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Sunday 31 August 2014

Expert backs skin doctor who told teen patient to use sunbed

Kevin Keane

Published 18/12/2012 | 05:00

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Dr Adam Jacobus Smith: denies professional misconduct

A MEDICAL expert has defended the actions of a dermatologist who recommended that a teenager use sunbeds to treat psoriasis.

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Dr John A Cotterill has said it was "a reasonable view" that limited time on a sunbed might benefit a patient and that the risk "was virtually immeasurable".

The retired consultant dermatologist, who is based in the UK, has been giving evidence to a Medical Council fitness to practise inquiry in the case of Dr Adam Jacobus Smith.

Dr Smith is accused of poor professional performance and professional misconduct on more than 100 grounds in relation to his treatment of the teenager and 11 other patients who attended his surgery in the Whitfield Clinic, Waterford, between 2006 and 2009.

He has accepted a number of the charges against him as to fact but denies that any of the allegations under examination amount to poor professional performance or professional misconduct.

The 17-year-old attended Dr Smith's clinic with his mother in August 2008 as the teenager was about to go on holiday and was self-conscious about his psoriasis.

Dr Smith prescribed the drug methotrextrate and told the patient that he could use sunbeds, but to limit this to two sessions over a two-week period.

Acting for Dr Smith, Gabriel Gavigan told the inquiry that his client's evidence would be that, provided the patient limited his use of sunbeds, UV in a tanning parlour would not cause him any significant difficulties.

Dr Cotterill, who has been called to give evidence by Dr Smith's legal team, said he was in agreement with this "on common sense grounds". He added that the risk was "absolutely minute".

"Every time we go out on a sunny day, we have no idea what wavelengths we are being exposed to. If you take his argument to the end, it means that none of us should go out in the daylight as it is carcinogenic. Two or three exposures to a sunbed are not going to lead to skin cancer later in life."

Asbestos

Dr Cotterill added: "I think people who are going in to sun parlours every day or every week are running the risk of skin cancer."

Solicitor for the CEO of the Medical Council, JP McDowell asked Dr Cotterill if he did not think it extraordinary that Dr Smith recommended the use of sunbeds, given that they were classed in the same category of cancer risk as tobacco and asbestos.

Dr Cotterill responded that a doctor had to weigh up the risks but that the limited use of sun-beds was "neither here nor there".

"I have lost sleep over a lot of things that have come before me in this case but I wouldn't lose sleep over the sunbeds."

Dr Cotterill said he was more critical of Dr Smith's failure to monitor the teenager after prescribing methotrextrate, which he believed amounted to poor professional performance.

Dr Smith has admitted as to fact that he prescribed methotrextrate without first providing a test dose to the patient and that he failed to monitor the patient on a regular basis. The case continues.

Irish Independent

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