AN A&E doctor who allowed a psychotic woman to leave hospital just hours before she killed her two-year-old son has been found guilty of serious misconduct.
Dr Clement Agbatar failed in his duty to ensure Melanie Ruddell was seen by the mental health crisis team at University Hospital of Hartlepool after she arrived by ambulance in August 2010.
Mrs Ruddell discharged herself and later that night strangled and stabbed her son Christy at her brother’s home in West Rainton.
Mrs Ruddell, formerly of Castle Eden, pleaded guilty to manslaughter on the grounds of diminished responsibility in February 2011 and detained under the Mental Health Act.
Retired Dr Agbatar was found guilty of serious misconduct at a fitness to practise hearing at the Medical Practitioners Tribunal Service in Manchester, where Mrs Ruddell is referred to as Patient M.
Chair Dr Susan O’Connor said: “The panel considers that in your care of Patient M there was a sequence of failures which each, in turn, amplified the seriousness of the subsequent failure.
“You failed to ensure that you had all the available information, to physically examine the patient, to undertake a structured assessment, to adequately explore the patient’s symptoms, and to make a clear diagnosis.
“As a consequence you had less information and less appreciation of any risks on which to base subsequent decisions.
“You referred Patient M to the crisis team, but when she determined to leave the department before the assessment, you allowed her to do so.
“Although each event taken in isolation may not amount to misconduct, when taken together, the panel considers these failures are serious and constitute serious misconduct.”
The tribunal has heard that Mrs Ruddell had been persuaded to go to hospital by friends and family on August 8, 2010 as she believed she had been drugged and raped on a night out nine days earlier.
Dr Agbatar had claimed that he did not make a diagnosis, but the panel found there was sufficient evidence to indicate psychosis, as was suggested by his referral to the crisis team.
The General Medical Council, represented by Nigel Grundy, alleged that Dr Agbatar had failed to detain the patient under the Mental Health Act when it was clinically indicated.
But giving evidence, the doctor insisted he did not have the power to have her sectioned, and the panel agreed on Friday, clearing him of the charge.
“You correctly stated that you had no power under the Mental Health Act to detain Patient M,” Dr O’Connor said.
Dr Agbatar was also found guilty of serious misconduct over his treatment of another woman, known only as Patient A, who he treated at the Hartlepool hospital in September 2010 after she was assaulted by her ex-partner.
The tribunal found he did not recognise the abnormality of her low blood sugar and tachycardia, seek a medical opinion or refer her to the physicians.
The medic is now facing a ban from the profession after the panel ruled that his “fitness to practise” was impaired.
“The panel notes that you have been retired since 2012. There has been no evidence to demonstrate you recognise the seriousness of your misconduct or that you have gained insight into the gravity of it,” Dr O’Connor said.
“It has reminded itself of your submissions, and in particular your evidence in which you stated that if you were still in practise, you would ‘do the same again’,” she added.
“The panel therefore accepts, on the basis of the evidence before it, that there is a risk of repetition of your misconduct.
“Therefore the panel can only conclude that your fitness to practise is impaired by reason of your misconduct.”
Dr Agbatar could now be struck off the medical register, suspended or only permitted to work under strict conditions.
Mr Grundy has told the panel that despite his assertions that he will not work as a doctor again he would be free to change his mind at any time while his name remains on the medical register.
The hearing, which is expected to last until April 4, continues.