The RCVS Disciplinary Committee has dismissed a case against Duncan Davidson MRCVS, a South London veterinary surgeon accused of clinical failings in relation to his treatment of a cat and of keeping poor and misleading clinical records.

The Committee heard the case against Dr Davidson, who was the sole practitioner and owner of Mitcham Veterinary Clinic until his retirement from clinical practice in November 2014, at a hearing which concluded on 22nd January.

The first charge against Dr Davidson alleged that, between 7 November 2013 and 13 December 2013, he had failed to provide adequate care to Ameira, an Egyptian Mau cat. The charge was in four parts: that he had inappropriately administered corticosteroids; had failed to administer adequate fluid therapy; discharged the cat to its owner suggesting a referral when he should have suggested or arranged a same-day referral; and that he failed to communicate the urgency of referral/ further investigation of the cat’s condition to her owner.

The second charge was that, between 7 November 2013 and 17 January 2014, he dishonestly made retrospective alterations to Ameira’s clinical records and failed to keep clear, accurate and detailed clinical records.

From the outset Dr Davidson, who attended the hearing, did not admit the charges against him and denied that his conduct, if found proven, constituted serious professional misconduct.

A summary of the circumstances of the case were that the cat had been admitted to Dr Davidson’s practice on 8 November 2013 with poor appetite and a piece of thread in its mouth. The cat was later admitted, on 21 November, with dehydration and was diagnosed with a linear foreign body (ie the thread) on 25 November 2013. Dr Davidson continued to treat Ameira with corticosteroids and rehydration fluids at the practice but a second opinion was sought by Ameira’s owner from a nearby veterinary practice. This practice referred the cat to the Royal Veterinary College for treatment. Surgery to remove the linear foreign body was undertaken on 13 December 2013, albeit with a poor prognosis, and Ameira subsequently suffered two cardiac arrests and died on 14 December 2013.

In terms of its findings on the first charge, the Committee heard from an expert witness, Mr Hurst, regarding the use of the corticosteroids which were administered to the cat by Dr Davidson on 22, 27 and 30 November 2013 and 5 and 12 December 2013. Although Mr Hurst said that a minority of veterinary surgeons may have provided corticosteroids when the cat was first presented to Dr Davidson on 8 November; when it was determined by Dr Davidson’s colleague Mr Holden that the cat’s condition was due to it having ingested thread, the use of corticosteroids was inappropriate from then on and would be considered contra-indicated. The Committee found this charge proven.

The Committee did not find the charge against Dr Davidson that he failed to provide adequate fluid therapy proven. When the cat was presented to the practice on 21 November 2013 suffering from dehydration, fluid rehydration was given but not administered intravenously. The Committee concluded that intravenous hydration was not necessary because the clinical records from both Dr Davidson and the Royal Veterinary College indicated that Ameira was only moderately dehydrated.

Regarding the referral of Ameira, the Committee could not be sure that the cat was sufficiently unwell on 23 November that it required immediate referral. Dr Davidson had sent Ameira home with her owner on that date on the basis that she was stable and that he would arrange a referral for her on 25 November. There was conflicting evidence from Dr Davidson and Ameira’s owner on the matter of whether, on 23 November, Ameira’s owner was advised that the cat’s condition was critical or that a referral was urgently required. Dr Davidson accepted that he did not seek to make an urgent referral. The charge was not proven.

Regarding the communication of the urgency for further investigation of Ameira’s condition, the Committee found that there was insufficient evidence to suggest that Dr Davidson did not adequately communicate with Ameira’s owner after the diagnosis of a linear foreign body was made on 25 November. According to Dr Davidson, he explained the risk of further damage to the oesophageal and gastrointestinal tract and offered further radiography. This was strongly contested by Ameira’s owner. However, ultimately the Committee were unable to be satisfied as to which version was correct to the necessary standard of proof required.

Regarding the retrospective amendment of clinical records, the Committee found that although there were some “troubling aspects” about the case, particularly evidence of a telephone call with the RCVS Professional Conduct Department in which Dr Davidson said that no retrospective alterations had been made, it was unable to be satisfied so as to be sure of his motivation for changing the records. His contention was that changes had been made as he was concerned he would be subject to civil litigation by Ameira’s owner. However, the Committee found the charge not proven, also taking into account Dr Davidson’s good character and unblemished professional record over 40 years.

However, the Committee did find that Dr Davidson’s clinical records were illegible. Dr Davidson recognised the poor quality of his handwriting, which the veterinary surgeons to whom Ameira was referred were unable to understand. The Committee found this charge proven.

Taking into account the charges it found proven, the Committee then considered whether they constituted serious professional conduct either individually or cumulatively. Judith Webb, who chaired the Committee and spoke on its behalf, said: "It does not consider that on the facts of this case the administration of corticosteroids amounted to disgraceful misconduct."

She added: "The Committee has already emphasised the importance of making legible handwritten records but it does not consider that the failure to do so in this case amounts to disgraceful misconduct.... The Committee has found that Dr Davidson was wrong to make retrospective entries in this case without making it clear when such alterations were made. The Committee does not consider that in this case the making of those alterations was capable of being disgraceful misconduct. The case is dismissed."

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