Wednesday 24 January 2018

GP guilty of misconduct over cancer victim's care

Breda Heffernan

A DOCTOR has been found guilty of professional misconduct after he failed to adequately manage the care of a young father who later died of skin cancer.

Dr Peter Ting removed a mole from the back of William Cashell but did not send it for tests.

Mr Cashell (36) died in May 2008 -- 15 months after he was first treated by Dr Ting.

Following the verdict at an Irish Medical Council (IMC) hearing, the GP -- who is based in Artane, Co Dublin -- could have his registration cancelled or receive a written warning.

Mr Cashell's devastated family yesterday welcomed the ruling of the IMC's fitness-to- practise inquiry, and said they hoped his death would help raise awareness of the dangers of skin cancer.

His father, Michael, said it had been a difficult three years for the family.

"I'm happy with the verdict and I'm glad it's all over," he added.


The inquiry found Dr Ting guilty of six out of eight allegations of professional misconduct, including failing to send the mole for biopsy and failing to keep a record of the consultation with Mr Cashell in February 2007.

The GP gave evidence before the inquiry yesterday morning but was not present when the verdict was delivered in the afternoon.

Mr Cashell's partner -- Lorraine Coady, with whom he has a son, Jake (7) -- told the hearing earlier this week how the mole was sore and itchy, and had grown in size and darkened in colour between December 2006 and February 2007 when he went to Dr Ting.

In his evidence, the GP said he would never have removed the mole if he had believed it was cancerous.

He said he diagnosed it as a keratosis -- a benign growth on the surface of the skin -- and followed the usual treatment, which is to remove it by cauterising it. However, in doing so, the mole was destroyed and it could not be sent for testing.

The lawyer for the chief executive of the Medical Council, JP McDowell, said yesterday was the first time the doctor had mentioned a diagnosis of keratosis and he accused Dr Ting of "shilly shallying".

He said that if Mr Cashell, of Rush, Co Dublin, had been asked specific questions, he would have given "very concerning information", and he suggested a detailed history was not taken. "I did not think it was sinister in nature at all and that's why I proceeded with the procedure. If I did, I would not touch it and send the patient to a dermatologist," said Dr Ting.

He explained that when a doctor was confronted with a skin lesion, they considered all the possibilities and chief among these was melanoma.

He said that he looked at the features of the lesion and arrived at a diagnosis of benign keratosis.

Dr Mary Gray, a GP with a special interest in dermatology and who gave evidence on behalf of Dr Ting, said the appearance of a keratosis is very distinct from that of a melanoma.

Dr Gray said that normally it was sufficient to make a diagnosis of keratosis based on just the lesion's appearance and feel.

Dr Ting told the hearing that the morning of Mr Cashell's consultation had been "very busy" and he estimated that he saw up to 40 patients between 10am and 1pm.

But the committee also found that the failure to keep a record was an "unacceptable practice" and amounted to professional misconduct.

Dr Ting admitted he had delayed in responding to correspondence from the Medical Council because he was in a "state of denial" and that the case had caused a lot of upset and confusion.

Irish Independent

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