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The charge against Dr Irvine was that in July 2017, he failed to discuss with the owners alternative treatment options to dental surgery under general anaesthetic, or the risks of dental surgery under general anaesthetic, and failed to obtain informed consent from the owners for the surgery.
Dr Vasilev was also originally charged with failing to discuss alternative treatment options or the risks of the surgery and failing to obtain informed consent. However, at the outset of the hearing, as a result of new information which came to light, the RCVS opted to offer no evidence in relation to these charges. Mr Vasilev was separately charged with failing to maintain clear, accurate and detailed clinical records in relation to his treatment of the dog.
At the outset of the hearing, Mr Irvine denied all aspects of the charge against him; while Dr Vasilev admitted all aspects of the remaining charge.
The Committee heard how Rupert's dental surgery under general anaesthetic was recommended by Mr Irvine on 10th July and performed by Dr Vasilev on 11th July 2017. After the surgery, Rupert was discharged, but vomited in his sleep that same night. He was brought back to the practice on 12th July, where Dr Vasilev administered antiemetic and antibiotic medication.
However, Rupert continued to vomit over the next five days, and was seen by the practice on 17th July and then on 18th when blood tests were conducted. Rupert’s condition deteriorated as he continued to vomit and lose weight and he was brought back to the practice on 22nd July where he was euthanased by Dr Vasilev.
The Committee heard evidence from Rupert’s owners as well as two expert witnesses. It found the first aspect of the charge against Mr Irvine proven on the basis that there was an inadequate discussion with the owners regarding the option of delaying the dental treatment on Rupert because of his recent ascites caused by congestive heart failure.
The Committee found the second aspect of the charge against Mr Irvine proven on the basis that he had not discussed the risks of Rupert undergoing general anaesthetic given the recent diagnosis of congestive heart failure, following which (in relation to the third aspect of the charge against Mr Irvine), it was therefore found proven that he had failed to gain informed consent.
With all aspects of the charge against Mr Irvine being proven, and with Dr Vasilev admitting the charge against him, the Committee went on to consider if the proven and admitted charges against both amounted to serious professional misconduct.
In respect of Mr Irvine, Stuart Drummond, chairing the Committee and speaking on its behalf, said: "The Committee was not persuaded that the failure to obtain informed consent from [the owner] and discuss matters further with her on 10th July 2017 in the circumstances of this case would amount to serious professional misconduct which would bring the profession into disrepute.
"In the Committee’s judgment, the breach of standards, whilst amounting to professional misconduct, was not serious professional misconduct, in the context of other discussions which had taken place…. The Committee further decided that a finding of serious professional misconduct in this case would be disproportionate having taken into consideration the discussions that Mr Irvine had with [the owner] prior to 10th July 2017 and the fact he was dealing with a complex and changing case.
"The Committee therefore found that Mr Irvine was not guilty of disgraceful conduct in a professional respect."
The Committee noted that Dr Vasilev had admitted breaching the Code of Professional Conduct for Veterinary Surgeons in respect of failing to keep adequate clinical and client records.
However, in mitigation, the Committee considered a number of factors including that, in failing to maintain adequate notes related to Rupert’s treatment, Dr Vasilev had followed the standard of notetaking in the practice as set out by Mr Irvine who was practice principal; that Dr Vasilev had only worked with Mr Irvine in the UK and his record-keeping was limited to working in one practice; that Dr Vasilev admitted his failures at an early stage of the proceedings; that he had made efforts to avoid repetition in the future by undertaking webinars and research; and, that he had shown insight into the need to ensure full communication and detailed note-taking.
Stuart Drummond added: "In relation to Dr Vasilev, the Committee was satisfied that [his] standard of record-keeping was in breach of the Code of Professional Conduct for Veterinary Surgeons and that the breach… amounted to professional misconduct.
"The Committee concluded that the breaches overall, when considering the context and number of mitigating factors, were, in the Committee’s view, insufficient to amount to serious professional misconduct…. Accordingly it found Dr Vasilev not guilty of disgraceful conduct in a professional respect."
The full facts and findings from the case can be found at www.rcvs.org.uk/disciplinary.
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