A CONSULTANT dermatologist failed to take skin biopsies from a number of his patients and failed to diagnose certain conditions or provide adequate treatments, a Medical Council hearing has heard.
The Medical Council yesterday began a fitness to practise inquiry into allegations made against Dr Adam Jacobus Smith (65), of the Whitfield Clinic in Waterford, by the Munster Dermatology Group.
The 12 patients at the centre of the allegations came under the care of other consultant dermatologists, who are members of the Munster Dermatology Group, after being treated by Dr Smith.
One of the patients, described at the hearing as Patient A, was referred to Dr Smith in November of 2008 with a rash on his left leg.
The 63-year-old man told the hearing that Dr Smith examined him for "three or four minutes" but when he asked him what was causing the rash, the doctor said he would write to his GP.
Dr Smith referred him for an MRSA swab but, according to the patient, he then said he wouldn't do it in the Whitfield Clinic as it would be "too expensive".
The MRSA swab was eventually done in Cork University Hospital (CUH) where the patient was already on dialysis for a renal condition.
He was diagnosed by consultant dermatologist Dr John Burke in CUH with calciphylaxis, a rare skin disorder, after Dr Burke ordered a biopsy and this cleared up with different medication.
Gabriel Gavigan, for Dr Smith, said his client couldn't have diagnosed the calciphylaxis or ordered a biopsy as he wanted to first ensure there wasn't a skin infection, which is why he ordered the MRSA swab.
Patient B, a 74-year-old man, said he first attended Dr Smith in January of 2008 with a rash on his chest. He went four more times but the rash didn't clear up with medication prescribed by the consultant.
Early in 2009 he went to his GP who referred him to another dermatologist, Dr Gillian Gibson, and by the time he saw the second consultant, he had blisters on his skin. Dr Gibson ordered a biopsy and then diagnosed bullous pemphigoid.
Mr Gavigan, questioning the patient, asked if Dr Smith had ever seen the blisters. The witness replied that he hadn't.
According to Mr Gavigan, the blisters are indicative of bullous pemphigoid, commonly known as ringworm.
Dr Gibson told the hearing there was "collective concern" among members of the Munster Dermatology Group about patients seen by Dr Smith.
Originally from Zimbabwe, Dr Smith qualified as a doctor in 1973 and practised in South Africa as a dermatologist for 22 years. He registered with the Irish Medical Council in 2005 as a specialist in dermatology.
The inquiry continues today.