AN A&E doctor failed to ensure a psychotic woman was properly assessed before leaving hospital just hours before she killed her two-year-old son, a tribunal has ruled.
Dr Clement Agbatar had a 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, it was found.
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 was detained under the Mental Health Act.
Dr Agbatar is accused of misconduct at a fitness to practise hearing at the Medical Practitioners Tribunal Service in Manchester, where Mrs Ruddell is referred to as Patient M.
The MPTS panel found on Friday that Dr Agbatar had failed to take account of the ambulance record, failed to adequately assess Mrs Ruddell, and failed to ensure she was assessed by the crisis team, but stopped short of finding him culpable of failing to ensure she was sectioned under the Mental Health Act.
Chair Dr Susan O’Connor said: “Although you correctly referred Patient M to the crisis team, you had a duty to ensure that the assessment was carried out.
“You knew at the point that Patient M took her own discharge that an assessment was not going to be carried out at Hartlepool A&E department.
“Furthermore, you cancelled any further assessment by the crisis team. The panel considers this to be a culpable failing as Patient M was presenting with hallucinations and delusions, i.e. symptoms of psychosis.”
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, 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.
“The panel is of the view that an assessment under the Mental Health Act may have been clinically indicated, but until that assessment had been completed, it is not possible to determine whether a detention under the Mental Health Act was appropriate.”
Dr Agbatar was also found to have made mistakes in 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 ruled he did not recognise the abnormality of her low blood sugar and tachycardia, seek a medical opinion or refer her to the physicians.
The panel must now decide if any of his actions amounted to misconduct and if his fitness to practise is impaired as a result.
“On the basis of what you have found the GMC would invite you to conclude that there has been serious misconduct on the part of the doctor in the exercise of his practice as an associate specialist in accident and emergency in respect of both charges,” Mr Grundy told the panel.
“As far as Patient M is concerned you have found a number of failings, culminating in what could be described as your finding of a failure to ensure Patient M was assessed by the crisis team,” he added.
But, making submissions by telephone, Dr Agbatar told the panel he was “aggrieved” by the findings and “not very happy about them”.
“Well I’m not impaired in any way, but I do not intend to practice anymore because I am so annoyed about it,” he said.
“I’m so angry about it I don’t want to participate anymore and I want to apply to the GMC to take my name of the medical register.”
Mr Grundy 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.
If the panel find against the doctor he could face being struck off, suspended or only permitted to work under strict conditions.
The hearing, which is expected to last until April 4, continues.