In total Mr Hendrie Smith had faced eight charges against him, all of which related to him undertaking the euthanasia of a German Shepherd named Bouncer during a home visit in January 2017.
The charges alleged that when John Hendrie Smith undertook the euthanasia of Bouncer he had:
1. failed to ensure he was sufficiently prepared for the euthanasia in that he failed to attend the visit with a muzzle and failed to attend with any sedative and the means of administering sedative;
2. failed to delay the euthanasia until he was in possession of the above items;
3. undertook the euthanasia by means of an injection without first sedating Bouncer;
4. failed to provide Bouncer’s owner with an adequate explanation of the procedure. Including:
a. failing to explain that the procedure involved an attempt at injection directly into the heart;
b. failing to explain that an injection into the heart without sedation is (except in extreme circumstances) not an accepted means of euthanasia;
c. wrongly stated that Bouncer would not feel the injection;
d. failed to provide an explanation of the risks;
e. failed to explain the risks and signs of narcotic excitement;
f. failed to explain the risks of injection into the heart without sedation;
5. failed to obtain Bouncer’s owner’s informed consent for the procedure;
6. failed to make any clinical records in respect of the procedure;
7. provided inadequate veterinary care to Bouncer and caused him unnecessary suffering; and
8. failed to communicate with Bouncer’s owner.
Having considered evidence about the case from Bouncer’s owner, his owner’s former partner, two expert witnesses and Mr Hendrie Smith, the Committee found all of the charges against Mr Hendrie Smith proven, with the exception of charge 4(e) on the grounds that there was insufficient evidence against him on this particular charge.
In considering whether the charges that were found proven amounted to serious professional misconduct, the Committee heard further evidence from the College’s two expert witnesses, and submissions from both the College and Mr Hendrie Smith. Having considered the evidence and submissions, the Committee concluded that in relation to each of the charges found proven, Mr Hendrie Smith’s conduct had fallen far below that which was to be expected from a veterinary surgeon and was therefore serious professional misconduct.
The Committee went on to consider what sanction was appropriate following its earlier findings against Mr Hendrie Smith. The Committee took into account a number of mitigating and aggravating factors. In mitigation the Committee considered that this was a single, isolated incident and that Mr Hendrie Smith had been a practising veterinary surgeon for 65 years and had an otherwise unblemished career with no adverse professional findings against him. It also took into account testimonials from professional colleagues, clients and his local community.
However, the Committee also considered the aggravating factors which included actual injury and unnecessary suffering to an animal, a blatant disregard of the systems that regulate the veterinary profession including the RCVS Code of Professional Conduct and its supporting guidance relating to euthanasia, informed consent, preventing unnecessary suffering and working within one’s area of competence.
In explaining its decision to direct his removal from the Register of Veterinary Surgeons, the Committee noted Mr Hendrie Smith’s lack of insight into his behaviour, which included denying that he was at fault, challenging several of the Committee’s findings and disputing that an intracardiac injection into the heart of a dog without administering sedation or anaesthesia was wholly unacceptable, despite expert opinion to the contrary.
Chitra Karve, chairing the Committee and speaking on its behalf, said: "The respondent, in his oral evidence, admitted that he was not really a small animal vet, and had not been dealing regularly with small animals for a significant period of time. His specialisation in recent years was with large farm animals. The Committee considered that the respondent had, and still has, no concept of the difficulties now recognised as inherent in the procedure he performed, or the risks of pain and suffering it posed to the animal."
She added: "The Committee has found that the respondent’s conduct in attempting an intracardiac injection without prior sedation or anaesthesia caused appalling pain and suffering to Bouncer, as evidenced by his screaming, and was wholly unnecessary. The respondent accepted that he had a sedative in his car, but chose not to postpone attempted euthanasia so that he could sedate his patient first.
"The respondent explained in his oral evidence that he had, in the past, euthanased over 200 dogs by intracardiac injection without sedation or anaesthesia. The Committee concludes that this was the respondent’s customary method of euthanasia, and he did not understand why it was wholly unacceptable for a reasonably competent veterinary surgeon to carry out euthanasia in this way. Given his lack of insight, the Committee considers that there is a risk that, if the respondent were to be asked to euthanase a dog in the future, he would be likely to use his customary method, and thereby cause injury and suffering to another animal."
In determining the sanction the Committee decided that, because there had been a serious departure from the professional standards set out in the Code, serious harm was caused and there was a serious risk of harm to animals in the future, that removing Mr Hendrie Smith from the Register was the only means of protecting animals and the wider public interest.
Mr Hendrie Smith has 28 days from being informed of the Committee’s decision to make an appeal to the Privy Council.
Dr Botes faced a total of nine charges against him, relating to performing (or recommending) inappropriate total hip replacements on five dogs without adequate investigation and without getting informed consent from the owners.
One of the charges also related to a failure to keep adequate, clear and detailed clinical records in relation to the five dogs.
Dr Botes denied the first two charges which were later dismissed because the owner did not attend the hearing and counsels agreed that it would not be in the public interest to pursue them.
Dr Botes admitted the other seven charges and that they amounted to serious professional misconduct, and they were therefore found proven by the Committee.
In considering whether the charges amounted to serious professional misconduct, the Committee considered an expert report from Professor John Innes, RCVS Specialist in Small Animal Surgery (Orthopaedics) and Mr Midgley, RCVS Advanced Practitioner (Small Animal Orthopaedics).
Ian Arundale, Chair of the Committee, said: “In coming to its decisions, the Committee took into account Professor Innes’ opinions that it was not reasonable for Dr Botes to have carried out the THR without sufficient investigation into Kilo’s pain; that the THR undertaken in respect of Sora was not in the animal’s best interests; and that it was ‘entirely unnecessary’ to recommend the THR in respect of Penny.
"In addition, the Committee has found that both THRs performed in respect of Daisy were not in her best interests.
"Thus, in the Committee’s view, Dr Botes’ actions and omissions did not ensure the animals’ health and welfare.”
The Committee took into account that the THRs in question were a source of financial gain, that Dr Botes’ conduct was repeated over a considerable period of time and that he was in an increased position of trust and responsibility because of perceived expertise in small animal orthopaedics and its education.
However, the Committee took into account, as a mitigating factor, that Dr Botes has indicated some insight into some aspects of the charges in his written communications to the College, in his witness statement dated 29 December 2021, and in his admissions at the start of this inquiry.
The Committee then considered what would be an appropriate and proportionate sanction, hearing from several character witnesses including Dr Midgely, who was put forward as Dr Botes’ proposed supervisor if the committee agreed to a postponement with undertakings.
When making their decision, the Committee took into account the fact that Dr Botes had been suspended from the Register in 2008 for six months for serious professional misconduct over the care of a dog that had been involved in a road traffic accident.
The Committee considered a postponement of judgment with undertakings, which was submitted by Dr Botes’ counsel.
However, the Committee took the view that a postponement would not be appropriate because the failings were not in limited aspects of practice but were wide-ranging, covering the fundamental requirements of any veterinary surgeon.
In the Committee’s view, this would mean nothing less than direct supervision, where Dr Botes’ practice was directly monitored on a day-to-day basis would be sufficient to protect animals, clients, and to uphold the wider public interest.
It would be impracticable to formulate undertakings capable of effectively addressing these issues.
The Committee also noted that the disgraceful conduct was serious and there was a pattern of sustained and persistent misconduct.
The Committee therefore did not believe that no further action, a reprimand or a warning were appropriate or proportionate outcomes.
The Committee also considered whether suspension was appropriate but concluded that there was a real risk of repetition of the behaviours outlined in the charges, and so the Committee was unable to conclude that Dr Botes would be fit to return to practice after a period of suspension.
The Committee therefore decided to direct that Dr Botes should be removed from the Register indefinitely.
In coming to this decision, the Committee carefully applied the principle of proportionality and took into account the impact of such a sanction on Dr Botes both professionally and financially, and took into account his witness statement in this regard.
Ian Arundale added: “In light of the gravity of the conduct, and all of the factors taken into account, any lesser sanction would lack a deterrent effect and would undermine public confidence in the profession and the regulatory process.
"Removal was the only appropriate and proportionate sanction.”
Dr Botes has 28 days from being notified of his removal from the Register to lodge an appeal with the Privy Council.
The Committee’s full findings can be viewed at www.rcvs.org.uk/disciplinary
Earlier this month, the government had exempted veterinary surgeries from the requirement to close their doors during the pandemic. Strictly speaking, the exemption meant that practices could carry on offering the same level of service as before, provided they followed further government guidelines on social distancing.
However, the College then advised that non-essential treatments should not be carried out until further notice, and that animals should only be seen in emergency, or if their health was likely to deteriorate as a result of inaction.
This included vaccination, where RCVS advice stated that whilst routine vaccinations were considered not urgent, there "may be scenarios where, in your professional judgement, vaccines are being given to reduce a real and imminent risk of disease; this includes in the face of an animal disease outbreak, or in a scenario where part of a vaccine course has been given and the animal may be exposed to the disease."
The updated College guidelines, issued last Thursday evening, appeared little changed, except to say that its advice concerning vaccinations is under review. Meanwhile, its new flowchart gives a very clear framework for veterinary professionals to work within, essentially leaving it to your own professional judgement to weigh up the risks.
However, the BVA went further, declaring amongst other things, that:
Vaccinations – we are now recommending that primary vaccinations and year 1 boosters in dogs and cats go ahead due to the increased risk of disease outbreak over a longer period of time, and annual leptospirosis vaccination due to the zoonotic risk. If additional component of the core vaccine is due at the same time, it should also be administered. In addition, we’re recommending rabbit vaccinations go ahead due to the seasonal disease risks. Rabies vaccinations should be carried out if required for certification reasons
.... leading to an outcry that the BVA's advice appeared to be being relaxed at precisely the point when the government is imploring the public to stay at home, and that:
To add further fuel to the flames, the British Small Animal Veterinary Association then issued a statement to the effect that it had not been consulted during the preparation of the new BVA guidelines, which BVA past President Robin Hargreaves felt was so economical with the truth that he resigned his BSAVA membership on the spot.
COMMENTAt the end of it all, there is but one simple truth for every veterinary surgeon who is working in these difficult times, and it is this: The government and the RCVS guidance gives you the freedom to exercise your professional judgement concerning whether or not an animal needs to be seen for whatever reason. Provided you can explain why you reasonably concluded that an animal should or should not be seen, that is all that matters. It trumps everything else.
This whole farago has highlighted a number of important issues in the profession, starting with the social media conspiracy theories that the new guidance came after pressure from corporate practices when as far as I can tell, it appears to have been driven by a genuine concern that that failure to vaccinate could cause significant welfare issues in the future.
That seems a reasonable argument, and very much in line with the College advice. But that in turn raises a far bigger question, which is what on earth the BVA (a voluntary membership organisation) was doing issuing what appeared to be instructions ostensibly for all members of the profession. Notwithstanding the fact that BVA recommendations have no legal weight, having all these chefs running around with different recipe books is itself a recipe for muddled communications and confusion over leadership.
In turn, that raises the even bigger question of what the BVA's role should be. Should it be snuggling up in bed with the RCVS, issuing joint edicts? Or should it instead be holding the College to account, challenging its decisions and demanding clarification where clarification is necessary. I would argue the latter. In this situation, the ONLY organisation issuing guidelines about vaccinations for practising vets should be the regulator. And it is the role of the BVA to challenge those guidelines if necessary, or to demand clarification.
Which leads me on to the next thing, which is that increasingly, members of the profession seem to demand explicit rules or guidelines to operate within. There are lots of hypotheses for why this might be true. Perhaps because we live in a more (or seemingly more) litigious world and veterinary professionals like the reassurance rules provide. Perhaps it is because the younger cohort of vets lack the self-confidence needed for decision-making. Perhaps corporatisation has a part to play, in that employees of larger organisations tend to play more by the rules. Or perhaps it is a consequence of the growth in the 'refer everything’ culture which means vets take fewer clinical risks.
Whatever the reason, it seems clear that in some cases, the RCVS tack of "you're a professional, decide for yourself" is perfectly reasonable, whereas on other occasions, such as Schedule 3, more explicit guidelines are demonstrably necessary. Once again, surely the role of the BVA as the "Voice of the profession” is not to issue its own advice, but to press the College for more explicit guidelines as necessary.
Lastly, there is the role of Facebook in all of this. Quite obviously vets are no more immune to conspiracy theories than members of the public who think that coronavirus is spread by 5G telephone masts. Sadly, the truth is usually far less exciting. However, the problem at the moment is that the growth in social media and Facebook groups has left the regulator and the representative associations on the back foot, such that it is often left to individuals from those organisations who 'happen to come across OK online' (rather than having any properly defined role) to firefight.
Photo: https://www.scientificanimations.com/wiki-images/
The proposals put to Council by the Education Committee included six key recommendations for changes to CPD policy:
To change the CPD requirement – as stated in the Codes of Professional Conduct – to 35 hours per calendar year for veterinary surgeons and 15 hours in the same period for veterinary nurses, from the start of 2020. This replaces the previous requirement of 105 hours and 45 hours of CPD over a rolling three-year period for veterinary surgeons and veterinary nurses respectively.
Making the use of the new CPD platform (currently in development) for recording learning and development mandatory from 2022.
Giving veterinary surgeons and veterinary nurses who, upon renewing their registration, have confirmed their compliance with the requirement, the opportunity to download a certificate demonstrating this.
The introduction of an administration fee (which is currently yet to- be determined) that will be charged to any veterinary surgeons or veterinary nurses who continually (defined as two or more years in a row) fail to confirm their compliance with the requirement and/or fail to respond to requests from the College for their CPD records.
Changing the words of the Codes of Professional Conduct to include the fact that CPD should be ‘regular’ and ‘relevant’.
The continuation of the RCVS CPD Referral Group, which meets to consider what further steps should be taken in cases of veterinary surgeons and veterinary nurses who continually fail to comply with CPD requirements and/or respond to requests.
RCVS Council agreed, by a majority vote, to approve the above recommendations.
RCVS Council member Dr Sue Paterson (pictured right), who introduced the paper and is the incoming Chair of the Education Committee, said: "While the majority of both veterinary surgeons and veterinary nurses do recognise the importance of continuous learning and development for their professional practice, their clients and, ultimately, animal health and welfare, it’s clear that there has been a cohort of people in both professions who take a more lax view of undertaking CPD.
"The changes to our CPD policy are intended to tighten up our processes and are targeted at those who, when challenged about why they have not undertaken sufficient CPD, say that they will meet the requirement one or two years down the line as part of the rolling three-year system. The administration fee also recognises the amount of time and effort spent by staff in the College in contacting and chasing up those people who aren’t compliant.
"However, we also recognise the fact that some members of the profession may have personal circumstances that means they are unable to meet their CPD requirement in a given year – whether that’s because of parental leave or other caring responsibilities, or long-term sick leave. So we will be retaining flexibility within the system and will be considerate and compassionate when taking into account individual circumstances when considering non-compliance.
"Furthermore, in light of the fact that the majority of vets and vet nurses do meet the requirement but also often go above-and-beyond it, we also thought it would be a good idea to introduce a downloadable compliance certificate in recognition of their achievement. This could be displayed, for example, in the practice and would be particularly useful for Practice Standard Scheme assessments.
"Over the coming months we will be fine-tuning the details of these policies and will be making further decisions about how they will work in practice in due course."
Veterinary surgeons and nurses who feel they will struggle to complete their CPD requirement within a 12-month period due to personal circumstances can contact RCVS confidentially at any time to discuss their difficulties on cpd@rcvs.org.uk
For full details about the decision, you can download the RCVS Council paper at: www.rcvs.org.uk/document-library/rcvs-council-papers-13-june-2019/
The RCVS Disciplinary Committee has struck off the Register a veterinary surgeon who delayed attending a dog that had been run over at a farm, causing her to suffer unnecessarily.
Following a two-day hearing, the Disciplinary Committee found Munhuwepasi Chikosi guilty of unreasonably delaying attending Mitzi, a fourteen-and-a-half-year-old Labrador cross, and of unnecessarily causing her to remain in pain and suffering for at least an hour.
On 9 September 2011, Mr Chikosi had been working as a locum veterinary surgeon at the Vets Now out-of-hours emergency service in Barton-le-Clay, Bedford, when Mitzi's owner telephoned him to say that his dog was severely injured and to request a home visit for the purpose of euthanasia.
At Mr Chikosi's request, the owner attempted to bring Mitzi into the practice using a blanket. However, it was not possible to get Mitzi into a Land Rover, and she uncharacteristically bit the owner's son, so her owner called the practice again.
Mr Chikosi repeated the request to bring the dog in, saying that he was unable to leave the practice because he was looking after other animals, but that he could possibly organise another veterinary surgeon to visit "probably within the next hour or two".
The Committee considered Mr Chikosi's actions in context of the RCVS Guide to Professional Conduct 2011, which listed a number of factors for veterinary surgeons to consider when deciding whether to attend an animal away from the practice premises.
These included the likely treatment needed, the possibility of the animal being safely conveyed to the veterinary surgery, the health status of the animal and ability of the owner to manage the animal's pain until veterinary attention could be sought during normal hours, and travelling time for the veterinary surgeon.
However, the Committee found Mr Chikosi had made no enquiries to determine whether Mitzi was in a fit condition to be moved, and offered no advice as to how her condition could be alleviated whilst waiting for the home visit. Further, his advice that Mitzi should be moved on a blanket was wrong, as she may have had an injured back.
The Committee concluded that, from the outset, Mr Chikosi took the stance that he was unable to leave the practice because he was the only veterinary surgeon present.
However, the Committee noted, from the information available, that there were only three in-patients, no critical cases and a qualified veterinary nurse was present. The Committee found there was no good reason why he should not have attended the farm, which was only 10 to 15 minutes' drive away.
The Committee said that, by the time Mitzi's owner called a second time, it was clear that the out-of-hours service was experiencing difficulty finding a second veterinary surgeon but, instead of going to the farm himself, Mr Chikosi waited another hour until the second veterinary surgeon arrived at the out-of-hours service.
Professor Peter Lees, chairing and speaking on behalf of the Committee said: "The Committee is satisfied that the delay caused Mitzi unnecessary suffering, which was evidenced by her uncharacteristically biting [her owner's] son. [Her owner] had recognised the severity of the injuries and the need for euthanasia as soon as was practicable. [Mr Chikosi's] failure to attend a seriously injured dog promptly in the circumstances described falls far short of the conduct to be expected of a reasonably competent veterinary surgeon."
He directed that Mr Chikosi's name be struck off the Register.
In his first year of what would normally have been be a four-year term, Colin served on the College’s Education Committee, PIC/DC Liaison Committee, and on the Advancement of the Professions Committee as Council Deputy Lead for the ViVet innovation programme.
VetSurgeon.org caught up with Colin, who explained: "I've never had any problem with the idea of respecting Council decisions, even those I disagree with.
"However, I questioned the interpretation of collective responsibility when I first joined Council, and was told that in the event of disagreement, it was OK for councillors to say publicly that there was a 'split vote', or 'opinions varied'.
"This new statement would mean that if I disagree with a Council decision, I would now either have to lie in public and say I supported it, or run away and hide.
There were two other aspects of the new statement which Colin was not prepared to sign up to.
The first was a new requirement that councillors "support the College’s vision".
Colin said: "People who actively disagree with the College's vision should be free to stand to join Council, and if the profession disagrees with the College's vision, they'll get elected!"
The second was a requirement for councillors to "Live the College’s values"
Colin said: "Although perhaps inline with a corporate ethos, I think it represents quite a conflict.
"The values someone lives by are a deeply personal matter, and shouldn't be imposed by the majority vote of a committee they happen to sit on - however much they may or may not be likely to align."
Colin's resignation prompted VetSurgeon.org to carry out a quick analysis of the percentage of RCVS Council meeting agenda items marked as 'Confidential' from November 2015 to June 2022, to see whether the requirement to tow the party line reflected a broader lack of transparency at the College.
In the four Council meetings from November 2015-2016, 12% of the agenda items in the Council minutes were marked 'Confidential'.
By 2022, that figure had more than doubled to 36% (see graph right).
The new RCVS 'How we work' statement can be read in full in Annex One of the June 2022 Council Papers.
Ms Parody faced two charges, the first of which related to her treatment of a cat named Shadow and had multiple elements:
The second charge was that her conduct in relation to all parts of the first charge was dishonest.
At the outset of the hearing Ms Parody’s counsel admitted to the majority of the elements of the first charge, although denied she had removed the microchip in order to mislead others about Shadow’s identity.
Ms Parody also admitted that her failures to inform the owner that euthanasia had not been carried out, of the treatment plan, of the removal of the microchip and that she had taken Shadow home was dishonest.
However, she denied dishonesty in relation to failing to make adequate records.
The Committee went on to consider the facts of the remaining, contested charges.
After hearing evidence from a number of witnesses, the Committee concluded that it was not proven that Dr Parody removed the microchip in order to mislead others about his identity, and that, in this respect, she had therefore not acted dishonestly.
In relation to whether Ms Parody was acting dishonestly in relation to failure to make adequate clinical records, the Committee also found this not proven.
Having determined the facts of the case, the Committee went on to consider if the proven charges amounted to serious professional misconduct.
In terms of aggravating factors, it considered that there was actual injury to an animal – albeit small and while the cat was under sedation - and that Ms Parody had engaged in conduct that was in breach of a client’s trust.
In mitigation, the Committee considered the immense pressure that Ms Parody and her colleagues in the practice were under at that time due to the coronavirus pandemic and the fact that she had acted in a way which she thought was best for Shadow’s welfare and which clouded the rest of her decision making.
Furthermore, the Committee considered this was a single isolated incident, that she took the decision without the opportunity for full reflection and the length of time since the original incident.
However, it found Ms Parody guilty of serious professional misconduct in relation to all the proven charges.
Paul Morris, chairing the Committee and speaking on its behalf, said: “However well-intentioned, Dr Parody made some serious errors of judgment with regard to her approach to Shadow and embarked upon a course of dishonest conduct, which started with her failure to inform the owner about her decision not to euthanase Shadow, was followed by her treatment of Shadow, including his castration and microchip removal, all without the consent of the owner, and ended with her taking Shadow home over Christmas, again without the owner’s consent.
"In addition, she failed to make adequate clinical records with regards to Shadow.”
The Committee then went on to consider the most appropriate sanction for Ms Parody.
It heard a large number of positive testimonials as to her character and professionalism from both clients and former and current work colleagues.
The Committee also considered further mitigating factors such as the fact she had no previous disciplinary issues, had a long and unblemished career both before and since this isolated incident, her open and frank admissions regarding some of the charges, the significant impact she displayed regarding her misconduct, and her genuine expressions of remorse and apology.
Paul Morris added: “The Committee recognises that there is a scale of seriousness of dishonesty and therefore gave careful consideration as to where Dr Parody’s dishonest conduct fell to be judged.
"The Committee was concerned with her conduct between 20 December and 31 December 2021, as found proved.
"What led to what she has admitted as dishonest behaviour, was her acting to protect the welfare of the cat.
“The Committee was confident that she most certainly did not set out to act dishonestly.
"She made an initial error of judgement and everything that followed flowed from that.
"What she went on to do was something of a panicky attempt to cover up what she had done initially, so that she could decide on how to rectify it but, the Committee was satisfied, all done with the best of intentions and in the best interests of the cat and its owner.
"She had not acted out of any personal or financial gain or malicious intent.
"She had created a mess and she was trying to sort that mess out.”
After deciding that a reprimand was the most appropriate and proportionate sanction to impose, Paul Morris concluded: “In all the, somewhat exceptional, circumstances of this case, the Committee was satisfied that a reprimand would provide adequate protection to animals, as it was satisfied Dr Parody was most unlikely to ever make such a flawed set of decisions again.
"The Committee was satisfied that Dr Parody does not represent a risk to animals going forward, indeed from the character evidence it is clear that she always puts the welfare of animals first.
"She has also shown, since this episode, that she can work under pressure and not resort to making bad decisions and thus the Committee considered the wider public interest would be served in this case by a reprimand.”
www.rcvs.org.uk/disciplinary
The hearing concerned an incident which took place at the VetsNow Huyton premises in Liverpool. There were two charges against Dr Rafiq. The first was that in December 2017, shortly after a litter of puppies was delivered by caesarean to a French Bulldog named Lila, she took one of the puppies away from the practice with the intention that it should not be returned to Lila’s owner and that, in doing so, she was dishonest, misleading and had not acted in the best interest of the puppy’s welfare.
Another puppy was taken away by an animal care assistant who was also working at Vets Now Huyton on the night in question.
The second charge against Dr Rafiq was that she had told her employer at VetsNow that the puppy she had taken from the practice had died in the car when she had been driving home when, in fact, the puppy was alive at that stage and, in telling her employer this, she had been dishonest and misleading.
There was one charge against Mr Perez: that he had made an entry in the clinical records for Lila that she had given birth to four live puppies when in fact she had six; that he had only discharged four of the six puppies to the owner; that he knew that his colleagues intended to remove or had removed the puppies; that he had failed to prevent the removal of the puppies and had failed to report to a colleague the removal of the puppies. The charge also stated that, in relation to the incident, Mr Perez had been dishonest, misleading, did not act in the best interests of the puppies’ welfare and failed to keep accurate clinical records.
At the outset of the hearing, Dr Rafiq admitted in full the charges against her and accepted that she had acted dishonestly. Mr Perez admitted some of the charges against him including that he had made the false clinical record, had discharged four rather than six puppies and had failed to keep accurate clinical records, however he denied any knowledge of the intention to remove puppies and denied that his conduct had been misleading or dishonest.
The Committee was not satisfied that Mr Perez knew at the time of surgery that his colleagues intended to remove the puppies and also considered there was insufficient evidence that he subsequently became aware of their removal.
As a result, the Committee found that he could not have prevented their removal or reported the matter to a colleague. However, the Committee did find that his actions were unintentionally misleading regarding the clinical records and the discharge of the incorrect number of puppies.
The Committee found all the charges against Dr Rafiq proven.
The Committee considered whether the admitted and/or proven charges against Dr Rafiq and Mr Perez amounted to serious professional misconduct.
In respect of Mr Perez, the Committee was critical of his failure to keep accurate clinical records and considered that it was his duty to know how many puppies were born and to record them accurately.
However, while the Committee concluded that Mr Perez’s conduct fell below the expected professional standards of a veterinary surgeon, it did not fall so short as to constitute serious professional misconduct. As a result, no further action was taken against Mr Perez.
In regard to Dr Rafiq, the Committee recognised her admission at the outset that her actions constituted serious professional misconduct and noted her expression of remorse.
The Committee did however have concerns regarding the evidence she gave as to her actions being motivated by animal welfare concerns. The Committee felt that such concerns should have been raised with colleagues and it found that Dr Rafiq had acted recklessly and had been dishonest both with the owner and with her colleagues.
The Committee therefore concluded that her conduct fell so far short of what would be expected of a veterinary surgeon that it constituted serious professional misconduct.
The Committee then considered the sanction against Dr Rafiq, taking into account aggravating and mitigating factors. The aggravating factors included a risk of injury to the puppies, an abuse of the client’s trust, sustained misconduct as the puppy was retained by Dr Rafiq from 2/3 December until its actual death on the night of 5 December, that the dishonesty was sustained until 7 December and that she had only demonstrated limited insight in respect of her wider professional responsibilities.
In mitigation, the Committee considered that her actions involved no financial gain, that it was a single and isolated incident, that she had no previous adverse findings, that she had demonstrated genuine remorse and that she had made admissions at an early stage.
Dr Rafiq, who was unrepresented during the hearing, also submitted evidence in mitigation including testimonials from colleagues and clients, her youth and inexperience at the time, and her remorse, among other things.
In deciding the sanction Ian Arundale, who chaired the Committee and spoke on its behalf, said: "The Committee concluded that Dr Rafiq was a competent veterinary surgeon who was very unlikely to pose a risk to animals in the future.
"However, it considered the reputation of the profession and the need to uphold standards was an important consideration that outweighed the hardship which would be suffered by Dr Rafiq by not being able to practise in her chosen profession. It considered that Dr Rafiq would be fit to return to the profession after a period of suspension.
"It therefore determined that, notwithstanding the nature and extent of the dishonesty in this case, a suspension order was a sufficiently severe sanction to maintain the reputation of the profession and to meet the wider public interest. It took into consideration the overall dishonesty, including that Dr Rafiq had been dishonest when first confronted about these matters, when deciding on the length of any suspension.
"The Committee considered the sanction of suspension was proportionate in the circumstances of this case where there was supporting evidence that Dr Rafiq was a competent and well-regarded veterinary surgeon. It considered the positive testimonial evidence given… and that she was held in high regard by her current employers who were aware of the admitted misconduct, were significant factors in deciding that a suspension order was the proportionate sanction."
The Committee determined that a six-month suspension order would be the most appropriate sanction under the circumstances and directed the Registrar to remove Dr Rafiq from the Register for this period of time.
Mrs Grecko faced two charges.
The first was that she got a nurse colleague to order griseofulvin, a prescription-only antifungal medication, knowing that it was for human use, rather than legitimate veterinary use.
It was also alleged that she then caused a student veterinary nurse to record the order in the name of another veterinary surgeon, who was not involved in the order or prescription of the medication, and falsely record that it was for Mrs Grecko’s dog.
The second charge was that she had acted dishonestly and misleadingly, as the medication was, in fact, intended for use by her husband.
At the outset of the hearing, Mrs Grecko admitted she had asked her RVN colleague to order the medication and for her SVN colleague to record that the medication was for her dog and that doing this was dishonest and misleading.
Mrs Grecko accepted that these admitted charges amounted to serious professional misconduct.
She denied asking an SVN to record it under the name of another veterinary surgeon.
However, the Committee heard from two eye-witnesses who testified consistently that Mrs Grecko had told her SVN colleague to record the medication under another vet's name, and from another witness who testified that Mrs Grecko had made a similar admission.
It therefore found it proven that she had asked her SVN colleague to make a false record, that it was dishonest and misleading, and that together, the charges amounted to serious professional misconduct.
Paul Morris, chairing the Committee and speaking on its behalf said: “The Committee considered that Mrs Grecko’s conduct had breached her obligations as a veterinary surgeon to respect the proper protections that were in place for the control of prescription-only medications.
"She had committed a serious abuse of her position in using the fact that she could obtain medications by virtue of her profession to circumvent the protections.
"She had been prepared to involve others in the course of the conduct.
"In addition, Mrs Grecko had been prepared to engage in an attempt to conceal her actions and falsify the clinical records in the process.
“Although it was acknowledged that Mrs Grecko may have been subject to some conflicting demands, being affected by her husband’s interests and may have felt a pressure to act, the Committee considered that she had completely failed to acknowledge and respect her overriding professional responsibilities.”
The Committee considered that the offence was a serious one, taking into account the abuse of position and pre-meditated and dishonest conduct.
The Committee also took into account previous adverse findings against Mrs Grecko from 2011, which involved misconduct of a very similar nature, which meant that they could not accept her argument that she had learnt her lesson, and also meant that, in the Committee’s judgement, she presented a significant risk of further repeated errors of judgement and dishonest conduct.
Mr Morris added: “Further, the Committee considered that members of the public would be very concerned to learn that, having once been reprimanded for her previous dishonest conduct, Mrs Grecko had repeated her behaviour.
“It [the Committee] concluded that this rendered Mrs Grecko’s disgraceful conduct in a professional respect incompatible with continued registration and no lesser sanction than removal from the Register would be sufficient to protect the wider public interest in maintaining public confidence in the profession and declaring and upholding proper professional standards.”
Mrs Grecko now has 28 days from being informed of her removal from the Register to lodge an appeal.
The Disciplinary Committee heard that in 2018, when Dr Dyson was employed as Head of Clinical Orthopaedics at the Animal Health Trust (AHT), she completed a research project: ‘Influence of rider: horse body weight ratios on equine welfare and performance – a pilot study’, for which she had previously been given the go-ahead by the AHT’s Clinical Research Ethics Committee. The results of the study were then submitted to the Journal of Veterinary Behaviour: Clinical Applications and Research for publication.
After peer-reviewing the project paper at the request of Journal Editor Karen Overall, Dr Matthew Parker, a Senior Lecturer in Behavioural Pharmacology at the University of Portsmouth, was concerned by the lack of a Home Office licence and asked for details of the licence or an explanation of why the project didn’t need one, and for the paper to be re-submitted.
In reply, Dr Dyson then emailed Ms Overall saying: “We have a former Home Office Inspector on our AHT Ethical Committee and two current licence holders (Named Veterinary Surgeons) who are fully conversant with the current legislation ... I also sought informal advice from a current Inspector. All were fully aware of the protocols to be employed and gave me assurance that in their opinion Home Office approval would not be required”.
Ms Overall then asked Dr Dyson to obtain a letter from the Home Office to support this position.
On 24 December 2018, Dr Dyson sent Ms Overall a letter purportedly from a Home Office Inspector called Dr Butler who, she explained, had advised her during the planning phase of the project. In the letter, the fictitious Dr Butler confirmed that their advice was sought for the project and that in their opinion, a Home Office Licence was not required.
Ms Overall then sent the letter to Dr Parker for further review, who decided to contact Dr Martin Whiting, Head of Operations at the Home Office Animals in Science Regulation Unit (ASRU) to ask if he knew of Dr Butler.
Dr Whiting confirmed that the Home Office had no record of employing a Dr Butler as an Inspector and that they were in the process of making further inquiries into the matter.
After Dr Whiting’s reply was forwarded to Dr Dyson, she replied to him saying that she thought the studies’ procedures did not meet the criteria for the Animals (Scientific Procedures) Act 1986 (ASPA), but that this was questioned by peer reviewers.
She said that her decision to send Dr Butler’s letter was one that she would ‘eternally regret’ and that she was ‘an inherently honest person’.
She explained that she was under a huge amount of pressure in her personal and professional life and that she was ‘fully aware that [she] acted completely inappropriately and she requested the incident be overlooked’.
In March 2019, Dr Dyson sent a letter to William Reynolds, Head of the Home Office ASRU, in which she expressed remorse for writing the letter. Mr Reynolds subsequently raised a concern with the RCVS about Dr Dyson’s alleged behaviour.
Dr Jane Downes, who chaired the Disciplinary Committee, and spoke on its behalf, said: “The Committee heard from Dr Dyson that she had no recollection of several events detailed in the charge, including writing the letter from Dr Butler and sending the email to Ms Overall which contained Dr Butler’s letter. She accepted that the letter was dishonest and that it should not have been sent. However, she also claimed that, as she could not remember writing the letter, she did not act dishonestly.
The Committee heard testimonials from several witnesses who held Dr Dyson in high regard, including colleagues from the AHT, who attested to her integrity.
However, there were many dubious claims made by Dr Dyson throughout the hearing, including that the Home Office Inspector that she referenced as ‘my friendly inspector’ was someone who could have given informed consent to a project as Dr Dyson confirmed that she had met the individual briefly, around two and a half years ago at a drinks reception.
In reaching its decisions, the Committee considered Dr Dyson’s previously impeccable character, the written and verbal testimonies from witnesses. They also considered that during the hearing, Dr Dyson explained that at the time she fabricated the letter, she was under a lot of work and personal pressures, including managing a workload amidst colleagues’ resigning or going on maternity leave and it being the anniversary of her dog having to be humanely destroyed.
However, it did not accept Dr Dyson’s claims that she had amnesia at this time, and considered that she had not owned up to her wrongdoing until it was discovered. Although Dr Dyson maintained her actions were not pre-meditated, the Committee considered that, in the case of the forged letter, a certain amount of planning and careful thought was involved. The Committee believed that Dr Dyson knew what she was doing at the time, but acknowledged she may subsequently have blanked out what she did.
The Committee found all but one of the allegations proved and confirmed that it “was satisfied that the writing and sending of that letter was the culmination of a course of dishonest conduct.”
Committee Chair Dr Downes said: “In assessing [the evidence of] Dr Dyson the Committee took into account the difficulty faced by any Respondent appearing before their Regulator and also the various interruptions occasioned by issues which had to be dealt with during her evidence. Whilst [Dr Dyson is] undoubtedly highly qualified and highly respected, the Committee nevertheless considered her evidence lacked credibility and was not reliable.”
The Committee found that Dr Dyson’s conduct had breached parts of the RCVS Code of Professional Conduct for Veterinary Surgeons and amounted to serious professional misconduct.
Dr Downes continued: “The Committee determined that it was important that a clear message be sent that this sort of behaviour is wholly inappropriate and [was] not to be tolerated. It brings discredit upon Dr Dyson and discredit upon the profession.
"For whatever reason, Dr Dyson chose not to respond to Ms Overall’s email on 30th November 2018 in an honest and straightforward way. Instead, she lied about the makeup of the AHT Ethical Committee in order to cloak her response with authority.
"She also lied about having received advice from a current Inspector for the same reason. In the Committee’s view, she made a conscious decision to provide a dishonest response. She no doubt believed that would be the end of the matter.
"When that did not work, she lied further in the email to her co-author, Andrew Hemmings, claiming to have a letter from her friendly Inspector. When that too did not work, she impersonated a Home Office Inspector in creating the ‘Dr Butler letter’.
"She then added a false declaration to the manuscript, which she subsequently submitted to the Journal along with an email containing yet further lies. That was all done in a blatant and wilful attempt to deceive Ms Overall ... into believing the contents of the correspondence to be true, that confirmation a Home Office Licence was not required had been obtained and all was therefore well with the submitted manuscript.
"There was no rush, or urgency to have the paper published and the actions were not done in a moment of panic. No doubt she had not planned the entire course of events in advance, but instead reacted to each new obstacle that came her way, but her overall course of dishonest conduct spanned over three weeks.
“The Committee was well aware of the impact and ramifications for Dr Dyson of any decision to remove her from the Register but had to weigh her interests with those of the public.
"In doing so it took account of the context and circumstances of the case, all matters of personal mitigation, as detailed above, Dr Dyson’s undoubted distinguished international career and reputation and the need to act proportionally.
"However, for all the reasons given above, the Committee was of the view that the need to uphold proper standards of conduct within the veterinary profession, together with the public interest in maintaining confidence in the profession of veterinary surgeons, meant that a period of suspension would not be sufficient and that the only appropriate and proportionate sanction in all the circumstances of this case was that of removal from the Register."
Ms Hill and Wilfred Wong snatched the child from their foster carer when they arrived home from school on Anglesey.
Hill wrestled the child from the car and put them in a waiting vehicle while Wong held a knife to the foster carer’s throat before slashing one of the carer’s car tyres to stop them following.
Having made their escape, they then transferred the child into the hands of two other conspirators who had hired a car to take the child abroad.
The child was rescued four hours later when the hire car was stopped by police on the M1 in Northamptonshire.
A police investigation later concluded that the child had not been the victim of any abuse.
Ms Hill was sentenced at Caernarfon Crown Court to 19 years, 5 months, with a custodial term of 14 years and five months.
Ms Hill did not attend the RCVS disciplinary hearing as she was serving her prison sentence, and she was not represented.
In relation to the charges, the Committee was presented with the sentencing remarks from Ms Hill’s conviction at Mold Crown Court.
The judge said that Ms Hill had led the conspiracy to kidnap, and that it had caused the victim and the people responsible for their care “unspeakable misery and considerable harm”.
The judge also said that Ms Hill posed a significant risk of causing serious harm in the future.
Dr Hazel Bentall, chairing the Committee and speaking on its behalf, said: “The Committee took into account a number of aggravating features when considering the sanctions.
"In particular, the Committee considered that the conviction arose as a result of careful planning over several months and involved the use of violence.
"The Committee concluded that there were no mitigating factors apart from that Dr Hill had no previous regulatory history and that the only appropriate and proportionate sanction was that Dr Hill’s removal from the Register of veterinary surgeons be maintained.”
Dr Hill has 28 days from being notified of her removal from the Register to lodge an appeal with the Privy Council.
Lowestoft vet Frank Eric Ainsworth MRCVS has received a severe reprimand and warning as to future conduct from the RCVS Disciplinary Committee after being found guilty of serious professional misconduct.
The charge against Mr Ainsworth was that in July 2013, he failed to provide adequate care to Ash, a dog presented to him whilst he was working as a locum at Pinebank Veterinary Surgery in Kent.
Specifically, the charge was that having diagnosed Ash with heatstroke, Mr Ainsworth failed to admit the dog to the practice for urgent treatment, failed to transfer the dog to another practice, failed to suggest euthanasia, and failed to offer the owner, Mr McMahon, adequate treatment advice.
On presentation to Mr Ainsworth at Pinebank between 7am and 8am, Ash was collapsed and his symptoms included diarrhoea, vomiting, lethargy and a high temperature.
On being told that Ash had heatstroke and was unlikely to survive, Mr McMahon asked Mr Ainsworth whether anything could be done to save him, but was told the practice did not have the necessary treatment facilities. Mr McMahon was advised to take Ash home and use cold running water, ice packs and fans to reduce his temperature.
After Mr McMahon took Ash home and showered him in cold water, his wife telephoned Pinebank to complain. The practice receptionist, Ms Baldock, confirmed to her that there was nothing they could do.
Mrs McMahon asked if her husband could take Ash to Pinebank's out-of-hours service provider, but was told this was not an option.
Eventually, Mr McMahon took Ash to an alternative practice, Sandhole Vets, where the dog was treated by the practice owner, Mr Johnson. Mr McMahon was told that Ash was unlikely to survive and that, if there was no improvement, he should consider euthanasia. Around 45 minutes after the treatment was started, Ash suffered seizures and died shortly thereafter.
Mr Ainsworth told the Committee that he did not think Pinebank had adequate facilities to treat a dog of Ash's size for heatstroke and was unaware that it had a hosepipe and watering can. In addition, he did not believe it would be practical and effective to reduce Ash's temperature with wet towels and considered that the main priority of reducing the temperature would be best done at home.
Mr Ainsworth told the Committee that he intended to make enquiries about referring Ash to another practice once his temperature had been reduced at home. He was about to search the internet for alternative practices when he overheard his colleague's phone conversation with Mrs McMahon and assumed that Ash had been taken to another practice.
Mr Ainsworth accepted that he did not discuss euthanasia with Mr McMahon, which he said he would have done at a later stage if Ash's condition did not improve. He also accepted that he made no further enquiries of Ms Baldock and did not telephone Mr McMahon to check if Ash had gone to another practice.
Before reaching its decision the Committee considered, in detail, the testimony of a number of witnesses and experts for both the College and Mr Ainsworth. It rejected Mr Ainsworth's evidence that his treatment plan was to follow up his investigations into Ash's case or contact Mr McMahon by telephone. It concluded that, if such a plan had been in place, he would have informed Mr McMahon of his intentions.
The Committee also rejected Mr Ainsworth's evidence that he had overheard the conversation between Ms Baldock and Mrs McMahon. It said it was not credible that, if he had heard the call, that he would not have made further enquiries.
The Committee found the charges proven. For example, it concluded that Mr Ainsworth should have made further enquiries about the treatment facilities available at the practice for cooling Ash and, if he felt that they were inadequate, should have advised Mr McMahon to take the dog to another practice. It also felt it was inappropriate for Mr Ainsworth to have sent Ash home to the care of his owners while in a critical condition without first seeking the option of referral.
Furthermore, the Committee felt that Mr Ainsworth should have given Mr McMahon the full range of treatment options available, including oxygen and fluids as Ash was in a collapsed state, before he left the practice, as well as discussing euthanasia.
However, the Committee did accept, on the basis of Mr Ainsworth's clinical records, that he had given advice to Mr McMahon on how Ash could be cooled down at home, although it felt the advice could have been more detailed.
In deciding its sanction for Mr Ainsworth the Committee accepted that his actions were not motivated by indifference to animal welfare but that, on this occasion, there was a serious lapse of judgment.
The Committee also considered that this was a single incident on Mr Ainsworth's first day at the practice and that he had been confronted with an emergency situation before the practice had opened. It accepted that Mr Ainsworth had an unblemished career over the past 38 years and that he had produced character references from other veterinary surgeons attesting his integrity, skill and conscientiousness.
Judith Webb, chairing the Disciplinary Committee and speaking on its behalf, said: "The Committee has concluded that the sanction proportionate to Mr Ainsworth's conduct is one of severe reprimand and warning as to his future conduct."
She added: "The Committee considers that veterinary surgeons are required to be proactive in their duty of care and refer cases when they do not have the ability to deal with cases appropriately."
The Committee also recommended that Mr Ainsworth should undertake, in the next 12 months, continuing professional development with an emphasis on emergency and critical care and client communication.
The Committee's full findings and decision are available on the RCVS website (www.rcvs.org.uk/disciplinary).
Mr Cortes had pleaded guilty to the offences in January 2017 at Cardiff Crown Court. In February 2017, he was sentenced to six months imprisonment suspended for two years with a requirement to complete unpaid work and rehabilitation activity and a victim surcharge. Following Mr Cortes’ conviction the matters were referred to the RCVS and Mr Cortes was subsequently referred to the Disciplinary Committee.
Mr Cortes did not attend at the Disciplinary Committee hearing and was not represented. The Disciplinary Committee, being satisfied that Mr Cortes had been served with the Notice of Inquiry and having considered and taken into account a number of separate factors, decided that it would be in the interests of justice to proceed with the hearing in his absence.
The Committee considered whether Mr Cortes’ convictions rendered him unfit to practise as a veterinary surgeon. Chitra Karve, chairing the Committee and speaking on its behalf, said: "The Committee has reached the conclusion that the respondent’s possession of this material which has led to his convictions was so reprehensible as to merit the description disgraceful. It considers that by possessing this material, the respondent has brought disgrace on the profession and will have undermined confidence in it. It therefore finds that the convictions have rendered the respondent unfit to practise veterinary surgery."
In considering the sanction the Committee decided that removing Mr Cortes from the Register of Veterinary Surgeons was the only available option. Ms Karve added: "The Committee has determined that the respondent’s behaviour is fundamentally incompatible with being a member of the veterinary profession. It therefore directs the Registrar to remove the respondent’s name… from the Register of Veterinary Surgeons."
The RCVS Disciplinary Committee has agreed to adjourn multiple charges against a Hampshire-based veterinary surgeon who first registered in 1950, following his undertakings firstly to request removal from the RCVS Register and secondly never apply to be restored to it.
At yesterday's hearing, William Bamber Cartmell of Wickham, near Fareham, was due to face seven heads of charge containing "serious allegations" relating to his provision of expert evidence in a case involving the RSPCA; his certification, following clinical examination, of the health of two horses for a prospective purchaser; and his clinical competence during treatment of a Cavalier King Charles Spaniel called Milly.
However, before the Committee considered any of the facts behind these charges - all of which Mr Cartmell denied - the College submitted an application suggesting that they should be adjourned, providing that Mr Cartmell agreed to the three undertakings (the third being not to act as an expert witness in litigation in future). The College also suggested that, should Mr Cartmell subsequently apply to be restored to the Register, the Committee should resume its consideration of the charges, along with his breach of the undertakings.
The Committee was advised that none of the complainants in the case - which could have exceeded four weeks and incurred considerable costs - dissented from the proposed course of action. It also heard that Mr Cartmell had recently retired from his practice, which was now closed and his clients dispersed to other practices. In over 60 years of practising, there had been no adverse disciplinary findings against him.
Speaking on behalf of the Disciplinary Committee, its Chairman, Professor Peter Lees, said: "Having carefully considered the matters put before us, we have concluded that it would not be in the public interest to refuse the College's application and proceed with this case.
"We are satisfied that the undertakings offered by the Respondent protect the welfare of animals and uphold the reputation of the profession. [These undertakings also] go beyond any sanction that this Committee could impose at the conclusion of a contested hearing where any of the heads of charge were found proven.
"We do not consider that it would be proportionate for either party to incur the substantial costs of a contested hearing. We have also paid particular regard to the age of the Respondent and to his length of service without any adverse findings having been made against him."
It’s very significant because it’s the first time the College has produced material for practices that highlights the responsibilities of pet owners, as well as those of veterinary surgeons and nurses.
As such, it should be a really useful tool to support the advice given by veterinary surgeons and nurses in practice.
In other words, don’t just stick it on the wall in some hidden part of the waiting room. Display it prominently by the reception desk, and point to it when explaining why owners need to make their own arrangements to bring the animal into the practice in emergency, for example. Or why you can’t prescribe drugs when you haven’t seen the animal for 8 years.
The idea for the poster was first mooted by Jonathan Wray MRCVS in the forum on VetSurgeon.org, after he’d seen a similar thing produced by the French regulator for veterinary practices in France.
VetSurgeon.org decided to produce an English version with input from vets as to what they would like a UK version of the poster to say.
On reflection, however, it was always something which would carry so much more clout if it came from the regulator, so we turned the idea over to the RCVS.
To its great credit, the College ran with the idea and had the poster designed and put through its Standards Committee. The result has now been posted to all practices in the UK, with a pdf version available to download from www.rcvs.org.uk/poster.
The RCVS is now inviting feedback about the poster at communications@rcvs.org.uk.
If you like the poster, I really do urge you drop the College a quick line at that email address and say so. Better still - and I will probably be put on the naughty step for saying this - cc L.Lockett@rcvs.org.uk and i.holloway@rcvs.org.uk. It was they who took the idea forward and made it happen. I think they deserve a round of applause.
At the June 2017 meeting of RCVS Council, members decided to look into two models by which paraprofessionals working in the veterinary, animal health or related fields, might be regulated by the College under powers granted by the RCVS’s Royal Charter in 2015.
The first was an accreditation model, which would involve the RCVS accrediting an organisation which would regulate the profession in question. The second was an associate/ full regulation model, in which individual paraprofessionals would receive a similar level of regulation to that already received by veterinary surgeons and veterinary nurses.
At its January 2019 meeting, RCVS Council agreed to proceed with both proposed models of paraprofessional regulation, with the suitability of each model being considered on a case-by-case basis, depending on the nature of the profession applying for recognition.
Paraprofessions whose work will need to be underpinned by Schedule 3 reform would need to apply for the associate model, as the RCVS would be required to be directly responsible for the register of any individuals undertaking such minor acts of veterinary surgery.
Two paraprofessional groups that have already expressed an interest in being regulated by the College, namely meat inspectors and animal behaviourists, will now be invited to apply for associate or accredited status.
Eleanor Ferguson, RCVS Registrar, said: "This is a very significant decision by Council to open up a pathway to related paraprofessions to apply to become regulated by the College.
"It is difficult to give a time-frame at this stage as to when these particular professions will be brought on board, as we will have to go through a process of developing a number of new regulatory structures including registration, education and investigation and disciplinary, as well as the appropriate governing bodies for each of the professions.
"However, we are very pleased that the Association of Meat Inspectors (AMI) and the Animal Behaviour and Training Council (ABTC) have expressed an interested in being regulated by the College and we look forward to working with them to make this happen."
David Montgomery, President of the ABTC, said: "The ABTC enthusiastically welcomes the news that the RCVS is expanding its influence to include paraprofessionals. We look forward to exploring the opportunity to demonstrate the professional status of ABTC-registered Animal Trainers and Behaviourists by coming under the regulatory umbrella of the RCVS for the benefit of animal welfare."
Ian Robinson, a Trustee of the AMI, said: "The Association of Meat Inspectors welcome the news that the Royal College of Veterinary Surgeons intends to invite paraprofessionals to be regulated under the ambit of the RCVS. We believe it will offer enhanced security, opportunity and status, and we look forward to further dialogue to explore the various models in due course."
The College says it is also in touch with a number of other paraprofessional groups, including those representing animal musculoskeletal practitioners and equine dental technicians, about the future of paraprofessional regulation. However, before such professions could become associates, there would need to be reform of the Veterinary Surgeons Act in order to remedy some of the deficiencies of the current legislative regime and make sure that these groups have appropriate legal underpinning for their work. This, says the College, complements ongoing discussions on changes to the legislative framework to bolster the role of veterinary nurses.
On particular issue that the College says the new proposals are designed to remedy is that of equine dental procedures being carried out by well-trained but nevertheless unregulated paraprofessionals. Neil Townsend, Chair of the British Equine Veterinary Association’s (BEVA) Allied Professional Committee, said: "Change to the current situation, where legislative enforcement is impossible, horse owners are confused, and horse welfare is compromised, is long overdue. BEVA is really pleased that the RCVS has listened and is supporting a proposal for regulation of all equine dental procedures. We hope that Government will act."
RCVS President Amanda Boag, said: "This is a real milestone in the history of the RCVS and represents quite possibly the biggest change to our regulatory role since the introduction of the Register of veterinary nurses in 2007, and should Schedule 3 reform be achieved it would be the most significant change since the role of veterinary nurses was first recognised in law in 1991. It is particularly befitting for our 175th anniversary year, as it demonstrates we are an organisation that can evolve to meet the changes occurring in the wider veterinary and animal health sector and use our regulatory experience and expertise to ensure that animal health and welfare and public health is safeguarded in different, but related fields of endeavour."
The full approved paper regarding the review of the minor procedures regime and paraprofessional regulation can be found on the RCVS website at: https://www.rcvs.org.uk/news-and-views/policy/veterinary-legislation-review/
The Committee heard seven charges against Dr Elefterescu. The charges were:
In September 2015, in relation to a male cat called Kitty Brown, he failed to undertake an adequate examination prior to surgery and that he undertook an unnecessary laparotomy.
In February 2016, in relation to a male cat called Storm Page, he failed to undertake an adequate clinical examination prior to anaesthesia and made dishonest or misleading entries in the clinical records stating that he had undertaken a full clinical examination.
In February 2016, in relation to a male cat called Sampson Page, he failed to undertake an adequate clinical examination prior to anaesthesia and made dishonest or misleading entries to the effect that he had undertaken a full clinical examination.
In February 2016, in relation to Tibial Plateau Levelling Osteotomy (TPLO) surgery performed on a female Bichon Frise called Lucy Allen, he failed to undertake adequate examinations into the possibility of a cranial cruciate ligament rupture or failed to record the same; performed the TPLO surgery with insufficient clinical justification; performed the surgery inadequately; failed to take steps to rectify inadequate surgery having obtained post-operative radiographs; made dishonest/ misleading entries into clinical records; and, in a letter to the RCVS on 7 August 2016, made dishonest and misleading comments.
In February 2016, in relation to a male cat called Kipper Morley, he failed to take and record a sufficiently detailed history; failed to undertake an adequate clinical examination; that, having noted the possibility that Kipper might have anaemia, he failed to make arrangements for urgent investigations to be undertaken; that, having decided to administer intravenous fluids to Kipper, failed to make arrangements urgently; and failed to keep clear, accurate and detailed clinical records.
Between September 2015 and February 2016, he failed to keep clear, accurate clinical records in relation to seven cases.
In February 2016, in relation to a male cat named Chino Biggs, he failed to undertake adequate clinical examination and dishonestly made entries in the clinical records saying that he had undertaken aspects of an examination when he had not done so.
Having heard evidence from complainants, witnesses (including expert witnesses) and the respondent himself the Committee determined that the facts of all the charges were proven – with the exception of part of Charge 6 regarding his keeping inadequate clinical records in relation to a male cat called Dax Parham.
The Committee then went on to consider whether the proven charges, both individually and cumulatively, amounted to serious professional misconduct. In relation to the first and fifth charges the Committee found that, while Dr Elefterescu’s conduct fell below what was expected of a professional veterinary surgeon – they did not constitute serious professional conduct.
In relation to the parts of the second, third, fourth, sixth and seventh charges that were found proven, the Committee determined that each constituted serious professional misconduct.
In relation to these determinations, Ian Arundale, chairing the Committee and speaking on its behalf, said: "The respondent’s clinical failures… are very serious, amounting as they do to failures in the basics of animal care and resulting in suffering to the animal. They involve widespread breaches of the Code, including not only the obligation in relation to animal health and welfare… but also the specific obligations of the Code in relation to record keeping.
"In addition to his clinical and record keeping failures the respondent has been found to have acted dishonestly. This dishonesty would have impacted upon professional colleagues and any owner who viewed the records. It has the potential to undermine public confidence in the profession. The respondent was also dishonest in a letter written in August 2017 to his regulator."
In considering Dr Elefterescu’s sanction, the Committee took into account a number of aggravating and mitigating factors.
Aggravating factors included actual and risk of injury to animals, dishonesty, recklessness, breach of client trust, repeated misconduct and limited insight into his failings.
In mitigation the Committee considered that, at the time of the misconduct, the respondent was new to the UK, he had language difficulties which resulted in communication problems, that he was unfamiliar with UK veterinary computer systems and procedures, that he is of good character, that he has taken steps to avoid a repetition of his misconduct and that there have been no subsequent complaints since the dates of the matters in the charges.
However, the Committee found that, in light of the seriousness of the charges found against him, the only sufficient sanction was to direct the Registrar to remove Dr Elefterescu’s name from the Register.
Mr Arundale, commenting on the sanction, said: "The respondent’s misconduct involved very serious departures from the professional standards set out in the RCVS Code…. In particular, the unnecessary surgery (both the initial and revision) carried out on Lucy Allen constituted very serious harm to an animal. The Committee considers that the respondent’s lack of insight into his failings, and his wholly unjustified confidence in his abilities constitute an ongoing risk to animal welfare. In these circumstances, the Committee has determined that the only sanction which is appropriate and proportionate, in order to ensure the welfare of animals, the public interest and the reputation of the profession, is to direct the respondent’s removal from the Register."
Dr Elefterescu has 28 days in which he can lodge an appeal with the Privy Council regarding the Disciplinary Committee’s decision.
The RCVS Disclipinary Committee has severely reprimanded and warned as to her future conduct a Brighton-based veterinary surgeon who failed to maintain a proper boundary between her professional and personal relationships with a client.
The eight charges considered at the seven-day hearing involved Marie-Louise Schlemm's treatment of Ratszy, a 16-year old Jack Russell with chronic renal failure, and her relationship with the dog's owner, Ms B, who suffers from mental illness, during May 2010. At that time, Ms Schlemm was employed by Coastway Veterinary Group in Brighton to work for its out-of-hours veterinary services, Vetcall, to which Ratszy had been referred by the PDSA.
The College alleged that Ms Schlemm deliberately misled Ms B as to the condition and prognosis of Ratszy, removed the dog without Ms B's consent, and behaved unprofessionally and inappropriately in her dealings with Ms B. Other allegations were that that she had suggested Ms B tell the PDSA a fabricated story in order that she might see the dog again; made an offer that Ms B and Ratszy could come and stay with her at her home; required Ms B to attend a supermarket car park at 12.30am to collect Ratszy; and took money from Ms B other than for the purposes of legitimate veterinary treatment.
The Committee found both Ms Schlemm and Ms B to be truthful and honest witnesses, and that Ms B's recollection was given to the best of her ability. However, where recollections differed, it relied on contemporaneously prepared clinical records to find that Ms Schlemm did not mislead Ms B to the effect that the dog was not dying. Although recognising that Ms Schlemm's actions were misguided the Committee found that the dog was not taken without consent.
Furthermore, the Committee said in making the offer that Ms B and Ratszy might come and stay with her, Ms Schlemm was wholly misguided and had blurred the distinction between personal and professional activities. By this time, she was aware Ms B suffered from mental illness and so should have allowed the mental health services to take control of the situation. Similarly, she should not have required Ms B to meet in a car park to collect Ratszy, behaviour the Committee described as bizarre and which had compromised Ratszy's welfare. Although the Committee gave Ms Schlemm the benefit of the doubt as to whether money taken was, in fact, to pay for alternative therapy for Ms B, she did not deal with the matter openly and it was a clear breach of trust to both Ms B and Vetcall.
In mitigation, the Committee was satisfied that Ms Schlemm now had a genuine insight into her lack of judgement in her relationship with Ms B, had reflected on the decision of the Committee and fully accepted the "utter stupidity" of her actions. She had also attended courses on teamwork and managing client relationships, and had established good working relationships in a new practice.
Professor Peter Lees, chairing and speaking on behalf of the Committee said: "While the Committee has accepted that Ms Schlemm was motivated by good intentions towards Ms B and Ratszy, she breached the trust of both of Ms B and Vetcall in the way in which she behaved [and] acted in a misguided way in dealing with a vulnerable client, who was suffering from mental illness. In light of the serious nature of its findings, the Committee does not consider it appropriate to take no further action. The Committee has concluded that Ms Schlemm should be severely reprimanded for her conduct and given a warning as to her future conduct [and] reminds the profession of the importance of maintaining a proper boundary between the professional and personal relationships of client and veterinary surgeon."
The RVN Disciplinary Committee of the RCVS has removed an Armagh-based nurse from the Register after finding that she'd entered the details of four injections into clinical records when she had no reasonable basis for doing so.
During the four-day hearing, the Committee considered two alternative charges against Ms Tracy Nicholl (nee Wilson) relating to her actions on 3 February 2011, whilst employed by O'Reilly & Fee veterinary surgery, Armagh.
Ms Nicholl was alleged by the College to have administered Dolethal, a pink liquid containing pentabarbitone and used for euthanasia, to a dog called Butch without being directed to do so. It was also alleged that she had made dishonest entries into the dog's clinical records, or had administered drugs without a veterinary surgeon's prescription.
Ms Nicholl was alleged to have administered the Dolethal via a fluid bag and giving set on the morning of 3 February, which she denied. The Committee found that, although a veterinary surgeon believed that she saw pink fluid in the line, uncertainties in the surrounding circumstances made the Committee unable to be sure the line contained pink liquid. Expert and forensic evidence revealed Butch had received Dolethal, but not the route of administration or the timing. Therefore the Committee could not be sure Ms Nicholl administered the Dolethal and dismissed this charge.
However, the Committee found that Ms Nicholl did enter on Butch's clinical records that four drugs had been injected, when she had neither administered them nor been told that the drugs had been administered. Although she denied making the entries in evidence submitted to the hearing, in evidence from an interview with the College on 11 July 2011 she had admitted this and her initials were on the record entries.
The Committee noted these injections would be chargeable, and was satisfied the public would regard making these incorrect entries as dishonest. As Ms Nicholl was a highly experienced, senior nurse who also lectured to veterinary nursing students, the Committee was sure she knew she was acting dishonestly. Further, she had breached her responsibilities to clients by failing to maintain accurate case records, and the entries raised potential animal welfare issues. In mitigation, her actions affected no animal's actual welfare, and there was no evidence that Ms Nicholl had made any financial gain or repeated her conduct.
Ms Judith Webb, chairing and speaking on behalf of the Committee, said: "In addition to the fact that the charge involved dishonesty, there were a number of other aggravating features. The Respondent has not demonstrated any recognition of the seriousness of the record entry allegation, specifically the importance of keeping proper records ... It is in the wider public interest and to protect the reputation of the veterinary nursing profession that the Respondent's name should be removed from the Register."
Ms Nicholl is the first Registered Veterinary Nurse to be struck off since the introduction of the title.
Ms Burrows faced 11 charges against her.
The first alleged that in November 2017 she had allowed or caused her horse to be re-registered at the Cardiff equine practice where she worked under a different patient name, and had failed to consolidate and cross-reference this new record with the previous one.
The second charge alleged that between November 2017 and March 2018 she failed to make entries into the practice’s clinical records for her horse about its epistaxis and the investigations into the condition.
Charges 3 to 9 related to various telephone conversations and email exchanges Ms Burrows had with NFU Mutual in 2018 in which she failed to disclose the horse’s full clinical history and knowingly gave false statements to the effect that the horse’s condition of epistaxis had started more recently than it actually had. These charges also include asking an administrative colleague in the practice to, unknowingly, provide the insurance company with false information.
Charge 10 alleged that Ms Burrows asked a colleague to provide incorrect and/or dishonest information to the insurance company about the date of an endoscopy that had been performed on her horse in or around November or December 2017.
The final charge (Charge 11) alleged that, in regard to all previous charges, Ms Burrows had acted dishonestly.
At the outset of the hearing Ms Burrows admitted to Charges 2 to 9, as well as charge 11 in so far as it related to these charges.
However, she denied that she had allowed the creation of a new record for her horse under a different name for the purposes of concealing its clinical history or that she had attempted to induce a veterinary surgeon colleague to provide false information about the treatment of her horse.
Nevertheless, the Committee found all the charges proven.
Next the Committee considered whether the charges amounted to serious professional misconduct.
In doing so the Committee considered the pre-meditated nature of Ms Burrows’ conduct in setting up the second record for her horse with the intention of benefitting financially by providing false information. Likewise, the Committee considered that Ms Burrows had abused her professional position by asking her colleague who was a practice administrator to, unknowingly, provide false information to the insurance company on her behalf and in attempting to induce a veterinary surgeon colleague to lie on her behalf.
The Committee found her guilty of serious professional misconduct in respect of all 11 charges and stated that her conduct could be characterised as deplorable.
Cerys Jones, chairing the Committee and speaking on its behalf, said: “The Committee noted that, in the event, no actual harm had been occasioned to any animal or person. There had been an attempt at, but no actual, financial gain. The Committee had not been informed of any previous regulatory findings against Ms Burrows. In addition Ms Burrows had made some, limited, admissions to the College in her responses to it and has admitted a number of the Charges, including her dishonesty, before the Committee. Ms Burrows has apologised for that to which she admitted and in the Committee’s view has displayed a limited degree of insight.”
Having determined serious professional misconduct, the Committee then went on to consider the appropriate sanction for Ms Burrows. Ahead of the decision she made representations to the Committee in which she acknowledged that she had let the profession down, multiple breaches of the Code, and highlighted that her actions had prejudiced the delicate relationship between the public and the profession and had tarnished the reputation of the profession. She asked the Committee for the opportunity for a second chance, saying that she had started her own veterinary practice now and that honesty and integrity were now integral to her practice.
The Committee also heard several character witnesses as well as testimonials from both professional colleagues and clients attesting to her integrity and capabilities as a veterinary surgeon. Ms Burrows’ counsel also highlighted that at the time of the misconduct she was young and relatively new to veterinary practice and had been going through a difficult time, both professionally and personally.
Ultimately, however, the Committee decided that removal from the Register was the most appropriate and proportionate sanction.
Cerys Jones, speaking on behalf of the Committee, said: “In the view of the Committee, honesty in a veterinary surgeon is a fundamental professional issue, and that is the case regardless of age and experience. The public, other professionals and insurers all at times rely on the word of a professional veterinary surgeon to honestly attest to matters of importance. All need to be able to trust the veterinary surgeon. Any departure from a standard of honesty undermines public confidence in the profession.
“In the Committee’s determination, Ms Burrows had shown a repeated disregard for the principle of honesty on a number of occasions when dealing with the insurance claim in her telephone calls. Moreover, the Committee had found that Dr Burrows had caused or allowed the preparation of documentation concealing the full history of her horse and attempted to involve another professional in the matter.
“The Committee had found that Ms Burrows’ dishonesty had extended over approximately five months, and she had had several opportunities to resile from it. However, it took until [a colleague] raised the issue with Ms Burrows before she took steps to end the claim.
“The Committee determined that Ms Burrows had put her own interests ahead of those of the public and undermined the trust that underpins the relationship with insurers.”
She added: “In the Committee’s determination, the repeated dishonesty in the case in all the circumstances could not be met other than by directing that Ms Burrows’ registration be removed from the Register.”
Ms Burrows has 28 days from being informed of the outcome of the hearing to appeal the Committee’s decision.
The full findings for the case can be found at: www.rcvs.org.uk/disciplinary
The first change has been made to paragraph 1.6 which now advises general practitioners to check whether the vet they are referring a case to is on the RCVS Specialist or Advanced Practitioner list, explaining the difference to the client and what sets them apart from other vets who might be prepared to accept a referral.
Also, practitioners who accept a referral should provide information to the referrer about the experience and status of those likely to be responsible for the case.
The guidance about conflicts of interest in paragraph 1.7 has also been amended such that referring surgeons should tell clients if they are referring their case to a practice owned by the same group.
There is new guidance about how vets and nurses talk about referral practitioners, with the new advice being to focus on accepted terms such as 'RCVS Specialist' and 'RCVS Advanced Practitioner', and avoid more general terms like 'referral surgeon' or 'consultant' to avoid confusion or implying that individuals hold more qualifications than they do.
Lastly, there is new guidance that vets may only use the name 'Specialist' in the name of their practice where there is genuine and meaningful involvement, and oversight, in case management by at least one RCVS specialist in all disciplines where any clinical services are offered under the business name.
https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/referrals-and-second-opinions/
Mr Garcia had pleaded guilty of harassment at Nottingham Magistrates Court last September and was sentenced to six weeks’ imprisonment, suspended for 12 months. The magistrates also imposed a restraining order and ordered Mr Garcia to pay compensation and costs as well as a surcharge to fund victim services.
The harassment conviction related to incidents between 30 September 2016 and 27 December 2016 in which Mr Garcia engaged in conduct that amounted to harassment towards a woman including sending offensive text messages, visiting her place of work, attempting to contact her through social media, going to her home address and driving past her home address.
At the outset of the disciplinary hearing Mr Garcia admitted the College's charge against him and that his conviction rendered him unfit to practise veterinary surgery.
Following cross-examination of Mr Garcia on the facts of the case and having considered representation from his counsel, the Disciplinary Committee found that Mr Garcia’s conduct leading to conviction and the conviction itself rendered him unfit to practise as a veterinary surgeon.
Mehmuda Mian, chairing the Committee and speaking on its behalf, said: "It was a serious conviction as demonstrated by the sentence imposed and by the nature of the harassment. It brought distress on [the victim] and will have damaged the reputation of the veterinary profession. The respondent was right to accept that this was the case."
Turning to the sanction for Mr Garcia the Committee considered a number of aggravating factors in his case including the distress caused to the victim as some of the text messages could be interpreted as threats to harm; the fact that Mr Garcia had continued to contact the victim after receiving a warning from the police; the fact he visited her place of work; that there was a sexual element to some of the messages he sent to the victim; and that the pattern of behaviour was sustained over three months and only ended with his arrest. It also considered that his behaviour was contrary to the Code of Professional Conduct and its supporting guidance’s advice on professional and appropriate use of social media.
The Committee also considered mitigating factors such as the fact that, during the period of his conduct, there was a family illness and bereavement; that he admitted the charges before the magistrates and the Committee; that ‘social ineptitude’ was a factor and that he did not recognise the rejection he received from the victim; testimonials as to his capabilities as a veterinary surgeon; and insight into his behaviour as well as taking steps to avoid its repetition.
Ms Mian concluded: "The Committee has determined to suspend the respondent’s registration for a period of five months. This sanction reflects the seriousness of the conviction and the concerns expressed by the Committee in this determination. It will send a message to the respondent and to the profession that conduct such as this is unacceptable. It will afford an opportunity to the respondent to reflect further on his behaviour."
Mr Garcia will have 28 days from the end of the hearing to appeal against the Committee’s decision.
The Committee’s full findings and decision are available at: www.rcvs.org.uk/disciplinary
The RCVS DC has directed that a Wirral-based veterinary surgeon should be removed from the Register after finding that he had treated clients badly, kept inadequate clinical records, was dishonest in dealing with the RCVS, and that animals in his care were placed at risk.
At the end of the five-day hearing, the Committee found that Ian Beveridge, of the Daryl Veterinary Centre, Heswall, was guilty of charges relating to two separate cases: one concerning a crossbred bitch named Holly, who belonged to Mr and Mrs Flanagan and was treated in February 2011; and the other, a cat called Blu, belonging to Ms Simpson and treated in March 2010.
On the morning of 23 February 2011, Holly was admitted to the Daryl Veterinary Centre in a collapsed state with a swollen abdomen. The Committee found a proper assessment should have led Mr Beveridge to perform an abdominocentesis at the practice, the results of which, in view of the practice and its facilities, would inevitably have led to Holly immediately being referred elsewhere. However, the Committee heard that Mr Beveridge simply placed her on a heat pad for observation until about midday, something it considered no reasonably competent veterinary surgeon in general practice would have done. The Committee also found that, on more than one occasion, Mr Beveridge had refused to discuss referral with Mrs Flanagan, and this amounted to failing to treat her with courtesy and respect as required by the RCVS Guide to Professional Conduct 2010, which applied at that time. Holly was ultimately referred elsewhere and survived. The Committee also found the records of Holly's admission to be completely inadequate.
Blu was presented on 22 March 2010 in a collapsed state by Mr Taylor, Ms Simpson's former partner with whom the cat lived. The Committee found that Mr Taylor was told that the cat would be kept on a heat pad, that no other treatment or diagnosis was discussed, and that the possibility of euthanasia was not raised. Having been unable to contact Mr Beveridge that evening, Ms Simpson went to the practice the following morning, intending that her cat be discharged and taken elsewhere. However, the Committee found, when Mr Beveridge eventually fetched Blu, who had died, he blocked Mrs Simpson's exit from the consulting room, saying words to the effect that had she been a better owner, none of this would have happened.
Mr Beveridge also sent to the College clinical records for Blu detailing a blood sample taken at 19.00 on 22 March, and subcutaneous fluids administered during that night. The Committee found this to contain deliberately false information in order to cast a better light on his management of Blu and that he was dishonest; the document was essentially a fabrication to enhance his own interests.
In reaching its decision, the Committee said that it made allowances for the fact that Mr Beveridge operated in first-opinion practice at a basic level. Notwithstanding this, however, it found him guilty of a very serious failure of care to both patients, which gave rise to serious risks to their safety and welfare.
Professor Peter Lees, chairing and speaking on behalf of the Committee said: "On each occasion [Mr Beveridge] treated the owners with a lack of courtesy and respect and made the difficult and distressing circumstances in which they found themselves much worse than they need have been. The Committee takes a very serious view of his attempt to prevent Ms Simpson leaving the consulting room with Blu, and of the unjust and upsetting way in which he sought to blame her for the animal's death. He showed her no consideration at all. Likewise his refusal to contemplate referral for Holly until compelled by Mrs Flanagan to do so and his persistent refusal to engage with her about this at all was, in the Committee's view, reprehensible."
The Committee directed Mr Beveridge's name should be removed from the Register.
The RCVS Disciplinary Committee has suspended two veterinary surgeons from the Register after finding them guilty of lying to clients and the College about the circumstances of a castration procedure which led to the death of a dog.
The Committee suspended Mr Mpho Donald Lesolle and Mr Georgi Cheshmedzhiev from the Register for four and two months respectively, following surgery undertaken on Benson, a two-year-old male Labradoodle belonging to Mr and Mrs Grayson.
During the proceedings, the Committee heard that, on 6 August 2013, Mr and Mrs Grayson brought Benson to the Swinfen Veterinary Centre in Stafford, where Mr Lesolle is the practice principal and Mr Cheshmedzhiev was his assistant, for the operation which was undertaken by Mr Cheshmedzhiev. Mr Lesolle did not directly supervise the procedure telling the Committee that he was confident that his colleague could carry out the castration, having permitted him to do so on previous occasions.
The Committee heard that, after the operation, a nursing assistant, Ms Bell, had noticed that there was blood on the bedding and that Benson had a swollen scrotum. Mr Lesolle then performed a scrotal ablation on Benson, who was discharged later that day.
However, on the morning of 8 August 2013, Mrs Grayson discovered that Benson had died during the night. An independent post-mortem concluded that he had probably died of intra-abdominal bleeding which caused circulatory collapse. Mr and Mrs Grayson raised a concern with the RCVS in September 2013.
The charge against Mr Lesolle relates to his actions following the operations and during the investigation. The four parts of the charge were that he failed to be sufficiently open with Mr and Mrs Grayson on the circumstances of Benson’s surgery; that, in September 2013, he wrote to the College indicating that he had in fact performed the castration and failing to state that there had been two operations; that, on 23 January 2014, he informed Pam Mosedale, a Veterinary Investigator employed by the College, that he had carried out both procedures; and that, on the same day, he also encouraged his veterinary nursing assistant Ms Bell to be dishonest with the College’s investigators.
Mr Lesolle, who was present at the hearing, admitted all parts of the charge against him. He told the Committee that he decided to take responsibility for Mr Cheshmedzhiev’s operation out of a desire to protect his colleague whom he regarded as vulnerable and lacking in self-confidence. He also accepted that he had encouraged Ms Bell to lie during her interview. He told the Committee that he had persisted with the deceit until 15 January 2015, when he gave a full account of what had occurred.
The three parts of the charge against Mr Cheshmedzhiev, who was not in attendance or represented at the hearing, were that in a letter to the College sent in September 2013, he indicated that he had not undertaken the castration procedure on Benson; that on 23 January 2014 he had denied carrying out the operation while being interviewed by Pam Mosedale; and that, on 19 June 2014, while being interviewed by a solicitor instructed by the College, he said that Mr Lesolle had carried out both procedures.
The Committee found the charge against Mr Lesolle amounted to serious professional misconduct, falling far short of what is expected of a professional. The Committee highlighted the protracted nature of his deceit and the fact that he encouraged another member of staff to participate in it. However, it did accept that his motivation was to protect Mr Cheshmedzhiev.
In deciding on the sanction for Mr Lesolle, the Committee considered the aggravating and mitigating factors. Ian Green, chairing the Committee and speaking on its behalf, said: “Having taken the calculated decision to deceive the College as to what had occurred, he abused his position of responsibility to obtain support for his deceit by involving a junior employee, without any proper consideration of the effect of that decision upon her. Instead he continued with the deceit until he was presented with incontrovertible evidence that he had not carried out both procedures on the dog. In the Committee’s view he showed a wilful disregard for the College’s investigatory process.”
However, in mitigation, it also accepted that he was protecting a colleague and that there was no financial gain. It also considered his personal circumstances, the fact that he is sole principal of a small mixed practice which provides his sole source of income and that the rented accommodation also provides a home for his wife and two children. Taking all factors into account, the Committee imposed a sanction upon Mr Lesolle of four months’ suspension from the Register.
In regards to Mr Cheshmedzhiev, the Committee did not find the part of his charge relating to the letter sent in September 2013 to be proven but, in respect of the other two parts of his charge, found that his conduct fell far short of what is expected of a professional. It highlighted his willing participation in the deceit over a protracted period and his failure to take responsibility for his own involvement in the operation on Benson.
In deciding the sanction, the Committee said that the fact that Mr Cheshmedzhiev had lied to the College’s investigators on two occasions and did not admit that he had carried out the castration and apologise for his actions until February 2015, after he had returned to his native Bulgaria, was an aggravating factor.
Ian Green added: “The Committee accepts that he allowed himself to be persuaded by Mr Lesolle to provide a dishonest account of what had taken place to the College’s investigator Mrs Mosedale, and solicitor, Mr Hudson. It also accepts that he has been described by Mr Lesolle as a vulnerable person, lacking in self-confidence in his ability to practise as a veterinary surgeon in the United Kingdom.
“Nevertheless, Mr Cheshmedzhiev accepted the obligations contained in the Code of Professional Conduct when he registered as an MRCVS, which included an obligation to cooperate honestly with the College’s investigatory process. It has also noted that he has expressed a present intention not to work in or visit the United Kingdom again.”
Taking into account all factors, the Committee decided the appropriate sanction was to suspend him from the Register for two months.
Mrs Mullen faced four charges against her.
The first was that she failed to provide information to her clients about her practice OOH provision.
She was also charged with discharging a Labrador, called Cleo, that was unfit to be discharged following spay surgery, with an inadequate abdominal dressing and inadequate information given to the dog's owners regarding complications from surgery, the risk of post-operative haemorrhage and arrangements for out-of-hours care, as well as failing to make adequate clinical records.
The third charge alleged that she had failed to obtain informed consent for anaesthesia/ surgery performed on an English Bulldog, called Boycie, from his owners, failed to ensure the dog had adequate monitoring whilst recovering from anaesthesia, failed to offer an adequate range of overnight care for the dog, left the dog alone overnight when it was not in a fit condition to be left, failed to provide information to its owners on post-operative care at home and out-of-hours emergency arrangements, and failed to make adequate clinical records relating to its treatment.
Finally, she was charged with failing to have Professional Indemnity Insurance (PII) or equivalent arrangements in place or failing to provide details of it, failing to respond to requests regarding her continuing professional development records and failing to respond adequately to reasonable requests from the College for details and documents regarding her treatment of the two dogs.
Mrs Mullen indicated to the RCVS before the hearing that she would not be engaging with the disciplinary process.
The Disciplinary Committee therefore granted the RCVS permission to proceed in her absence on the basis that Mrs Mullen had made it clear that her absence from proceedings was deliberate and voluntary, that there was no indication she would attend any future hearing if it was adjourned and that the charges were of sufficient seriousness that it was in the interests of animal welfare to proceed with them.
The Committee heard evidence from a number of witnesses including the animals’ owners, an expert veterinary witness and College staff.
In the evidence, the Committee heard that the Labrador had died while undergoing treatment at another veterinary practice from complications arising from blood loss following Mrs Mullen’s surgery.
The Committee also heard that the English Bulldog had suffered brain damage and had lost its sight due to post-operative hypoxia, although it had otherwise recovered.
Having heard all the evidence, the Committee found all the charges against Mrs Mullen proven.
The Committee then went on to consider whether the proven charges amounted to serious professional misconduct.
In doing so it considered the aggravating factors, including that there was actual injury to animals, that the misconduct was sustained and repeated over a period of time, that the conduct directly contravened advice issued by the RCVS, and the blatant disregard of the RCVS’s regulatory role.
It also considered that Mrs Mullen had previously been suspended from the Register by the Disciplinary Committee for two months in April 2017 for failing to have Professional Indemnity Insurance arrangements in place.
It considered that there were no mitigating factors in the case and accordingly found serious professional misconduct in relation to all the proven charges.
The Committee then considered what the most appropriate sanction would be.
Judith Way, chairing the Committee and speaking on its behalf, said: “Animal welfare lies at the heart of the veterinary profession.
"The Committee considers that [Mrs Mullen’s] treatment of Cleo and Boycie constitutes a breach of this fundamental tenet of the profession.
"Other serious findings of disgraceful conduct against [Mrs Mullen] are her failure to provide informed consent, failure to provide details about out-of-hours cover, failure to have in place Professional Indemnity Insurance (PII), continuing professional development (CPD), and failure to respond to the College’s request for information.”
The Committee considered that the conduct was so serious that the only means of protecting animal health and welfare and public confidence in the profession was to direct the Registrar to remove Mrs Mullen’s name from the Register of Veterinary Surgeons.
Judith added: “The Committee considers that [Mrs Mullen] has displayed a persistent lack of insight into the seriousness of her actions or their consequences.
"The Committee considers that [Mrs Mullen’s] conduct raises serious clinical concerns, shows disregard of obligations in relation to out-of-hours care, indicates deficiencies in making decisions, demonstrates an obstructive attitude to her regulator and creates a potential risk to patients.
"She has not engaged with the regulator, she has not demonstrated insight into her misconduct, has learned nothing from her previous suspension in relation to PII, and has done nothing to remediate her disgraceful conduct.
"There is no evidence that [Mrs Mullen} has complied with any of her obligations in relation to CPD."
“In the view of the Committee, if [Mrs Mullen] were permitted to remain on the Register, there would be a serious risk of harm to animals. She has demonstrated a reckless disregard for the obligations of a registered veterinary surgeon.”
Mrs Mullen has 28 days from being informed of the Committee’s decision to lodge an appeal with the Privy Council.