LONDON, January 14, 2011 /PRNewswire/ -- The Disciplinary Committee of the Royal College of Veterinary Surgeons has this week directed that the name of a Grimsby veterinary surgeon should be removed from the RCVS Register, having found him guilty of serious professional misconduct for advising and undertaking surgical procedures without sufficient clinical grounds or considering alternative treatment options; failing to obtain the informed consent of his clients; undertaking procedures outside his area of competence; failing to refer or discuss the option of referral to a specialist; and, failing to provide his patients with adequate pain relief.
Mr Joseph Lennox Holmes, of Waltham Veterinary Clinic, Grimsby, faced nine charges relating to two separate complaints, at a two-week hearing in October which resumed this week [10 January].
These complaints concerned four consecutive staphylectomies and a tracheostomy that Mr Holmes performed on Jake, a Cavalier King Charles Spaniel owned by Ms Marsden; and, the dental treatment he gave to three Persian cats called Dream Topping, Charlie Brown and Henry, together with the advice he gave to their owner, Mrs Auckland.
On 25 October 2007, Mr Holmes performed a staphylectomy on Jake during dental surgery. He gave the Committee various reasons why he thought the procedure was necessary; however, the Committee accepted the opinion of two expert witnesses Professor Dan Brockman, a specialist in soft tissue surgery at the Royal Veterinary College, and Mr Andrew Ash, the senior veterinary surgeon at a 17-vet small animal practice, that there were insufficient clinical grounds for such a surgical procedure to be undertaken. The Committee also found Mr Holmes had not adequately considered other treatments, or obtained fully informed consent from Jake's owner for this procedure.
Mr Holmes performed further staphylectomies and a tracheostomy on Jake, a procedure described by Professor Brockman as "by definition, high risk and best performed by a specialist." He did not consider referral, or inform Mrs Marsden that such referral was an option. Nor did he provide sufficient aftercare or pain relief. Following these surgeries, Jake was euthanased .
In the second complaint, Mr Holmes performed dental extractions on two cats, Dream Topping and Henry, and advised removing teeth from a third, Charlie Brown, in October 2008. The Committee, however, accepted the view of expert witness Mr Ash and Dr David Crossley, RCVS Recognised Specialist in Veterinary Dentistry, that the dental extractions performed, and the advice given, were not justified on the available clinical evidence. The Committee also found that Mr Holmes did not discuss alternative treatment options with Mrs Auckland, or obtain her informed consent. In the case of Dream Topping, consent was sought after the cat had been sedated for an unrelated procedure and Mrs Auckland had felt under pressure to consent.
Mr Holmes had also relied on anaesthesia-inducing drugs to provide analgesia for the dental extractions, without any other form of pain relief. The Committee agreed with the expert witnesses that this was wholly inadequate.
The Committee found many aggravating factors in both cases, including actual injury to animals from unnecessary surgery, and a serious breach of the trust in which Mr Holmes' clients had placed in him to make the welfare of their animals his primary consideration. His repeated misconduct had been sustained over a period of time in the face of a previous adverse finding of the Committee in 2006.
It also found that Mr Holmes failed to appreciate when a case was outwith his experience, and had continued his course of action despite Jake's deterioration; he had not considered referral or accepted that others in the profession might know more than he did; in formulating clinical practice and policies, he made no reference to peer-reviewed literature or continued professional development; and, his use of outmoded drugs and medicines intended for human use was of concern, as was his lack of appreciation of the need for adequate pain relief when performing painful surgical procedures.
Towards the end of the hearing, Mr Holmes said in mitigation that he regretted unreservedly any adverse effects that his treatment had had on the animals concerned, and that he now realised that his long history of working alone had allowed him to become professionally isolated, to become over-confident in the value of his own experience and rather "set in his ways".
Having given serious consideration to postponing judgment, subject to undertakings from Mr Holmes, Disciplinary Committee Chairman Mrs Caroline Freedman said: "We are mindful that the sanction which we apply must be proportionate to the nature and extent of the misconduct found proved and must balance the public interests against the interests of the Respondent.
"We are, however, also mindful of Mr Holmes' conduct during the previous 11 1/2 days of the hearing, during which time his every action was vigorously defended and no insight whatsoever was shown."
The Committee also considered suspending Mr Holmes from the Register. "In view of the serious and long-term nature of the conduct found proved in the charges, we do not feel that it is appropriate that Mr Holmes should be permitted to return to the Register without further assessment of his efforts to update his knowledge," said Mrs Freedman, before concluding: "The only appropriate sanction in each case is that the Registrar be directed to remove Mr Holmes' name from the Register."
NOTES FOR EDITORS
1. The RCVS is the regulatory body for veterinary surgeons in the UK and deals with issues of professional misconduct, maintaining the register of veterinary surgeons eligible to practise in the UK and assuring standards of veterinary education. 2. RCVS disciplinary powers are exercised through the Preliminary Investigation and Disciplinary Committees, established in accordance With Schedule 2 to the Veterinary Surgeons Act 1966 (the 1966 Act). The RCVS has authority to deal with three types of case: a) Fraudulent registration b) Criminal convictions c) Allegations of disgraceful professional conduct 3. The Disciplinary Committee is a constituted judicial tribunal under the 1966 Act and follows rules of evidence similar to those used in a court of law. 4. The burden of proving an allegation falls upon the RCVS, and the RCVS must prove to the standard that the Committee is sure. 5. A respondent veterinary surgeon may appeal a Disciplinary Committee decision to the Privy Council within 28 days of the date of the decision. If no appeal is received, the Committee's judgment takes effect after this period. 6. It is a criminal offence contrary to section 19 of the Veterinary Surgeons Act 1966 to practise as a veterinary surgeon unless registered in the RCVS Register of Members. Further information, including the charges against Mr Holmes, and the Committee's findings and decision on sanction, can be found at http://www.rcvs.org.uk/disciplinary. For more information please contact: Claire Millington, Royal College of Veterinary Surgeons +44(0)20-7202-0783 / email@example.com