant was charged with the offence
of misconduct or neglect in a professional respect by :-
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| (a) |
upon being informed over the telephone
by the owner of a female Pomeranian dog ("the dog")
about the emergency situation of the dog, failing to make
proper arrangements for emergency services, appropriately
advise and/or to make appropriate response in a timely fashion; |
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| (b) |
after the owner brought the dog back
to her clinic for the dog's emergency situation, failed to
make proper arrangements and inappropriately restrained the
dog during medical examination causing the dog unnecessary
distress, serious pain and/or suffering; and |
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| (c) |
having taken on the care of the dog,
negligently in the provision of treatment to the dog by, failing
to give priority to the investigation of airway obstruction
and/or taking of appropriate action to the relief thereof. |
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Disciplinary
Inquiry held between 20 September 2004 and 9 April 2005 (Case Summary) |
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Summary of the charge(s): The Defendants were charged with the offence
of misconduct or neglect in a professional respect by :- |
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| (a) |
in about September 2002 to October 2002,
carried out or authorized the carrying out of treatments to
the left hind leg of the said dog in a negligent and/or inappropriate
manner; |
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| (b) |
at the night of 1 October 2002 or in
the early hours of 2 October 2002, failed to provide proper
and/or adequate arrangement for emergency after-hour service
to the said dog; |
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| (c) |
on 17 October 2002, carried out or authorized
or condoned the carrying out of surgical operation on the
said dog without performing any or any adequate or appropriate
pre-surgical investigations, and |
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| (d) |
(for the 2nd Defendant) during the period
from about September 2002 to October 2002, as the principal
of the Clinic, and as the 1st Defendant's employer and/or
supervisor, failed to adequately supervise and/or provide
adequate support, monitoring or advice to the 1st Defendant
in the treatment of the said dog. |
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Disciplinary
Inquiry held on 14 April 2005 (Case Summary)
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Summary of the charge(s): The Defendant was charged with the offence
of misconduct or neglect in a professional respect that he, being
a registered veterinary surgeon, on or about 23 February 2004,
in a veterinary clinic, performed a castration operation on the
complainant's dog, without the prior consent or authorization
from the owner.
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| Disciplinary
Inquiry held on 2 November 2000 |
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| 1. |
Under section 18 of the Veterinary Surgeons
Registration Ordinance, Cap. 529 (the "Ordinance"),
the Veterinary Surgeons Board referred a complaint alleging
a disciplinary offence on the part of a registered veterinary
surgeon to an inquiry committee for decision. The inquiry
committee subsequently met on 2 November 2000 to hear the
complaint. |
2. |
The veterinary surgeon had been charged with an offence alleging
misconduct or neglect in a professional respect by failing
promptly to notify the owner of the death of a cat following
post-surgical treatment. The cat had been returned to the
veterinary surgeon's care two days after having undergone
a surgical operation. It died the same evening, at 9:30 p.m.
The owner was not informed of the death until the next day,
at about 10:30 a.m. There were methods available to enable
the veterinary surgeon to contact the complainant at an earlier
stage, in the evening, but he had considered it more appropriate
and less distressing to the owner to delay the information
until the next day. The committee found that in all the circumstances
of the case it was not wrong for the veterinary surgeon to
delay reporting the death and dismissed the charge.
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3. |
The committee was satisfied that owners of pets must be informed
of the death of the pets in a timely manner. However it noted
that there were no guidelines, written or otherwise, as to
when such communications must be made. The expectations of
the public, and of registered veterinary surgeons themselves,
may vary. The committee therefore made a recommendation to
the Board that consideration be given to requiring registered
veterinary surgeons to obtain instructions in advance from
a client who leaves a pet with them as to the manner and timing
of any communication to the client.
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4. |
The Board considered the recommendation made by the inquiry
committee at its meeting held on 3 November 2000. After careful
consideration, the Board decided that the inquiry committee's
recommendation should be adopted and that with immediate effect,
the following guideline would be promulgated for observance
by registered veterinary surgeons ¡V
"A registered veterinary surgeon should
obtain instructions in advance from his/her client who leaves
an animal with him/her regarding the timing and manner of
any communication with his/her client as to the occurrence
of any emergencies including serious complications or death
of the animal, etc" |
5. |
Registered veterinary surgeons are advised to observe the
above guideline. The Board's Code of Practice for the Guidance
of Registered Veterinary Surgeons will be suitably amended
to incorporate this guideline in due course
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Disciplinary Inquiry held on 12 October 2000 and
22 November 2000 |
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1. |
Under section 18 of the Veterinary Surgeons Registration Ordinance,
Cap. 529, the Veterinary Surgeons Board referred a complaint
alleging a disciplinary offence on the part of a registered
veterinary surgeon to an inquiry committee for decision. The
inquiry committee subsequently met on 12 October 2000 and
22 November 2000 to hear the complaint.
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2. |
The veterinary surgeon had been charged with an offence alleging
misconduct in a professional respect by hitting a dog on the
head several times when examining it in his capacity of a
registered veterinary surgeon. The dog was being examined
because of an apparent weight loss. There were unsuccessful
attempts to weigh the dog and it was after these unsuccessful
attempts that the veterinary surgeon was alleged to have hit
the dog. The veterinary surgeon agreed that he had slapped
the dog once, on its shoulder, to elicit a submissive response.
The committee was satisfied that the dog was hit more than
once. It was unable to resolve the issue as to the amount
of force that was applied and was not satisfied that in this
case there was misconduct. The charge was dismissed.
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3. |
The committee stated that a veterinary surgeon must control
his patient and may be justified in applying some force to
the animal, but any force used must not be excessive. It is
not acceptable to cause pain or injury to an animal and veterinary
surgeons must approach the application of any force with caution.
A single application of force may not be acceptable
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4. |
Registered veterinary surgeons are advised to take note of
the views of the inquiry committee (para. 3 above) for observance,
where appropriate.
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Disciplinary Inquiry held on 21 March 2001 |
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1. |
Under section 18 of the Veterinary Surgeons Registration Ordinance,
Cap. 529, the Veterinary Surgeons Board had referred a complaint
alleging a disciplinary offence on the part of a registered
veterinary surgeon to an inquiry committee for decision. The
inquiry committee subsequently met on 21 March 2001 to hear
the case.
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2. |
The veterinary surgeon was charged with the offence of committing
a misconduct in a professional respect by (a) failing to properly
advise and refer the owners of an injured dog to seek timely
treatment from a better equipped clinic; (b) failing to provide
the owners with a written referral letter or to use other
means to provide the receiving veterinary surgeon with all
pertinent information of the injured dog; and (c) suppressing
and/or advising the owners to conceal the fact that the dog
had received treatment from him.
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3. |
An injured dog was taken in the late evening to the veterinary
surgeon. He treated the dog but then advised the owners to
go to another, unspecified, clinic in order to have X-rays
because internal bleeding was suspected. The committee heard
that the owner had understood from the veterinary surgeon
that there was no urgency; and that she was not to tell the
receiving surgeon of his treatment.
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4. |
Upon seeking treatment with a second veterinary surgeon, the
owner initially denied the earlier treatment. The first veterinary
surgeon had also not provided the owner with a referral letter
but did respond with details of the treatment, when paged
by the receiving veterinary surgeon.
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5. |
The committee found that it was possible that there had been
a misunderstanding between the first veterinary surgeon and
the owner. It was not satisfied that he had advised the owner
to conceal the fact of his treatment. Nevertheless, the committee
was of the opinion that a better practice in referring the
patient would have been providing a referral letter. The committee
dismissed the charges.
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Disciplinary Inquiry held on 19 and 20 June 2001 |
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1. |
An inquiry committee of the Veterinary Surgeons Board of Hong
Kong after due inquiry held on 19 & 20 June 2001 in accordance
with section 18 of the Veterinary Surgeons Registration Ordinance,
Chapter 529 of the Laws of Hong Kong, was satisfied that the
defendant veterinary surgeon ("Defendant") had been
guilty of misconduct or neglect in a professional respect
in that he, being a registered veterinary surgeon, performed
a sterilization operation on a female grey and white Persian
cat on or about 9 March 2000 at his clinic, which was not
up to the standard expected of a registered veterinary surgeon,
in particular:
| (a) |
only about one third of the abdominal muscle wound
had been stitched; |
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| (b) |
the left ovary had only been partially removed; |
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both uterine horns had been inadequately double ligated; |
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| (d) |
the right ovarian stump was inadequately ligated; and |
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| (e) |
massive abdominal haemorrhage and blood clotting was
present. |
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2. |
Three witnesses were called to give evidence by the Counsel
for the Secretary. A registered veterinary surgeon working
for the SPCA ("Dr A") gave evidence that the cat
in question was brought to the SPCA clinic for emergency treatment
at 5 a.m. on 10 March 2000 by the owner of a pet shop. The
cat was lying on its side, in a lot of pain, pushing its forelegs
forward in a circular motion; that it was quite pale. The
history that she was given was of the cat having been spayed
by the Defendant the previous day at about 2 p.m. and having
been returned to him at 11 p.m. because of bleeding. She was
informed that the Defendant had surgically explored the abdomen
and that he had checked the ligatures.
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3. |
Dr A said that she had checked the CBC; it was normal. There
was no blood obtained from an abdominal tap. She put the cat
on a drip and gave it analgesics. She replaced its bandage,
which was loose, with a tighter body bandage. She handed the
cat over to another vet of her organisation ("Dr B").
She explained that she decided not to surgically explore the
abdomen in view of the information given to her by the Defendant,
including that there had been an exploratory laparotomy earlier;
that her concern was that the cat was in shock with low blood
pressure; that further anaesthetic at that time could compromise
the blood pressure and lead to death.
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4. |
Dr B gave evidence that she examined the cat at 9.30 a.m.;
it was brought out from its cage and when the bandage was
removed blood came out of the wound. She said that the bandage
itself was fairly clean but when the pressure was released
the blood came. She therefore surgically explored the abdomen.
She stated that only part of the abdominal muscle wound had
been stitched; that the left ovary had only been partially
removed; both uterine horns had been inadequately double ligated;
the right ovarian stump was inadequately ligated; and there
was what amounted to massive abdominal haemorrhage and blood
clotting. She said there was 80 ml. of blood. She also said
that photographs had been taken at the time, which she asserted
were photographic representations of what she had seen. The
committee decided to allow the photographs to be admitted
in evidence.
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| 5. |
An overseas expert was called to give
expert evidence. He opined that the operation was not of a
standard to be expected of a registered veterinary surgeon,
with inadequate ligation of both uterine stumps and ovarian
pedicles, incorrect clamping of the left ovarian pedicle and
inadequate closure of the abdominal incision. He also commented
on the blood loss, both the amount and the timing. In his
opinion the anaesthetics had caused low blood pressure, the
anaesthetics would be wearing off resulting in blood being
seen at the time of the second operation; that it was probably
normal at the time Dr A saw the cat and by the time Dr B saw
the cat there was active on-going seepage. He said that it
was impossible for the blood to have accumulated from a nicking
of a mammary gland's blood vessel. |
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| 6. |
The Defendant described the steps and
procedures that he took in the operation; that he had performed
the operation correctly. He denied the allegations in the
charge. He said that two of his colleagues ("Dr X"
and "Dr Y") were present and observed the operation.
In cross examination he said that there was no particular
reason for their presence other than that it was their practice
to come in and greet each other. He said Dr X was present
for about 5 minutes; that he came in when he had already sutured
the muscle layer and was starting on the subcutaneous layer;
that Dr Y was present for about 10 minutes, coming in when
he sutured the muscle layer. He described the return of the
cat later that evening at around 11 p.m.; that there was blood
seeping from the wound; he applied a half dosage of anaesthetic
and cut the stitches of the outer layer. He saw 2-3 cc of
blood around the breast part. He applied a bandage to mop
the blood and held it there for a minute. There was no more
seepage of blood. He said he believed the blood had come from
around the mammary gland, so did not cut the stitches in the
muscle layer. He resutured the wound and put the cat on a
drip. He gave the cat back to the pet shop owner with instructions
as to the cat's care. |
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7. |
Dr X and Dr Y gave evidence of having been present during
the operation. There were some discrepancies between their
evidence and that of the Defendant but both gave evidence
of being present at a time when the Defendant was suturing
the wounds. The pet shop owner gave evidence. He said that
he had taken the cat back because there was blood seeping
from the abdomen and the Defendant had advised him to bring
it back. He said that he was called into the operating theatre
to observe the cat. He said that at that time there was not
much blood seeping from the wound; that the abdomen was open.
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8. |
There was one matter that the inquiry noted. There was evidence
that the cat had been released into the care of a lay person
whilst on a drip. The committee was concerned as to this practice
and would refer this issue to the Veterinary Surgeons Board
for its consideration of issuing an advice as to this practice.
The committee did not take this into account in deciding the
issues.
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9. |
Whilst the committee accepted that the Defendant perceived
that he performed the operation correctly, from what he had
presented to the committee by way of his descriptions and
diagrams, and his demonstration of surgical knots, even allowing
for the difficulties of presenting the situation on paper
and the difficulties for the demonstration the committee was
satisfied that he did not perform the operation to a standard
required of a registered veterinary surgeon.
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10. |
The charge particularised five matters in which it was alleged
the operation was not up to the standard expected. In respect
of the first matter the committee was satisfied that when
Dr B observed the site, there was a gap in the abdominal muscle
wound but they were not satisfied that this was because only
one-third of the wound had been stitched.
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11. |
The committee accepted that the photographs were an accurate
depiction of what was seen and done by Dr B. From the evidence
of Dr B, the photographs and the drawings of the Defendant
which reflected his lack of knowledge on anatomy and notwithstanding
the lack of histology the committee was satisfied that the
left ovary had only been partially removed. The committee
was satisfied that massive abdominal haemorrhage and blood
clotting was present. From Dr B's evidence and the fact that
the blood in the abdominal cavity could only come from the
surgical sites of the ovaries and the uterine horns with inadequate
ligation, the committee was satisfied that both uterine horns
had been inadequately double ligated and the right ovarian
stump was inadequately ligated. Even if there had been contributory
factors, such as a clotting problem, the main factor was inadequate
ligation. Dr A had considered whether there was a clotting
problem. There was no evidence that there was. The committee
was satisfied that the Defendant was guilty of misconduct
or neglect in a professional respect.
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12. |
The committee had been urged to consider a lenient disciplinary
order; that the cat was still alive, that the cat owner did
not complain. The committee put little weight on these matters.
The committee was concerned that this was not an isolated
incident, it was not a momentary lapse. Rather, from the evidence
before them there was a real concern that the Defendant had
inadequate surgical skills and was in need of remedial training.
The committee had taken into account that there was no facility
in Hong Kong where he could obtain such training. However
the committee would be failing in their duty to the public
to allow him to continue to practise surgery with his present
skills. The committee therefore on 20 June 2001 ordered the
Secretary to remove the name of the Defendant from the register;
that the order would not take effect for the period of 12
months from 20 June 2001; that for that 12-month period the
Defendant must not practise surgery; and that within the 12-month
period he must produce evidence, to the satisfaction of the
Board, that he was competent to practise surgery. If the Defendant
failed to produce such evidence, his name would be removed
from the register at the end of 12 months. If he practised
surgery within the 12-month period, his name would be removed
from the register immediately.
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Disciplinary Inquiry held on 24 April 2002 |
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1. |
The defendant veterinary surgeon ("Defendant") was
charged with a charge alleging misconduct in a professional
respect, the particulars being that he, being a registered
veterinary surgeon, on 2 June 2001, at his clinic, behaved
in a disgraceful or dishonourable manner towards the client
in relation to her request for the refund of HK$500 deposit.
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2. |
There was little dispute on the basic facts of the events
that gave rise to the charge. The complainant's dog had been
X-rayed at the Defendant's clinic on 27 May 2001. She had
later decided to take the dog to the SPCA for a second opinion
and had requested to borrow the two X-ray films. She had been
allowed to do so, upon the payment of a deposit of $500. On
2 June 2001 she had returned to the clinic, with the X-ray
films, and sought to recover the deposit. She failed to do
so, and it was the manner by which the Defendant declined
to do so that gave rise to the charge. The Committee's duty
was not to determine whether the complainant was entitled
to a refund of the deposit but whether the Defendant had behaved
in a disgraceful or dishonourable manner towards his client.
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3. |
The complainant gave evidence that she had decided to return
the films on her way back from a visit to the SPCA. She handed
the films to the receptionists who took them away to the back
office. It was not clear whether both the Defendant and the
Practice Manager of the clinic came out at the same time,
but she was told in the reception area by them that the films
had been damaged and the deposit would not be refunded. The
films were not produced in evidence, but it seemed to be accepted
that marks had been made, possibly by the SPCA vet.
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4. |
After some talk in the reception area, the Defendant and the
Practice Manager left and the complainant waited. She said
that in this period she telephoned her sister and brother
in law asking them to come. Fifteen minutes later she was
asked to go into a consultation room where the Defendant and
the Practice Manager were. She said that the Defendant's attitude
in the room was angry and rude and frightened her. She agreed
that he used no obscenities or foul language; that no one
prevented her from leaving the room and that there was no
physical contact between the staff and her. She said that
after looking at the X-rays he thrust the envelope containing
them onto her chest; she told him that he was very rude and
was not satisfied with his explanation; she said that he then
frightened her by trying to pass the Practice Manager to reach
her. (The layout of the consultation room was such that the
length of the consultation table separated the Defendant and
the complainant who were facing each other; the Practice Manager
was at the short end of the table.)
She left the consultation room and was still
there when her sister and brother in law arrived. When the
Defendant and the Practice Manager were leaving the clinic
they stopped the Defendant and attempted to speak to him.
Nothing was resolved. |
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5. |
The Practice Manager gave evidence. The Committee took into
account that he was still employed at the Defendant's hospital.
His recollection of the incident was not as clear as that
given by the complainant, but it did not appear that he was
attempting to tailor his evidence to put the Defendant in
a good light. The Committee did accept his evidence as to
the layout of the consultation room, in particular as to the
location of the second door of that room. This was relevant
as to whether the Defendant was intending to approach and
threaten complainant, rather than to simply leave the room.
He gave evidence that they were in a hurry to get to another
clinic at the conclusion of this meeting. (complainant said
that she was in the consultation room some 15 to 20 minutes;
the Practice Manager said that this was 30 minutes.)
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6. |
The Committee accepted that the complainant was an honest
witness, but believed that she may have misinterpreted the
Defendant's actions. It appeared to the Committee that the
Defendant had been prepared to spend time discussing the matter
with the complainant on an unscheduled appointment, but it
was also apparent to the Committee that he was in a hurry
to meet his commitments at the other clinic. The situation
was obviously not resolving itself, and this may have precipitated
grievances on the complainant's part that had not been intended
or appreciated. The Committee did not find that the charge
had been proved and dismissed the complaint.
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Disciplinary Inquiry held on 25 March and 14 May
2002 |
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1. |
Under section 18 of the Veterinary Surgeons Registration Ordinance,
Chapter 529 of the Laws of Hong Kong, the inquiry committee
of the Veterinary Surgeons Board met on 25 March and 14 May
2002 to hear a complaint. The veterinary surgeon was charged
with the offence of committing a misconduct in a professional
respect in that she, being a registered veterinary surgeon,
during the period from 26 December 2000 to 2 January 2001
at her clinic, in relation to treatment given to the complainant's
dog for an injury to its proptosed left eye, failed to provide
proper care and treatment for the said dog.
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2. |
The said dog was injured in an accident and, inter alia, had
its left eye proptosed. The dog was then taken to the veterinary
surgeon concerned for treatment from 26 to 29 December 2000.
On each of the 4 days, the treatment given by veterinary surgeon
consisted of a physical pushing back of the proptosed eye
into the eye socket by simply using lubricants. It was alleged
that during this process there was no anaesthetic used, nor
was there any lateral canthotomy ¡V a surgical incision in
the corner of the eyelids to allow relaxation of the constriction
around the base of the proptosed eye so as to replace the
eye back into its normal position. On each visit, the veterinary
surgeon attempted to replace the proptosed eye into the socket
but failed on each occasion. Eventually on 29 December she
succeeded in doing so. However subsequently the dog was taken
to another clinic and it was discovered that the left eye
was already dead and so had to be removed.
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3. |
The case against the veterinary surgeon was that the procedure
adopted by her was completely unacceptable, the reason being
that the eye itself being a very delicate structure, would
not tolerate the pressure required to push the eyeball back
into the socket forcefully; that in order to properly replace
the eyeball into the socket a surgical procedure is required
that would require putting the dog under anaesthesia, either
general or local, and then performing lateral canthotomy so
as to allow the relaxation of the constriction and to facilitate
the easing back of the eye. Furthermore, it was alleged that
the delay in that treatment, the replacement of the eyeball
into the socket, reduced the chance of recovery of the eye
completely; that whenever a proptosed eyeball occurs, it should
be immediately replaced since every hour of delay would seriously
reduce the chance of recovery; that because of the four days'
delay in replacing the eyeball into the socket that had reduced
the chances of full recovery to zero.
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4. |
The committee was satisfied that the veterinary surgeon concerned
did fail to provide proper care and treatment and that she
did not offer the client a lateral canthotomy. On the defendant
veterinary surgeon's own evidence, she appeared not to appreciate
what a lateral canthotomy entailed, nor did she appear familiar
with both the surgical procedure and the medical treatment
of the condition. In this regard, the committee considered
that that it did amount to neglect in a professional respect.
In accordance with section 19(d) of the said Ordinance, the
committee ordered on 14 May 2002 that a warning letter would
be served on the veterinary surgeon who was also required
to undergo 40 hours of continuing professional education which
was to be completed within 12 months from 14 May 2002. She
must supply proof of having completed such continuing professional
education to the Board.
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5. |
In accordance with section 23 of the Ordinance, the veterinary
surgeon concerned subsequently filed an appeal to the Court
of Appeal against the order of the inquiry committee. However,
on 26 March 2003 she abandoned the said appeal.
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Disciplinary Inquiry held on 17 March, 19 June and
4 July 2003 |
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1. |
The inquiry committee met on 17 March, 19 June and 4 July
2003 to hear the case in which both the complainant and defendant
were registered veterinary surgeons. The defendant veterinary
surgeon was charged with the offence of committing a misconduct
in a professional respect in that he, being a registered veterinary
surgeon, on a date unknown but prior to about 13 June 2001,
he
and that in relation to the facts alleged
he had been guilty of misconduct in a professional respect
thereby contravening section 17(1)(a) of the Veterinary Surgeons
Registration Ordinance. |
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2. |
The defendant veterinary surgeon entered into a franchise
agreement with the complainant to run a clinic in November
1998. In June 2001, the former veterinary surgeon opened his
own clinic. He was alleged by his previous franchiser to have
obtained confidential information, including information relating
to the names, contact telephone numbers and addresses of clients,
from the previous clinic. The defendant veterinary surgeon
was alleged that he had used such kind of information to solicit
and/or canvass business from clients of the said clinic.
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3. |
The committee was satisfied that the facts alleged in the
charge have been proved, and that they amounted to misconduct
in a professional respect. In accordance with section 19(d)
of the said Ordinance, the committee ordered on 4 July 2003
that a warning letter be served on the defendant veterinary
surgeon.
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Disciplinary Inquiry held on 21 - 22 October 2003
and 18 November 2003 |
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1. |
Under section 18 of the Veterinary Surgeons Registration Ordinance,
Chapter 529 of the Laws of Hong Kong, the Veterinary Surgeons
Board held and completed a disciplinary inquiry on 21-22 October
2003 and 18 November 2003.
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2. |
The veterinary surgeon was charged with the offence of misconduct
or neglect in a professional respect by failing to remove
completely the ovaries of two dogs referred to him by their
respective owners for sterilization operations. The inquiry
involved two separate complaints and complainants.
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3. |
The facts of both cases in relation to the charges were the
same. Two dogs were sterilized by the defendant in July 2001.
After the operations, both dogs still exhibited signs of estrus.
The owners took the dogs to another clinic for further examination,
and ovarian tissues were found present in the left ovarian
stumps of both dogs. Ovarian bursa tissue was also found in
the right ovarian stump in one of the dogs. These tissues
were then removed by the other veterinary surgeon and the
dogs did not have any further signs of estrus. An overseas
expert was invited to give expert evidence on the two cases.
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| 4. |
The Inquiry Committee ruled that given
the purpose of sterilization operation was to remove completely
the ovaries and the uterus, the non-removal of the ovarian
bursa is irrelevant to the propriety of the operation. The
overseas expert who attended the inquiry to give evidence
also accepted that the presence of the cystic ovarian bursa
had no clinical significance. The Inquiry Committee therefore
dismissed the part of the charge relating to the presence
of ovarian bursa tissue. |
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| 5. |
In deciding whether the subsequent finding
of the ovarian tissue in the two dogs was the result of the
surgical errors on the part of the defendant, the Inquiry
Committee noted both the overseas expert's views that these
were remnants of the ovaries which should have been completely
removed during the sterilization operations; and the defendant's
claim that this could have been the result of the unusual
position of the ovary in the case of one of the dogs and the
possibility of an accessory ovary in the case of both dogs.
After hearing the evidence, the Inquiry Committee accepted
that in one of the cases, the position of the ovary of the
dog was so unusually close to the kidney that a competent
veterinary surgeon exercising proper care could still have
left some ovarian tissue in the dog. The Committee therefore
could not be satisfied that it was a surgical error on the
part of the defendant in that case. For the other case, the
Committee noted that there were reported cases in cats, cows
and women of accessory ovaries or of ovarian tissue extending
into the ligament of the ovary. Although similar cases in
dogs had not been reported in those studies, it had not been
ruled out, nor was the overseas expert able to deny, that
accessory ovaries could exist in dogs. Furthermore, the manifestation
of two episodes of estrus within a month, which according
to the evidence of the owner of the dog occurred after the
sterilization on the dog, tended to reinforce the likelihood
of the existence of an accessory ovary. The Inquiry Committee
therefore could not be satisfied that the ovarian tissue subsequently
found in this dog was the result of a surgical error on the
part of the defendant and not the result of the existence
of an accessory ovary or ovarian tissue extending into the
ligament. In the circumstances, the Committee dismissed the
charges in both cases. |
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| Disciplinary
Inquiry held on 6 and 12 February 2004 |
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| 1. |
Under section 18 of the Veterinary Surgeons
Registration Ordinance, Chapter 529 of the Laws of Hong Kong,
the Veterinary Surgeons Board held and completed a disciplinary
inquiry on 6 February 2004 and 12 February 2004. |
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| 2. |
The defendant veterinary surgeon was charged
with the offence of misconduct or neglect in a professional
respect by failing to provide proper care and treatment for
the complainant's rabbit, in particular, (a) failing to diagnose
or correctly diagnose the medical conditions of the rabbit;
and (b) giving inappropriate treatment and/or failing to give
appropriate treatment to the rabbit. |
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| 3. |
The facts of the case were that the owner
of the rabbit found that the rabbit had stopped eating. She
took the rabbit to the defendant for consultation. The defendant
examined the rabbit and gave an injection to the rabbit. He
also prescribed medicine to be given to the rabbit at home.
Then, the complainant took the rabbit home and gave it the
Papaya tablets in accordance with the defendant's instructions
but not the other medicine prescribed. That evening the rabbit
developed diarrhea and died the next morning. An expert was
invited to give expert evidence on the case. |
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| 4. |
There were conflicting accounts of the
defendant's diagnosis and treatment given by the complainant
and the defendant. According to the complainant, the defendant
told her that the rabbit had a heat stroke which affected
its digestion. She said that the defendant never mentioned
that the rabbit was in a critical condition and never suggested
hospitalization or treatment in the form of drip. The defendant,
on the other hand, explained in his letter to the Preliminary
Investigation Committee in response to the complaint that
the rabbit was nearly dead when it was presented for treatment.
He also gave evidence in the inquiry that the rabbit was in
critical conditions and might not survive. |
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| 5. |
Having considered the evidence, the Inquiry
Committee found that the complainant was an honest and reliable
witness and accepted her evidence. Her evidence was also corroborated
by the medical history recorded in the defendant's medical
record. The Inquiry Committee did not accept the defendant's
allegation that, despite his diagnosis that the rabbit was
critically ill and required hospitalization and treatment
on drip, he did not record that finding in the medical record
owing to the brevity of time. That allegation was wholly incredible
given his recognition that this was a situation which called
for detailed records. Furthermore, that allegation was inconsistent
with the fact that in the defendant's letter to the complainant
earlier he only stated the diagnosis of ileus and bloat, and
no mention whatsoever was made about the critical condition
of the rabbit nor his suggestion of hospitalization and drip
treatment. |
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| 6. |
However, according to the complainant
the rabbit was not in a poor condition when it was taken to
the clinic for treatment. Even the expert witness was uncertain
whether the rabbit was in a critical condition at that time.
There was insufficient evidence for the Inquiry Committee
to come to the finding that the defendant's diagnosis of bloated
stomach, heat stress and maldigestion, as recorded in the
medical record, was incorrect. Therefore the allegation in
Charge (a) was dismissed. |
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| 7. |
The Inquiry Committee noted that the treatment
given by the defendant according to the complainant and the
medical record dealt only with the gastro-intestinal problems.
It also accepted the expert evidence that the treatment given
by the defendant did not deal with the problem of heat stress.
The Inquiry Committee was satisfied that in the circumstances
of the case fluid therapy was required to be given in the
clinic before the rabbit was released. It rejected the defendant's
allegation that hospitalization and drip treatment were suggested
but refused by the complainant. It was also satisfied that
fluid therapy was not given to the rabbit, nor was it suggested
to the complainant in the first place. |
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| 8. |
Therefore, the Inquiry Committee was of
the view that the treatment given by the defendant had fallen
below the standard expected of registered veterinary surgeons
and that this amounted to misconduct or neglect in a professional
respect. It therefore found the defendant guilty of Charge
(b). |
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| 9. |
Having considered the gravity of the offence
and the mitigating factors advanced by the defendant, the
Inquiry Committee ordered that the defendant be reprimanded
in writing and that the reprimand be recorded on the register. |
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| Disciplinary
Inquiry held on 18 May 2004 |
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1. |
Under section 18 of the Veterinary Surgeons Registration Ordinance,
Chapter 529 of the Laws of Hong Kong, the Veterinary Surgeons
Board held and completed a disciplinary inquiry on 18 May
2004.
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| 2. |
The defendant veterinary surgeon ("Defendant")
was charged with the offence of misconduct or neglect in a
professional respect by, being a registered veterinary surgeon,
in or about October and/or November 2002, seeking to acquire
an unfair personal advantage over or at the expense of another
veterinary surgeon ("Complainant"), in particular,
(a) by targeting the Complainant's clients and canvassing
business from them by distributing name cards and offering
discounts outside the Complainant's clinic; and (b) by advertising
through distributing name cards and offering discounts outside
the Complainant's clinic. Charge (a) was laid as an alternative
to Charge (b). In other words, if there was a finding of guilt
on Charge (a), there was no need to move on to consider Charge
(b). |
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| 3. |
Both charges were based on the same
facts. The case was that the Defendant was an employee at
the Complainant's clinic from October 2000 to 31 July 2002.
After the Defendant left the employment he opened his own
clinic in Hunghom. In around October and November 2002 a lady
distributed the Defendant's new name cards showing his new
clinic just outside and in close vicinity to the Complainant's
clinic. Two clients who went out from the Complainant's clinic
testified that when the name cards were handed to them the
lady also told them that discounts would be given to clients
from the Complainant's clinic. One of these two clients also
testified that the lady told her not to attend the Complainant's
clinic next time. |
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| 4. |
The evidence of the witnesses was challenged
by the Defence on the basis of inconsistency. The Inquiry
Committee ("Committee") was aware of the inconsistencies
which in their view did not affect the evidence of the two
witnesses. Given the independent status of the witnesses,
the Committee saw no reason for them to make up the evidence.
Having regard to the standard of proof appropriate to the
circumstances, the Committee was satisfied that the lady did
distribute the Defendant's name cards just outside the Complainant's
clinic. The Committee was also satisfied that she also told
the two witnesses that discounts would be offered to clients
from the Complainant's clinic. |
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| 5. |
The Inquiry Committee then had to determine
whether the lady did what they found proved at the instigation
of the Defendant. The Defendant gave evidence that he specifically
told the lady not to distribute the name cards in the vicinity
of other veterinary clinics, as he knew it was wrong to do
so and was an issue of importance to his profession. The Committee
did not accept his evidence, as in none of his two letters
to the Preliminary Investigation Committee was this mentioned
although he was specifically asked to explain the allegation
that he sought to acquire an unfair advantage over the Complainant
by distributing name cards and offering discounts outside
her clinic. |
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| 6. |
Taking the totality of the evidence
into consideration, the Inquiry Committee found as a fact
that the distribution of name cards right outside the Complainant's
clinic was instigated by the Defendant. The Committee saw
no reason at all why the lady worker would go and distribute
the name cards in a place which was not within her instructions
from the Defendant. The Committee gave the Defendant the benefit
of the doubt as to whether he instructed the lady worker to
also offer discounts, as the lady might have done so out of
her own motivation to do the job. However, the Committee was
of the view that he had a duty to take precautions to prevent
his lady worker, acting under his instructions, from breaching
the relevant principle of acceptable advertising as set out
in paragraph 18.2 of the Code of Practice. The Committee was
satisfied that he had not taken such precautions. |
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| 7. |
The Inquiry Committee found also that
the purpose for instructing the lady worker to distribute
name cards just outside the Complainant's clinic was to canvass
business from the Complainant's clients. The mere act of distribution
of name cards just outside another veterinary clinic was sufficient
for the Inquiry Committee to reach a finding of professional
misconduct. As such the Committee needed not decide whether
the failure to take precautions to prevent the lady worker
from offering discounts to these clients would amount to neglect
in a professional respect. However, if the Committee was required
to do so, it certainly thought that such failure would amount
to neglect in a professional respect. The Inquiry Committee
therefore found the Defendant guilty of Charge (a). As such
the Committee did not make any judgment on Charge (b). |
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| 8. |
Having considered the matters advanced
in mitigation and the gravity of the charge, the Inquiry Committee
agreed that this was a one-off incident which was unlikely
to recur and the case was towards the lower end of the scale.
Therefore the Committee ordered that a warning letter be served
on the Defendant. |
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Disciplinary Inquiry held on 22 - 24 November 2004 |
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1. |
Under section 18 of the Veterinary Surgeons Registration Ordinance,
Chapter 529 of the Laws of Hong Kong, the Veterinary Surgeons
Board held and completed a disciplinary inquiry on 22 ¡V 24
November 2004.
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| 2. |
The defendant veterinary surgeon ("Defendant")
was charged with the offence of misconduct or neglect in a
professional respect by failing to provide proper care and
treatment for the complainant's dog ("the dog").
In particular, she, being a registered veterinary surgeon,
during the period between 19 February 2002 and 18 March 2002,
in relation to treatment given to the complainant's Pekingnese
dog,: |
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| (a) |
failed to offer further diagnostic
testing and/or pursue differential diagnosis when the
dog's medical conditions failed to improve; |
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adopted inappropriate treatment
methods for the dog in that: (i) by prescribing human
cold preparations in the treatment of productive coughing
which indicates lower respiratory disease; and (ii)
by prescribing dexamethasone in a case where the drug
is contra-indicated; and |
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| (c) |
compounded different medications
together without due or any regard at all to the risk
that the efficacy and safety of each of the drugs prescribed
might be compromised. |
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| 3. |
The case involved the Defendant's treatment
of the complainant's dog during the period from 19 February
2002 to 18 March 2002. The dog was first presented to the
Defendant on 19 February 2002 with coughing and nasal discharge.
The Defendant made a diagnosis of upper respiratory tract
infection. Injections were given and medications prescribed.
On 26 February 2002 the dog was brought to the Defendant for
further consultation, this time with productive coughing and
nasal discharge. The same diagnosis was maintained and further
medications, which included dexamethasone, were prescribed.
On 14 March 2002 the dog was reported by the owner to be dyspnoeic.
The next day it was brought back to the Defendant. The Defendant
maintained the same diagnosis of upper respiratory tract infection
and explained that the condition was due to constriction of
the trachea during recovery. Injections of dexamethasone and
an antibiotic were given and similar oral medications were
prescribed. Nevertheless, the dog died on 18 March 2002 but
the cause of death was not determined. |
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| 4. |
From the Defendant's explanation to
the Preliminary Investigation Committee, the Defendant did
not dispute what the owner described as to what happened,
except that there was some dispute as to whether the dog was
dyspnoeic. Two overseas experts were invited to attend the
inquiry to give evidence. According to the evidence of the
expert in canine medicine, the Defendant should have been
alerted to other diagnostic possibilities at the 2nd consultation
on 26 February 2002, given that productive coughing was strongly
suggestive of lower respiratory tract diseases. Nevertheless
the Defendant maintained the diagnosis of upper respiratory
tract infection and treated the dog accordingly. During the
3rd consultation on 15 March 2002 the dog was presented with
a history of severe coughing since the previous day, and it
was obvious that lower respiratory tract infection should
be further investigated and examination conducted to question
the original diagnosis, given that if it had been a simple
upper respiratory tract infection the medication would have
been effective and the dog would not have re-presented with
the same signs. |
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| 5. |
The expert also testified that the medications
prescribed by the Defendant were preparations for human cold,
but made into powder form and mixed by the Defendant. Such
fixed-ratio preparations were inappropriate for the dog due
to the difference in pharmacokinetics between humans and canines,
and were likely to significantly worsen any concurrent lower
respiratory tract infection by dehydrating the airways and
making expectoration more difficult, thus trapping the infection
in the lungs. |
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| 6. |
Having considered all evidence including
the Defendant's explanation to the Preliminary Investigation
Committee and her written submission in her letter dated 10
November 2004, the Inquiry Committee was satisfied that given
the clinical progression and history of the dog the Defendant
should have pursued the investigation of other possible diagnoses,
if not earlier, at the latest by the 3rd consultation. In
failing to do so she must have failed to recognize the possible
presence of other underlying problems, despite the fact that
the clinical progression and history of the dog was strongly
suggestive of such possibilities. The Inquiry Committee was
also satisfied that the treatment given by the Defendant to
the dog was inappropriate for its condition, in particular
dexamethasone with its potential immuno-suppressive properties
and its potential to mask the clinical signs. This indicated
a lack of understanding by the Defendant of the overall effects
of dexamethasone in an immature dog. In this case she should
have at least eliminated the possibility of infectious aetiologies
before prescribing dexamethasone. As to the use of fixed-ratio
preparation for human colds, the committee accepted the opinion
of the expert that its use in this dog was inappropriate.
The committee accepted that there were risks associated with
the practice of compounding different medications. However,
there was insufficient evidence to prove that the Defendant
compounded the different medications without due regard to
the risk of so doing. |
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| 7. |
The Inquiry Committee was satisfied
that the conduct of the Defendant in failing to pursue the
investigation of differential diagnoses in the light of the
clinical progression and history fell below the standard expected
of registered veterinary surgeons. The inappropriate treatment
given by the Defendant also fell below the expected standard.
The committee was satisfied that this amounted to misconduct
in a professional respect and therefore found the Defendant
guilty in respect of paragraphs (a) and (b) but not guilty
in respect of paragraph (c) of the charge. |
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| 8. |
The Inquiry Committee was informed that
a disciplinary order was made in May 2002 by this Board in
respect of the Defendant for failing to provide proper care
and treatment in relation to a dog's eye injury. A warning
letter was served on her and she was required to undergo 40
hours of continuing professional education within 12 months
of the order, which she had fulfilled. |
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| 9. |
The Defendant put forward a number of
matters in mitigation. In the Inquiry Committee's opinion,
the only matters which carried weight in mitigating the gravity
of the charge were that (i) she was concerned about the potential
risks to a small puppy associated with the investigative procedures;
and (ii) in practice she had to make decisions on the cost-effectiveness
of the investigative procedures in the context of the dog
owner's financial situation. For the avoidance of doubt, the
committee's findings were neither influenced by the death
of the dog nor the outcome of the medical treatment. What
concerned them was the Defendant's clinical approach to the
case. |
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| 10. |
While the Inquiry Committee noted that
the previous disciplinary order was made after the commission
of the misconduct in the present case, the fact remained that
she had been found guilty in relation to treatment of two
dogs which reflected adversely on her competence. The committee
was particularly concerned as to (1) her ability to interpret
relevant clinical information and (2) her lack of understanding
of the effect of drugs which had potential harmful effects
if used improperly. In considering the order to be made, the
committee bore in mind their duty to protect the users of
veterinary services and to ensure the competence of registered
veterinary surgeons. |
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| 11. |
Having considered the mitigation advanced and the gravity
of the case, the Inquiry Committee made the following order: |
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| (i) |
A warning letter be served on the
Defendant; and |
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| (ii) |
The Defendant completes training
of 30 hours in clinical pharmacology and 30 hours in
clinical problem-solving skills in small animal medicine
within 24 months, such training to be approved by the
Board in advance. In the event of the Defendant's failure
to comply with the order, the following restriction
on her practice shall be imposed and recorded in her
practicing certificate unless the Board with legitimate
reason orders otherwise:
"That the Defendant shall only
practise under the supervision of a registered veterinary
surgeon who has at least 5 years relevant experience
in small animal practice until such time she has fulfilled
such requirements to be imposed by the Veterinary Surgeons
Board, the supervisor and the arrangement for the supervision
to be approved by the Board." |
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| Disciplinary
Inquiry held on 6 - 7 January and 18 February 2005 |
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| 1. |
The Veterinary Surgeons Board held and
completed a disciplinary inquiry on 6 - 7 January and 18 February
2005. |
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| 2. |
The defendant veterinary surgeon ("D | | |