ROYAL COLLEGE OF VETERINARY SURGEONS
V
MARCUS ADAM HUTBER
DECISION ON FACTS
The Respondent, Dr Marcus Adam Hutber, appeared before the Disciplinary Committee to answer the
following charges:
That being registered in the Register of Veterinary Surgeons:1. You failed to provide adequate professional care and/or failed to have regard to animal
welfare, in that:(a) on or about 16th June 2009, when you attempted to perform bilateral anal
sacculectomy upon TJ, a dog belonging to Ms Katie Ley, you:(i) removed the ducts associated with each of the anal sacs;
(ii) failed to remove the anal sacs;
(iii) failed to provide TJ with any or any adequate analgesia post-operatively;
(b) when asked how the operation had gone, you informed Ms Ley that everything was
fine when you ought to have known that you had not removed the anal sacs and / or
were reckless as to whether you had removed them;
(c) prior to the surgery described at (a) above you had not provided Ms Ley with advice
as to the available non-surgical alternatives to treatment;
(d) you failed to make and maintain adequate records in respect of your management of
TJ.
2. In the circumstances described at paragraph 1(c) above you did not obtain Ms Ley's
informed consent to the surgery.
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3. Between 20 and 21 July 2009 you failed to provide adequate professional care
and/or failed to have regard to animal welfare in that, during the admission to your
practice of Tufty, a cat belonging to Ms Elizabeth Smith, you failed to:-
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(a) ensure that Tufty's condition was monitored, alternatively adequately monitored;
(b) identify the abscess from which Tufty was suffering;
(c) ensure that Tufty received care or adequate care for the abscess;
(d) ensure that Tufty received any or an adequate volume of fluids;
(e) make and maintain adequate records in respect of your management of Tufty
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4. On or about 12 June 2009 you failed to treat a client, Ms Hilary Lang with due
courtesy and respect and/or brought the veterinary profession into disrepute, in that,
while in the waiting room, and in the presence of other staff and members of the public,
you:(a) responded to an observation from Ms Lang about your surgery opening times:(i) with words to the effect that you did not want any verbal and had had enough
verbal;
(ii) with a mouthing gesture with your hand;
(iii) with derogatory observations about the previous owners of the practice;
(iv) by questioning Ms Lang as to whether she wanted the tablets she had come for
or not, to the effect 'do you want the tablets or not';
(b) responded to Ms Lang producing her cheque book to pay for the tablets by saying
rudely the words, or words to the effect of, 'I hope you have got a card';
(c) responded to Ms Lang's return from home with the cheque card by saying rudely 'Oh,
you're back'
5. You failed to treat a Ms Walker, the owner of a collie cross called Bessie, with due
courtesy and respect and/or brought the veterinary profession into disrepute, in that on
25th January 2010 you telephoned Ms Walker and:(a) told her that she must come to the practice at once and give Bessie the tablets or
Bessie would die;
(b) informed Ms Walker that Bessie had Lyme Disease, when you had not carried out the
investigations required for such a diagnosis.
(c) after Ms Walker informed you that Bessie was being treated at a different veterinary
practice, repeated the instruction set out at (a) above.
6. You failed to provide adequate professional care and/or failed to have regard to animal
welfare in that, you failed to make and maintain adequate records in respect of your
management of Bessie.
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7. Between July and August 2009 you behaved unprofessionally towards a client Ms
Milton and/or brought the veterinary profession into disrepute, in that you failed to
provide Ms Milton with a copy of the clinical records you maintained in respect of her
dog Jenny.
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8. On or about 13 April 2010 you failed to co-operate with your professional colleagues
in that, when asked for copies of the clinical records you maintained in respect of Jazz,
a dog then under the care of the Deane Veterinary Practice, you:(a) said that no records were available because you had changed your practice computer
system 10 months previously;
(b) when asked for the records for the last 10 months, said that you were in Hampshire and
could not provide the records;
(c) when told that the request was not urgent and that the records could be sent by fax ,
said you would do it when you got around to it;
(d) failed to supply the records or copies of the records.
AND THAT, in respect of each of the above numbered charges, either individually or in any
combination, you have been guilty of conduct disgraceful in a professional respect.
The Respondent denies all the charges.
1.
The Committee has given detailed consideration to all the evidence in this case, the submissions
of Counsel, and the advice of the Legal Assessor. It has applied the law on the burden and
standard of proof, namely that the burden of proof is on the College and that the standard of
proof required is that it has to be sure before it finds any allegation of fact contained in the
charges proved.
2.
The Respondent became a Member of the Royal College of Veterinary Surgeons in 2004, having
previously obtained a degree in veterinary medicine from the University of Veterinary Medicine in
Kosice, Slovakia. From March 2009 he carried on practice through his company Epivet Limited
(Epivet) at two surgeries in Williton and Wiveliscombe, Somerset.
3.
This case involves a series of allegations against the Respondent of lack of adequate
professional care, failure to have regard to animal welfare, failure to make or maintain adequate
clinical records, and to provide them on request, and failure to treat clients with courtesy and
respect.
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Charges 1 and 2 (Ley/TJ)
The College’s case:
4.
These allegations relate to the care and treatment by the Respondent of a crossbred dog, called
TJ, who was owned by Ms Katie Ley. The College’s case is as follows. On 15 June 2009, Ms
Ley visited the Williton Branch of Epivet, complaining of an on-going problem with TJ’s anal
glands. She had been a client of the previous owners of the practice, where TJ had received
treatment for this problem. The Respondent proposed surgery to remove the anal glands. It is
alleged that he did not give advice as to non-surgical alternatives, with the result that Ms Ley was
unable to give informed consent to the surgery.
5.
On or around 16 June 2009, the Respondent purported to perform bilateral anal sacculectomy on
TJ. It is alleged that he removed the ducts associated with the sacs, but failed to remove the
sacs themselves, and failed to provide TJ with any or any adequate analgesia post-operatively.
On collecting TJ after the surgery, it is alleged that Ms Ley asked the Respondent if TJ would
need pain-killers and he said he would not. It is further alleged that the Respondent told Ms Ley
that everything was fine, when he ought to have known that he had not removed the anal sacs,
or was reckless as to whether he had removed them.
6.
Ms Ley described TJ as being significantly distressed post-operatively, and her evidence was
supported by the evidence of Ms Ley’s partner, Graham McGann, and her sister Andrea
Williams. On about 20 June 2009, Ms Ley took TJ back to see the Respondent because the dog
was in discomfort. The Respondent gave TJ an injection of Dexafort and applied EMLA cream to
his perianal area. On 30 June 2009, the Respondent removed the stitches from TJ’s operation
site.
7.
Subsequently, TJ appeared to Ms Ley still to have symptoms of anal sac problems, and, on 24
July 2009, she took him to another veterinary practice, White Lodge Veterinary Clinic, Minehead,
where Frances Stephenson MRCVS, examined TJ. She believed that the anal glands were still
present, and recommended an ultrasound scan to confirm this.
8.
On 30 July 2009, she performed an ultrasound scan, which confirmed the presence of anal
glands, but the absence of the ducts. She drained one of these glands, and advised surgical
removal of both structures.
9.
On 3 August 2009, Ms Ley questioned the Respondent about the findings at White Lodge, and
he maintained that he had removed the anal glands. He alleged that the veterinary surgeon at
White Lodge was lying. The following day, the Respondent left Ms Ley a telephone message,
saying that he had undertaken research and that dogs could have more than two anal glands,
which explained matters. He telephoned again and spoke to Ms Ley, saying that Mr Krzys
Kaminski MRCVS, a Polish veterinary surgeon working in the Hutber practice, had noticed a third
anal gland, which could be removed at a reduced cost. The Respondent continued to insist that
two anal glands had definitely been removed during the operation on 16 June 2009.
10. On 7 August 2009, another veterinary surgeon at White Lodge, Simon White MRCVS, operated
on TJ. He found both glands in place, and removed only the left one. Mr White elected not to
remove the right gland at that point, which was relatively empty; he decided that he should wait
until the gland refilled, so it could be removed more easily at a later date. Mr White found that
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there were no ducts present, but the scar tissue present was consistent with surgical intervention
in the area of the ducts. Mr White took photographs during this operation, which were seen by
the Committee. One photograph showed the left gland after removal. The right gland was
removed at a further operation on 25 September 2009. Both glands were preserved in formalin
after removal, but the left gland was subsequently mislaid. The right gland was produced by Mr
White in a bottle of formalin at the hearing, and the left gland was shown in the photograph taken
on 7 August.
11. It is further alleged by the College that the Respondent failed to make and maintain adequate
records of his management of TJ.
12. In the light of these factual allegations, it is alleged that the Respondent failed to provide
adequate professional care and/or failed to have regard to animal welfare. The expert report of
Mr A Robinson, FRCVS, is relied upon by the College in support of these allegations.
The College’s witnesses:
13. The Committee heard evidence from Ms Ley, who confirmed the account of events set out in her
witness statement dated 2 July 2010, in which she outlined and expanded upon the events set
out above in considerable detail. She told the Committee that, prior to the initial surgery, the
Respondent had not given her any advice as to any available non-surgical alternatives to
treatment, nor did he discuss the details of the surgical procedure or any complications which
might arise. Ms Ley could not remember whether she had signed a consent form for the
operation. The Committee was told by Ms Ley that her witness statement was based in part on
her contemporaneous notes, which she had then typed up and attached to the complaint she
made to the College dated 7 August 2009.
14. The Committee were impressed with Ms Ley as a witness, and found her to be honest and
reliable, straightforward, and clear in her recollection of events. Where necessary, she refreshed
her memory from her witness statement. In the view of the Committee, Ms Ley’s account of
events was not undermined or otherwise materially affected by cross-examination.
15. The Committee also heard evidence from Mr McGann and Mrs Williams, both of whom confirmed
the contents of their witness statements, which supported Ms Ley’s evidence to the extent that
they witnessed the events she described. There was no significant challenge to their evidence.
16. The Committee also heard evidence from Miss Jennifer Sumpter, a student veterinary nurse,
who worked for the Respondent from June to August 2009. She was present during the
operation on TJ, but she had limited recall of what happened, and her evidence did not assist the
Committee.
17. The two veterinary surgeons, who treated TJ at White Lodge, Miss Frances Stephenson and Mr
Simon White both gave evidence to the Committee.
18. Miss Stephenson described her involvement in the treatment of TJ as set out above. The
Committee found her to be a very reliable witness, who came across as extremely competent,
professional and honest. When she had been unsure as to her initial findings on examination,
she asked her senior partner to give a second opinion. He agreed with her initial findings, namely
that the two anal glands were still present, as was later confirmed by the ultrasound scan.
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19. Mr White’s involvement in the operative procedures on TJ described above was indicated in
some detail in his witness statement. He exhibited copies of the clinical notes relating to TJ’s
treatment sent to White Lodge by the Respondent. He explained his findings at the first operation
on 7 August 2009, namely that both anal glands were still in place. He identified the photograph
that he had taken at the first operation of the left anal gland, which he had removed, and
identified the right anal gland that he had removed at the second operation, and which had been
preserved in formalin and was shown to the Committee.
20. The Committee found Mr White to be an honest witness, who came across as a confident,
competent and experienced veterinary surgeon. The Committee did not consider that the
evidence of either Miss Stephenson or Mr White was undermined or otherwise materially
affected by cross-examination.
21. Mr Krzys Kaminski, the veterinary surgeon who assisted the Respondent with the operation
performed on TJ on 16 June 2009, gave evidence to the Committee. He prepared TJ for surgery
and administered the anaesthetic. He told the Committee that he thought he had seen a third
duct opening at the bottom of the anus. He was not familiar with the operation for the removal of
anal sacs. Although he was present during the whole operation, his evidence indicated that his
primary role was induction, maintenance and monitoring of the dog’s anaesthetic. He took no
part in the surgery, which was performed solely by the Respondent.
22. Mr Kaminski had a limited understanding of English, and gave most of his evidence through an
interpreter. The Committee did not find his evidence of any real assistance in relation to the
allegations relating to TJ.
The Respondent’s evidence:
23. The Respondent in oral evidence initially confirmed that he had performed a bilateral
sacculectomy on TJ. However, during cross-examination, the College made reference to his
previous written evidence, in which he had stated that he was not sure whether he had operated
on both sacs or whether Mr Kaminski had removed one.
24. In relation to charge 1(a)(i), the Respondent admits that he removed the ducts associated with
each of the anal sacs. In relation to charge 1(a)(ii), the Respondent denies that he failed to
remove the anal sacs, although he concedes he may have left some glandular tissue behind but
does not accept he left behind one or two complete anal sacs.
25. In relation to charge 1(a)(iii), the evidence supports his claim that an injection of Metacam was
given at the time of the operation, which he believed to be sufficient, although he conceded that
its duration of effect is limited to 24 hours. In both oral and written evidence he accepted that he
had not provided any further analgesia. When asked why, he replied “In my judgement none
was required” and he supported this judgement by referring to his training in Slovakia and to his
concern about possible gastro-intestinal side-effects. Furthermore he said that he had informed
the owner that she should return if she had any concerns.
26. In relation to charge 1(b) the Respondent reported that he would routinely check tissue he
removed during surgery. However in this instance he was unable to recall whether he had done
so.
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27. With regard to charge 1(c) he did not have a strong recollection as to whether or not he had
discussed the available non-surgical alternatives with Ms Ley. There is no mention of a
discussion in the clinical records. He does not remember if he discussed the complications of
sacculectomy with Ms Ley. On his own admission, he did not discuss flushing the sacs because
he does not consider that to be an effective treatment. He agreed that infected sacs would
require antibiotic treatment but he said that he had discovered no sign of infection in TJ’s sacs.
28. With regard to charge 1(d), the Respondent produced copies of clinical notes and an invoice
which he believed were adequate, in that they were “full, accurate and effective”.
29. The Respondent was of the opinion that informed consent was a ‘subjective concept’, but he
believed it had been obtained from Ms Ley. The consent form was not available. He could not
recollect explaining the risks of the procedure to Ms Ley.
The evidence of expert witnesses:
30. Mr Andrew Robinson FRCVS gave expert evidence on behalf of the College. Mr Nigel HarcourtBrown FRCVS gave expert evidence on behalf of the Respondent.
31. In the view of the Committee, both expert witnesses were honest, knowledgeable and
competent. Their evidence was clear, and given in a concise manner.
Charge 1(a)(i) and (ii)
32. Mr Robinson said that material removed from TJ by Mr White was consistent with a gland. In his
written report he stated that if it had not been a gland it would have been irregular and not a
globular structure. “Proliferative tissues tend to follow line of least resistance which is within the
surgical site so that it tends to have an irregular infiltrative edge.” From his own experience and
a literature search, Mr Robinson was unconvinced as to the validity of the three alternative
theories proposed.
33. Mr Robinson gave an instructive account of different procedures for dealing with anal gland
problems.
34. In his first report, his conclusion in relation to TJ was that “as a probe (open technique) was used
by the Respondent to aid dissection it is probable that he removed only the most distal segment
of the duct leaving the sacs intact. …the Respondent completely failed to remove either of the
anal sacs”
35. Mr Harcourt-Brown was of the opinion that a surgeon operating with reasonable care could leave
behind a piece of one or both anal sacs, but that it was very unlikely that any competent surgeon
could think he had removed a relatively normal sac when he had in fact left the whole sac in situ,
removing only the duct. He stated that it would be normal practice to examine the excised tissue.
He stated in his report that any tissue left behind would form a ‘new’ sac which could vary in size.
Under cross-examination, he conceded that the structure shown to the Committee and exhibited
in photographs, following surgery by Simon White, could have been an original sac which was
99% complete.
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Charge 1(a)(iii)
36. Mr Robinson said that, as the region is very vascular and prone to swelling and irritation leading
to subsequent scooting, the provision of adequate post-operative analgesia is imperative. The
Metacam injection given at the time of surgery would only be effective for 18 to 24 hours and his
opinion was that this should have been followed by oral NSAID therapy daily for four to five days.
TJ was a young adult dog with minimal or no risk factors, and therefore the risks posed by
NSAIDs “would be infinitesimally small”.
37. When Mr. Robinson was asked if Dexafort, given to TJ by the Respondent three days after the
initial surgery, was an adequate analgesic he said: “No. Dexafort is a steroid and antiinflammatory drug and not an effective analgesic”.
38. Mr Robinson disagreed that a single dose of Metacam given by injection on the day of the
operation was adequate for acceptable pain relief for TJ post-operatively.
39. In relation to post-operative analgesia, Mr. Harcourt-Brown stated that it would be usual current
practice to administer a NSAID at the time of surgery and often provide a course of oral
medication post-operatively. However, he stated that NSAIDs are the most common cause of
gastric ulceration in dogs, and the amount and length of time that these drugs should be used is
very debatable. In his opinion, a reasonable compromise between achieving effective analgesia
and avoiding the risk of unwanted gastroenteric side-effects would be to administer a single dose
of Metacam at the time of surgery, as the Respondent did. However, under cross-examination
he stated that this compromise would only have been reasonable had the client been told to
return for an assessment as to whether further post-operative analgesia was required.
Charge 1 (b)
40. Mr Robinson said that he would expect any new veterinary graduate to know the position and
extent of the anal sacs in a dog, to recognise if dissection was inadequate during anal
sacculectomy and to take steps to rectify the situation.
Charge 1 (c)
41. Mr Robinson had examined the paperwork provided by Epivet and could find no evidence of Ms
Ley being provided with advice on the availability of non-surgical alternatives.
Charge 1 (d)
42. Mr Robinson commented that the records obtained from Epivet could not be considered
adequate, as they contained no information concerning the anaesthetic used or hospitalisation
sheets.
43. In his written evidence, Mr. Harcourt-Brown stated that in an uncomplicated surgical intervention,
he would be inclined to write “GA AG removal”. He would also accompany this with a list of
medications, dosages and duration of the course of treatment. Under cross-examination, he
stated that those notes would be shorthand for an uneventful operation. He did not answer when
asked if the Respondent’s clinical records ‘in totality’ were adequate.
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Charge 2
44. Both expert witnesses said that they could find no evidence that the Respondent and/or Epivet
had provided a consent form signed by Ms Ley.
45. In his report, Mr. Harcourt-Brown quoted from the RCVS Code to Professional Conduct:
“Informed consent, which is an essential part of any contract, can only be given by a client who
has had the opportunity to consider a range of reasonable treatment options, with associated fee
estimates, and had the significance and main risks explained to them”. It was his view that if the
Respondent had not discussed TJ’s case in that manner with Ms Ley, he could not have allowed
her to give informed consent for anal sacculectomy.
Charge 3 (Smith/Tufty)
The College’s case:
46. These allegations relate to the care and treatment by the Respondent of a cat called Tufty,
owned by Miss Elizabeth Smith. The College’s case is as follows.
47. On Saturday 18 July 2009 Tufty seemed to Miss Smith to be unwell, so she and her mother, Mrs
Alison Smith, took him to the Respondent’s practice in Williton. Mr Kaminski examined and Xrayed Tufty and found a fracture to Tufty’s sternum. He said that they should leave it until
Monday to see whether healing had started. If it had, he would let nature take its course. If not,
an operation might be needed. He asked the Smiths to bring Tufty back to the practice on
Monday 20 July 2009. Miss Smith’s father, a retired veterinary surgeon, told her that he thought
Tufty seemed dehydrated, and he advised Mrs Alison Smith to mention this to the veterinary
surgeon on their return to the practice.
48. Miss Smith took Tufty back to the practice as arranged on the morning of Monday 20 July 2009,
where the Respondent was present, and, it is therefore said, took ultimate responsibility for
Tufty’s care. They told Mr Kaminski about the concern as to dehydration. There is a dispute,
however, as to whether Mr Kaminski did then rehydrate Tufty, and it is alleged by the College
that he did not. Mr Kaminski states that he passed on the care of Tufty to the Respondent, who
was at the practice that day. The Respondent denies that he took charge of the case.
49. No-one from the practice contacted the Smiths until around 5 pm that day, when it was stated
that Tufty needed an operation on the fracture. The Smiths gave their consent. They were told
that Tufty would be kept in overnight, and operated on the next morning.
50. The next day, Tuesday 21 July 2009, Tufty was not rehydrated, according to Mr Kaminski. He
was concerned about the cat, and he tried to draw the Respondent’s attention to Tufty‘s
condition. It is alleged that the Respondent did not contact either of the Smiths until about 1 pm.
The Respondent then asked Miss Smith if she could pay for the operation. She confirmed that
she could. The Respondent would not guarantee that he would operate on Tufty that day. Both
the Smiths were concerned about the fact that Tufty had not yet been operated on, and told the
receptionist at the Williton practice that they were coming to collect Tufty to take him elsewhere
for a second opinion. They then travelled to the Respondent’s practice, and collected Tufty.
They asked for and were given a bill in the sum of £28.75 including VAT for “hospitalisation”.
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51. They took Tufty to another practice, Blake Veterinary Group in Bridgwater, where Mr Smith had
been a partner. As the Smiths transported Tufty, they noticed that there was a foul smell coming
from him.
52. At Blake Veterinary Group, Tufty was examined by Mr Richard Bruce MRCVS. He noticed the
smell, found an abscess on Tufty’s chest which had burst, probably en route to his practice, and
assessed that he was dehydrated. He found no evidence that Tufty had had an intravenous
catheter placed. Although Mr. Bruce thought that, given the cat’s age and what he could see of
the wound, euthanasia should be considered, it was agreed with the Smiths that he would
rehydrate Tufty, administer antibiotics and painkillers, and further investigate the wound the next
day.
53. The next day, Mr Bruce examined Tufty under anaesthesia, and found a large infected sinus full
of necrotic fat and muscle, extending along the right thoracic wall into the axilla and cervical
region. The infection was so extensive that he advised that Tufty should be euthanased. The
Smiths consented to this.
54. The College alleges that, while Tufty was in the care of the Respondent’s practice, he failed to:

ensure that his condition was monitored adequately or at all;

identify the abscess from which he was suffering;

ensure that he received any or adequate care for the abscess;

ensure that he received any or adequate fluids; and

make or maintain adequate records in respect of the management of Tufty whilst in his care.
55. The invoice given to Miss Smith by Epivet does not refer to rehydration being provided. The only
other records were those provided by Epivet to Mr Bruce at his request, and these relate only to
the X-ray procedure, and other treatment given to Tufty on Saturday 18 July 2009. There are no
notes in relation to the period when Tufty was in the care of the Respondent’s practice from
Monday 20 July to Tuesday 21 July 2009.
56. Miss Smith voiced her concerns to the Respondent by telephone shortly after Tufty had been
euthanased. The Respondent said that Tufty had not been in his care and was not his
responsibility. He said that Tufty had not been a priority over other animals. The Respondent
repeated this position in a letter dated 21 August 2009, in response to an earlier detailed letter of
complaint from Miss Smith. He also stated that Mr Kaminski rehydrated Tufty.
57. In the light of the above facts, the College alleges that the Respondent failed to provide adequate
professional care and/or failed to have regard to animal welfare in respect of Tufty.
The College’s witnesses:
58. The Committee heard evidence from Miss Elizabeth Smith and from Mrs Alison Smith, both of
whom confirmed the contents of their witness statements, dated mid 2010, and impressed the
Committee as being straightforward, honest witnesses.
59. Miss Smith wrote a detailed letter of complaint to the Respondent within a month of the date of
the relevant events, and her witness statement reflects that account. There were some minor
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inconsistencies between the recollections of these two witnesses. For example, Mrs Smith said
that she noticed the foul smell from Tufty as soon as he was placed in the car, whereas Miss
Smith said she noticed it within five minutes of starting the car journey.
60. The Committee does not consider that these minor differences of recollection, or some details of
events that occurred four years ago affected the reliability of their evidence. In the view of the
Committee, their evidence was not undermined or otherwise materially affected by crossexamination.
61. Mr Kaminski gave evidence concerning his dealings with Tufty. His recollection of matters of
detail was fairly limited, and he often referred to his normal procedure rather than giving his
specific recollection of what actually happened. He told the Committee that, after taking the X-ray
on Saturday, he had left a note for the Respondent on his desk expecting him to see it on the
Monday morning. The note told the Respondent what he had found, and advised him that he felt
that surgery was required to repair the fracture shown on the X-ray.
62. Mr Kaminski was present at the surgery on Monday and Tuesday when Tufty was an in-patient.
He says he thinks he gave Tufty some fluids subcutaneously at some point. He said that he had
no recollection of putting Tufty on a drip. He said he tried to speak to the Respondent about
Tufty on the Monday, but was told he (the Respondent) was too busy. Mr Kaminski said that
during the day on Monday Tufty was looking depressed in his cage, and was not eating or
drinking. There were no staff in the surgery overnight, so that Tufty was left alone after about
7pm on Monday until 9am on Tuesday.
63. On Tuesday Tufty seemed to be a little worse than on the Monday, and Mr Kaminski said he
noticed for the first time some necrotic skin on his chest which had not been apparent on the
Monday. He again tried to speak to the Respondent about Tufty on Tuesday, but the
Respondent was still not prepared to discuss matters. Mr Kaminski said he believed he was
unable to give any treatment to Tufty without the authorisation of the Respondent. His memory
of what basic care he gave to Tufty on the Monday and the Tuesday was very poor. There is no
evidence of any notes recording any clinical examination, attempts at rehydration, or any other
care given whilst Tufty was at the Epivet surgery.
64. Mr Kaminski was extensively cross-examined, and it was suggested to him that he was trying to
pass the blame for what had happened to Tufty from himself on to the Respondent. He denied
this. He was very firm in his denial when accused of lying. He said that this was not a
comfortable time in terms of his working relationship with the Respondent and he was trying not
to remember much about it. In his view, had he acted without the Respondent’s authority, his
employment would have been in jeopardy.
65. At the end of his evidence, the Committee was left with the impression that Mr Kaminski firmly
believed that Tufty was under the care of the Respondent from Monday morning, that he did not
believe that he could give any active treatment to the cat without the Respondent’s authority, and
that he felt that he was unable to get the Respondent to give his attention to Tufty’s case. That
said, he was not able to give any cogent evidence as to any monitoring, or basic checks or tests
on Tufty’s condition that he or anyone else carried out on the Monday and Tuesday, save
possibly for a single administration of limited fluids. On any view, he had a poor recall of many
material facts and matters of detail.
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66. Miss Sumpter, a student veterinary nurse, was present when Tufty was brought to the surgery on
the Saturday and seen by Mr Kaminski. She remembers him taking an X-ray. She further recalls
Mr Kaminski asking the Respondent to look at the X-ray of Tufty on either Monday or Tuesday.
Although the Respondent did so on the Tuesday, he did not examine Tufty at any time, and
seemed to be in a rush. Her recollection of events was very limited, and the Committee did not
find her evidence of any real assistance in relation to the allegations relating to Tufty.
67. Mr Bruce, who examined and treated Tufty at Blake Veterinary Group, gave evidence to the
Committee. He confirmed the contents of his witness statement, and produced photographs of
Tufty’s condition, copies of his detailed clinical notes of the results of his examinations,
treatments and advice given, and of the notes sent to him by Epivet. The Committee found him
to be an honest and competent veterinary surgeon, who had a good recall of the events
surrounding Tufty’s admission and treatment. His evidence was not significantly challenged, and
left the Committee in no doubt that Tufty was in a very poor condition when he arrived at the
Blake Veterinary Group surgery.
The Respondent’s evidence:
68. The Respondent consistently maintained that he did not have responsibility for Tufty’s care as
the cat was under the care of Mr Kaminski. He maintained that his involvement was confined to
giving a second opinion on the X-ray taken on 18 July, but he could be certain only that he had
seen the X-ray by the time of Tufty’s discharge on Tuesday. He was certain that he had been
told that Tufty had been receiving treatment, but cannot remember exactly when he became
aware or who had told him.
69. Although he was the owner of the practice, he maintained that he was not the principal clinician,
on the basis that Mr Kaminski was more experienced than himself.
70. In relation to charge 3(a), the Respondent informed the Committee of Standard Operating
Procedures in place to guide veterinary surgeons and animal assistants with regard to monitoring
animals although he had not produced copies of these.
71. In relation to charge 3(b), the Respondent admits that he did not examine Tufty at any time.
72. In relation to charges 3(c) and (d), the Respondent maintains that he knew on Monday 20 July
that the cat had received antibiotics, analgesics and fluid therapy but did not know any details.
73. With regard to the making and maintaining of adequate records, charge 3(e), the Respondent
maintained that the responsibility for records had been that of Mr Kaminski. However, he drew
the Committee’s attention to a document in which he described retrospectively writing up the
notes on behalf of Mr Kaminski, but could not then produce the notes written.
Evidence of expert witnesses:
Charge 3 (a)
74. It was the opinion of Mr Robinson that the Respondent had ultimate responsibility for the care
and supervision of Tufty during the time he was in the practice on Monday and Tuesday. He was
told that Mr Kaminski had left a message for the Respondent indicating that Tufty was very ill and
12
required attention, but the Respondent failed to carry out an examination or treatment at any time
during Tufty’s hospitalisation.
75. Mr Robinson said that it was impossible to know precisely what happened to Tufty whilst he was
an in-patient, but from the evidence presented there is no record of any examination or blood
tests to assess Tufty’s condition, degree of dehydration or kidney and liver functions. Whilst
clinical assessment may give a guide to dehydration, it alone is not adequate and haematocrit
measurement is required for proper assessment.
76. At the time that Tufty was discharged from the practice into Miss Smith’s care, there was no
check made on his condition to ensure that he was in a fit state to be transferred to another
practice.
77. With regard to what would have constituted adequate monitoring, Mr. Harcourt-Brown stated that
he would expect an in-patient to be visually observed on a regular basis, be stimulated in some
way on regular occasions throughout the day and be fully assessed three to four times per day.
He would have expected these examinations to be recorded either on the hospital sheet or in the
clinical notes. Even if such a system was in place, the Respondent should have carried out a
final inspection before leaving the premises at the end of the day.
78. Mr. Harcourt-Brown was absolutely sure that more should have been done for Tufty than was the
case.
Charge 3(b) and (c)
79. Both experts agreed that the abscess on Tufty’s thoracic region was at no time identified or
referred to whilst he was in the Epivet practice or in any clinical records made at the time.
80. Mr. Harcourt-Brown drew attention to the fact that the sternal fracture was a complicating factor
and “took everyone’s eye off the ball”.
81. As the abscess was not discovered, there was no opportunity to provide any or adequate care for
the condition.
Charge 3 (d)
82. Mr Robinson stated that the subcutaneous administration of fluids was totally inadequate to
rectify a serious level of dehydration. He further stated that in his opinion it would have been
necessary to administer a minimum volume of fluid, which he demonstrated by holding up a
500ml bottle of water. He said this should preferably be administered by the intravenous route.
There was no evidence that anyone subsequently found any signs that intravenous fluids had
been administered at Epivet.
83. Mr Robinson said that he had checked the evidence presented for details of any clinical records.
The only written record he could find related to the invoice for the in-patient period.
84. Mr. Harcourt-Brown stated that a single bolus of subcutaneous fluids would not be sufficient
treatment for Tufty. He explained that there were concerns about administering fluids by the
intravenous route in an aged cat, and stated that subcutaneous fluids would be a reasonable
13
compromise. He agreed that Tufty was dehydrated when seen by Blake Veterinary Group, but
stated that it was impossible to judge what was adequate because there was no diagnosis of
Tufty’s underlying condition.
Charge 3(e)
85. Neither expert had seen satisfactory records for this case.
Charge 4 (the Lang complaint)
The College’s case:
86. Mrs Hilary Lang was a client of the Respondent at Epivet’s Wiveliscombe surgery. The College’s
case is that, on 12 June 2009, the Respondent failed to treat Mrs Lang with due courtesy and
respect and/or brought the profession into disrepute in that, while in the waiting room of the
practice, in the presence of staff and members of the public, he
(i)
responded to Mrs Lang’s observation about the surgery opening times:

with words to the effect that he did not want any verbal and had had enough verbal;

with a mouthing gesture with his hand;

with derogatory observations about the practice’s previous owners;

and by asking Mrs Lang whether she wanted the tablets or not;
(ii) responded to Mrs Lang producing her cheque book to pay by saying
effect “I hope you have got a card”;
rudely words to the
(iii) responded to Mrs Lang’s return with a card by saying rudely “oh, you’re back”.
The College’s witnesses:
87. Mrs Lang gave evidence before the Committee, confirming the contents of her witness
statement. She had been a client of the veterinary practice in Wiveliscombe for over 30 years,
and in 2009 had a 12 year old Springer Spaniel, called Jack, who suffered from epilepsy, and
was on regular medication, namely Epiphen and Potassium Bromide tablets.
88. After the Respondent took over the practice in about April 2009, Mrs Lang started having
problems obtaining supplies of Jack’s medication, because the tablets were never ready for
collection, even when ordered some time in advance. These problems became acute during the
first week of June 2009, when ordered tablets were not ready or short of the number ordered,
and when supplied were in a dirty bottle later found to contain a syrup-like fluid. After resolving
this problem, Mrs Lang ordered a month’s supply of tablets for collection on 12 June 2009.
89. On that day, in the morning, Mrs Lang went to the Wiveliscombe surgery to collect her tablets,
but found it shut, with a notice saying that opening hours were 12 noon -3pm. She went back
during these hours, but her tablets were again not ready for collection. She met the Respondent
for the first time, who dispensed the tablets. Mrs Lang observed that everything seemed to be a
problem at the practice these days. She said that the Respondent then turned on her and told
her “I don’t want any verbal”, whilst making a mouthing gesture with his hand, and then said “I’ve
had enough of verbal”. He then proceeded to blame all the problems with the practices on the
14
previous owners, complaining that the phone and fax had been cut off, and that previous
customers owed the practice a lot of money. Mrs Lang thought that such comments were
inappropriate, particularly as they were made in the presence of staff and other members of the
public in the waiting area.
90. When Mrs Lang came to pay for her tablets by cheque, the Respondent said sharply “I hope you
have got a card”. Mrs Lang said that she had not, because she had never needed one before,
and became very upset. She left to go home and collect her card. When she returned with her
card, the Respondent looked at her and said “Oh, you’re back” in a very sarcastic manner.
Having paid for the tablets, Mrs Lang told the Respondent “I don’t think you have any
compassion for animals and no consideration for clients at all.” She said that she would not
return to the practice again.
91. As she was leaving the practice, Mrs Dorothy Hadleigh, a client sitting in the waiting area, who
was previously unknown to Mrs Lang, handed her a piece of paper with her name and phone
number on it, saying that she was willing to be a witness to what had happened.
92. Mrs Hadleigh also gave evidence to the Committee, confirming the contents of her witness
statement. She confirmed material aspects of Mrs Lang’s account of events. She described Mrs
Lang as visibly distressed, and said that the Respondent showed no empathy towards her at all.
When the cheque card problem arose, Mrs Hadleigh said that the Respondent’s manner was
very rude. His tone was appalling, especially when Mrs Lang was anxious about her dog, about
the delay, and her distress had become very noticeable. However, she was clear that Mrs Lang
was not aggressive or abusive, and said she never raised her voice. Mrs Hadleigh was shocked
by what she had witnessed, and never returned to the practice.
93. In response to Mrs Lang’s letter of complaint dated 9 September 2009, the Respondent stated
that Mrs Lang was abusive. That was not accepted by Mrs Lang. In another response he states
that he does not recall the incident.
94. Although Mrs Lang was rigorously cross-examined, she firmly maintained her version of events,
and denied that she lost her temper or was abusive. Mrs Hadleigh too, maintained her account
of events under cross-examination.
95. The Committee found Mrs Lang to be an honest and open witness, who had shown loyalty to the
practice which was closest to her home, despite inexcusably poor service by Epivet in providing
medication for her epileptic dog. She obviously cared deeply about her dog, and his welfare.
When cross-examined, she dealt calmly with the questions put to her, and came across as a
reliable witness, albeit a lady who was very distressed by what had occurred.
96. Mrs Hadleigh was consistent and clear in giving her evidence. She had a clear recollection of
events, by which she was sufficiently appalled to give her name and contact details to Mrs Lang,
who was previously unknown to her, and express her willingness to be a witness to what had
occurred.
97. There was a minor discrepancy between Mrs Hadleigh and Mrs Lang about the length and
content of a telephone conversation between them after the incident, which the Committee did
not regard as significant. Other minor discrepancies between their two accounts, in fact, lent
15
credence to their evidence, and indicated that they had not collaborated on their accounts.
However, the Committee found them to be reliable witnesses.
The Respondent’s evidence:
98. The Respondent confirmed that he had had a conversation with Mrs Lang in the waiting room in
the presence of Mrs Hadleigh. He accused Mrs Lang of being rude, abusive and using
expletives and said that when people used expletives he stopped interacting with them. He said
that he told her, while using his arms to gesticulate, that if she continued to give him “verbal”, he
could not serve her. His purpose in using a “visual cue” was to distract Mrs Lang from arguing.
To demonstrate his use of visual cues, the Respondent took off his shoe and placed it on the
witness stand, occasioning an enquiry as to his well-being from his Counsel.
99. His oral evidence was that he had not been derogatory about the previous practice owners,
merely that he had discussed the situation and “discussed what was real”. He did not remember
exactly what had been discussed, but said that if he had been asked a specific question by Mrs
Lang, he would have given an honest reply. However, under cross examination he said he had
no reason to disbelieve what Mrs Lang said. He explained that he had stared at the eyes of the
witnesses as they gave their evidence, so that he could assess whether or not they were telling
the truth. He conceded that some people might be uncomfortable with that.
100. In relation to Mrs Hadleigh, under cross-examination he described her as “cool, calm and
collected”. However, in his undated written rebuttal statement to the College he described her as
“significantly aggressive”. When questioned about this apparent inconsistency, he maintained
that the two descriptions were “not mutually exclusive”. He further stated in his rebuttal that he
honestly does not remember the incident.
101. In relation to his asking Mrs Lang if she wanted the tablets or not, the Respondent stated that he
did ask the question, but meaning ‘I don’t mind either way’.
102. The Respondent admitted that he asked Mrs Lang if she had a cheque guarantee card but did
not do so rudely. He accepted that she was very upset. However, his evidence was inconsistent
in that when she returned with the card, he initially said that he did not greet her, but then said
his greeting had been misread.
Evidence of expert witness:
Charge 4
103. Mr. Harcourt-Brown stated in his report that if Mrs. Lang was correct in her recollection of what
happened, it would seem that she was treated with less than due courtesy.
Charges 5 and 6 (the Walker complaint)
The College’s case:
104. Mrs Barbara Walker was the owner of Bessie, a collie cross. The College alleges that, on 25
January 2010, the Respondent failed to treat Mrs Walker with due courtesy and respect and/or
brought the profession into disrepute in that, he telephoned her and
a.
told her that she must come to the practice at once and give Bessie the tablets or she would die;
16
b.
informed her that Bessie had Lyme Disease when he had not carried out the investigations for
that diagnosis;
c.
after Mrs Walker stated that Bessie was being treated at another practice, repeated the
instruction at a) above.
105. It is further alleged that the Respondent failed to make and maintain adequate records in respect
of Bessie.
The College’s witnesses:
106. Mrs Walker gave evidence to the Committee, and confirmed her witness statement. Her
evidence was that she had been a client of the veterinary practice in Williton since 2006. In July
2009, she took Bessie for a booster vaccination, and discovered that the practice had been taken
over by the Respondent. She saw him on that occasion, and found him to be off-hand and
abrupt.
107. She next visited the practice on 18 January 2010, because Bessie was lethargic and unwell, and
saw the Respondent again. Mrs Walker explained that Bessie was unwell, had a temperature
and had developed a facial twitch. The Respondent took Bessie’s temperature, felt her
abdomen, and listened to her chest. On request, he checked her ears, and said they were
alright. He said that she had a high temperature, and she ‘must have an infection in there
somewhere’. He gave Bessie three injections of Finadyne, Ceporex and Clamoxyl and
dispensed some Baytril tablets. He told Mrs Walker to come back if Bessie was no better.
108. Mrs Walker was not satisfied with the Respondent’s treatment of Bessie, and, on 19 January
obtained a second opinion from Paul Gannon MRCVS, at White Lodge Veterinary Clinic,
Minehead. He examined Bessie, and discovered that she flinched when touched, and that her
abdomen and spleen were enlarged. He looked in her mouth and ears, and concluded that she
was anaemic, which was confirmed by a blood test.
109. Further tests and scans were performed the next day, and Mr Gannon diagnosed immunemediated anaemia. Bessie responded well to initial treatment, and was closely monitored over
the next few days by White Lodge. Unfortunately, on about 9 February 2010, it was discovered
that Bessie had developed an abdominal mass. The next day Mr Gannon performed a bone
marrow biopsy, which indicated that the bone marrow had stopped producing red blood cells. It
was decided that Bessie should be euthanased.
110. Prior to this, on 22 January 2010, Mrs Walker went back to the Respondent’s surgery,
complaining that the diagnosis that she had been given was ‘rubbish’, returned the Baytril tablets
that she had been given and demanded back the £55 that she had paid for the consultation. The
Respondent was not there, but telephoned Mrs Walker later. A heated conversation ensued,
during which the Respondent said that she could not have her money back and that she was
rude. The conversation ended with Mrs Walker saying that she was going to report the matter.
111. On 25 January 2010, the Respondent telephoned Mrs Walker again, and she stated that he said
“I just want to say, get down to this surgery at once and give your dog these tablets or it will die”.
He went on to say that Bessie had Lyme Disease. Mrs Walker knew that he was talking about
the tablets that she had left on the counter the previous week. Mrs Walker asked the
Respondent “How do you work that out? You haven’t seen her since last week and she is being
17
treated at White Lodge.” The Respondent replied “Get down and get these tablets or your dog
will die”.
112. It is alleged that the Respondent had carried out none of the necessary investigations required
for a diagnosis of Lyme Disease, and that in any event the medication provided to Mrs Walker by
him was not appropriate for treating Lyme Disease.
113. The Committee found Mrs Walker to be a clear and honest witness. She had a strong
personality. In cross-examination, she admitted to shouting and giving as good as she got on the
telephone, as did the Respondent. She admitted she was angry, but said this was because of
concern for her dog. She was very sure that the Respondent told her to come and get the tablets
or her dog would die. She was also certain that the Respondent had never mentioned Lyme
Disease at the consultation on 18 January 2010.
114. The Committee noted that Mrs Walker’s witness statement is consistent with the letter of
complaint that she wrote to the College in April 2010, shortly after the relevant events occurred.
The Committee considered that Mrs Walker was a reliable witness.
115. Mr Gannon gave evidence of the diagnosis and treatment of Bessie, as described above, and he
exhibited his detailed clinical notes recording that treatment. He also exhibited the notes
forwarded to White Lodge by Epivet, including a two-line note of the consultation on 18 January
2010 which did not mention Lyme Disease. Mr Gannon expressed the view that Baytril was not
an appropriate drug for the treatment of Lyme Disease. Mr Gannon’s evidence was not
significantly challenged.
116. It is alleged that the clinical notes made by the Respondent in relation to his management of
Bessie were inadequate. The Committee notes the brevity and lack of detail of those notes, and
finds it instructive to compare them with the detailed and comprehensive notes prepared by Mr
Gannon.
The Respondent’s evidence
117. The Respondent denies telling Mrs Walker that Bessie would die if she did not come to collect
the tablets. He said that he rang her to discuss the subclinical distemper situation in Stogumber
or the possibility of Lyme Disease. He denied that he told Mrs Walker that Bessie had Lyme
Disease. He had been expecting her to come back for a follow up consultation at which point he
would have taken a blood sample. He did not remember when he knew that she had taken
Bessie to another veterinary surgeon but he said that she had told him at some point. He agreed
that once he knew Bessie was being treating elsewhere, he should not have continued to
comment on her care.
118. In his witness statement the Respondent said that adequate clinical records were recorded and
compiled for Bessie Walker. In his initial rebuttal to the College, he stated that Lyme Disease
was one option considered and recorded in the clinical notes. However, the notes produced by
the Respondent contained no reference to Lyme Disease.
18
Evidence of expert witnesses:
Charge 5
119. If it was correct that the Respondent acted in the way alleged, Mr Harcourt-Brown stated in his
written report that that behaviour could be construed as bringing the profession into disrepute.
Charge 5(b)
120. Mr. Harcourt-Brown had little direct experience of Lyme Disease, but was aware that it was
difficult to diagnose. Having reviewed the literature, he knew that the clinical signs could be
equivocal and that treatment with oxytetracyline could be cheap and effective rather than running
costly investigations.
121. Mr Robinson said that no diagnosis of Lyme Disease in Bessie had been confirmed. If
prophylactic treatment was contemplated (because of local risk factors) then the medication
supplied would be ineffective for the treatment of Lyme Disease.
Charge 5 (c)
122. As an experienced veterinary surgeon, Mr Robinson’s opinion was that it was unprofessional to
contact the owner of an animal regarding its treatment in the knowledge that it was now under
the care of another veterinary surgeon.
123. Mr. Harcourt-Brown agreed that there was a risk to an animal if an owner were to act on two
different sets of independent advice. Under cross-examination, he agreed that it was
unprofessional to express views on treatment when it was known that the animal was under the
care of another veterinary surgeon. He stated that any discussions should be between
colleagues to minimise the dangers of contrary advice.
Charge 6
124. Mr. Harcourt-Brown thought that it was reasonable not to include an extensive list of differential
diagnoses in the clinical notes on a first examination. Under cross-examination he agreed that if
a veterinary surgeon dispensed drugs based on differential diagnoses, these should be recorded,
and therefore he agreed that in these circumstances the notes were inadequate.
Charge 7 (the Milton complaint)
The College’s case:
125. Mrs Jennifer Milton was the owner of Jenny, a pointer. The allegation in this case is that the
Respondent failed to provide Mrs Milton with a copy of Jenny’s clinical records, when she
requested them, between July and August 2009.
126. Between June and July 2009, Mrs Milton’s dog Jenny was under treatment at the Respondent’s
practice at Williton, having been a patient of the previous owners of the practice. At the
beginning of July 2009, Mrs Milton was concerned about Jenny’s continuing signs, and was
considering seeking a second opinion.
19
127. Before doing so she wanted to submit an insurance claim to Direct Line for the treatment
received from the Respondent’s practice. She dropped in the insurance claim form at the Williton
surgery for the Respondent to complete and sign at the beginning of July 2009.
128. After repeated visits to the surgery, she finally got the Respondent to complete and sign the form
on about 13 July 2009. Mrs Milton sent the form off to the insurers, who contacted her to say
that they needed copies of Jenny’s historical clinical records, and asked her to obtain them. She
went to the surgery and asked for the records, and the receptionist said that she would get them
for her.
129. Mrs Milton called at the surgery on a number of occasions chasing the records, but without
success. She was told by the receptionist that there were computer problems. On 11 August
2009, Mrs Milton received a letter from Direct Line saying that they still had not received the
records. Further attempts by Mrs Milton to obtain the records failed. Mrs Milton was told by
Direct Line that the Respondent had a legal obligation to provide copies of the records and that
she could complain to the College.
130. Accordingly, she made a complaint to the College, dated 26 August 2009. As a result of the
complaint, Mr Hepper from the College was able to obtain a copy of Jenny’s records from the
previous owners of the Williton practice. These were passed on to Direct Line, who then dealt
with the claim. Meanwhile, Mrs Milton had started taking Jenny for treatment to White Lodge,
another veterinary practice.
131. In November 2009, the Respondent telephoned Mrs Milton to say that she could collect Jenny’s
records if she still needed them. She was surprised and angry to receive the call, and told the
Respondent that, if she had waited for him, Jenny would have been dead.
The College’s witnesses:
132. Mrs Milton gave evidence to the Committee, in which she outlined the events described above.
The Committee found her to be a genuine and reliable witness. She was unable to remember
detail of the dates when she requested the records, but, having regard to the passage of time,
that was not surprising. She refreshed her memory from her statement, where necessary,
indicating a careful approach to her evidence. Mrs Milton’s evidence was not seriously
challenged.
133. Mr Christopher Milton, Mrs Milton’s husband, gave brief evidence in the form of an agreed
witness statement, which supported his wife’s evidence.
The Respondent’s evidence:
134. The Respondent’s written response to these allegations focused upon difficulties with the
practice’s computer systems. In oral evidence the Respondent said that as at the 9 July 2009,
there were no problems in accessing historical records or printing them off. However in his
witness statement he confirmed that a difficulty arose in relation to providing the insurance
company with over ten years of clinical notes. He relates that he spoke to Mrs Milton several
times to explain the delay. In his witness statement he emphasised the difficulties he faced
because of the peculiar and inadequate computer set up and arranged by (the previous owners)
and the idiosyncrasies of the VetCom software.
20
135. The Respondent confirmed that on 3 September 2009, the notes were obtained by the RCVS
from a third party.
Evidence of the expert witnesses:
136. In his written report, Mr. Harcourt-Brown stated that “the client and the insurance company have
every right to expect a prompt response by providing a full and accurate history. Failing to do so
is a breach of our code of conduct. A broken computer should not prevent the veterinarian in
charge from making a hand-written case history, which along with the invoices issued, would
satisfy the insurance company and therefore the owner”.
Charge 8 (the Jazz complaint)
The College’s case:
137. Jazz was a dog who had been under the Respondent’s care, and who was subsequently under
the care of the Deane Veterinary Practice in April 2010. Mrs Vikki Bray was an unqualified nurse
and receptionist, who had worked at the Williton practice, when it was taken over by the
Respondent in 2009, and subsequently she started to work for the Deane Veterinary Practice on
12 April 2010.
138. It is alleged that the Respondent failed to co-operate with professional colleagues, in that, when
asked by Mrs Bray on behalf of Deane Veterinary Practice for copies of Jazz’s records:
a)
said that no records were available because he had changed the computer system 10 months
previously;
b)
when asked for copies of the records for the last 10 months said that he was in Hampshire and
could not provide the records;
c)
when told that the request was not urgent and that they could be sent by fax, said that he would
do it when he got around to it;
d)
failed to supply the records or copies of the records.
139. On 13 April 2010, Mrs Bray spoke on the telephone to the Respondent to request Jazz’s records.
She had difficulty in finding a contact number for the Respondent’s practice, and obtained a
contact number for him from the College. This was his home number in Hampshire. After
receiving a hostile initial response to a call on this number, the Respondent gave Mrs Bray the
responses set out above. He spoke of being entitled to charge for the copies, and then stated
that she could have the records if she paid the £10,000 he would have to pay to Vetcom. There
was no constructive response to Mrs Bray’s request, and, so far as Mrs Bray knew, no records
were ever supplied.
The College’s witnesses:
140. Mrs Bray gave evidence of these matters. She described the Respondent’s manner on the
telephone as rude, shouting and aggressive in tone. She maintained her account of events. Mrs
Bray said that she was unable to say one way or another whether the records were ever supplied
to the Deane practice. She conceded that there were employment issues between herself and
21
the Respondent arising from the time that she worked at his practice. She identified herself by
her job title rather than her name, because she did not want the Respondent to know who she
was.
141. The Committee found Mrs Bray to be a reasonable witness, who was doing her best to assist
the Committee. She was an experienced receptionist who had worked for more than one
practice, and had telephoned other practices several times to ask for records, and followed her
usual procedure of giving the animal’s name and the client’s surname.
The Respondent’s evidence:
142. The Respondent acknowledged receiving a phone call asking for records for a dog named Jazz,
but said the surname was not supplied. He stated that the records were in Somerset, while he
was in Hampshire. He offered to drive to Somerset to obtain the records if the case was urgent,
but was told that it was not. He did not ascertain the identity of the caller but believed it might
have been the previous owner of his practice, and believed it to be a suspicious call. The
records were not supplied at that point and no further requests were made.
The Committee’s findings on the facts
The Committee’s impressions of the Respondent
143. Before setting out its findings on the facts, the Committee considers it necessary to set out its
views on the Respondent.
144. The Committee acknowledges that from the outset of setting up his new practices in Somerset,
there occurred a series of unfortunate adverse events which he found stressful.
145. Nevertheless, the Committee found the Respondent to be an unhelpful and uncooperative
witness. After being asked questions and during some of his responses, he frequently lapsed
into periods of silence which sometimes lasted minutes.
146. He would not answer simple questions without recourse to a large quantity of irrelevant
background and side issues. He was loquacious and discursive throughout. He frequently
asked for questions to be repeated as he lost his train of thought, saying “please bear with me”.
147. When questioned about inconsistencies between his written rebuttal to the College, his witness
statement and his oral evidence, he was evasive and illogical. The Committee noted that in both
his written rebuttal statement and his oral evidence, the Respondent frequently referred to
himself in the third person as ‘Hutber’, rather than in the first person as would be normal.
148. He treated Counsel for the College with a complete lack of respect and in the Committee’s
opinion was attempting to control the proceedings. He was by turns arrogant, rude, patronising,
sarcastic and angry. The Committee had observed the Respondent staring fixedly at a number
of College witnesses while they were giving evidence. The most extreme example of this staring
was when he fixed Counsel for the College with a penetrating stare as she was asking him to
refer to a document. It was only after several requests that he turned his attention to the
22
document. It was not clear what the purpose of the staring was, but the Committee has no
hesitation in concluding that some people would have found it extremely intimidating.
149. The Respondent is a Priesthood Holder of the Church of Jesus Christ of Latter Day Saints. He
frequently made reference to his religious belief and his work as a missionary for that church as
support for his honesty, his conduct, his behaviour and his ability to interact with people.
150. The Committee considers that this could not reasonably justify his behaviour on the witness
stand. He had an irrational self belief that he had not done anything wrong, and his attitude
throughout was to criticise and blame others for the unfortunate events that occurred.
151. The Committee has taken into account the fact that the Respondent is of good character, and
has taken into consideration the testimonial evidence given both orally, and in writing, as to his
honesty and integrity. The Committee allows the possibility that the Respondent has convinced
himself that his account of events is correct, that he is not to blame for what happened, and that,
at worst, he may have made a few mistakes. However, the Committee considers that this has
meant that the Respondent has never realistically considered that he may be wrong.
Charges 1 and 2 (Ley/TJ)
152. It is not disputed that the Respondent removed the ducts associated with the anal sacs. He
denies failing to remove the anal sacs, but admits that he may have left some anal sac tissue
behind when purportedly performing the sacculectomy on TJ. The Committee examined with
care the evidence of the veterinary surgeons who examined and operated on TJ at White Lodge,
Miss Stephenson and Mr. White. On initial examination, Miss Stephenson believed that she felt
two anal glands in place, but sought a second opinion from her senior partner, who agreed with
her. This appeared to be confirmed by an ultrasound scan, and examination under general
anaesthesia. Mr White was confident in his evidence that he found two anal glands still in place
when he operated on 7 August 2009, and the area where the ducts had been was covered by
scar tissue. He removed the left anal gland, which he photographed, and preserved in formalin.
He found no evidence of scar tissue in the area of the glands. He removed the right anal gland
on 25 September 2009, and preserved it in formalin. He produced the right anal gland in a bottle
of formalin to the Committee, but explained that the bottle containing the left gland had been
mislaid. However, he identified the structure on the photograph that he had taken as being the
left gland.
153. The detailed clinical notes made at White Lodge are in evidence, and are entirely consistent with
the evidence given by Miss Stephenson and Mr White. In the view of the veterinary surgeon
members of the Committee, the photograph of the left anal gland shows a complete glandular
structure, and the Committee accepts the evidence of Mr White that this is what he removed.
The same members considered that the sample shown to them in a bottle of formalin was a
complete glandular structure. The Committee accepts the evidence of Mr White that this is what
he removed.
154. It is the opinion of Mr Robinson that the anal sacs in TJ were not removed at the initial surgery.
155. The evidence of the Respondent as to exactly what he did when performing surgery on TJ was
far from clear. He was unable to recall specifically whether he had checked the tissue that he
had removed from TJ after the operation, as was his normal practice, whilst maintaining that he
23
was sure that he had removed the anal sacs. Strenuous efforts were made by Counsel for the
Respondent to argue, with the assistance of evidence from Mr Harcourt-Brown, that the available
evidence is not conclusive, and that it is consistent with some residue only of the anal sacs being
left behind. Mr Harcourt-Brown conceded that the photograph of the left sac could show 99% of
an anal sac.
156. The Committee accepts the contemporaneous factual evidence of Miss Stephenson and Mr
White, supported by the photographic evidence of the left sac and the evidence of the right sac in
the bottle. Mr Robinson’s opinion also supports their evidence. Nothing that the Respondent
has said has caused the Committee to question the evidence of Miss Stephenson and Mr White.
157. The opinion evidence of Mr Harcourt-Brown is of limited assistance on this point, because he can
only speculate after the event on the basis of the evidence he has seen. The Committee is left in
no doubt that the Respondent failed to remove the anal sacs as alleged in Charge 1(a)(ii).
Accordingly, the allegations in 1(a)(i) (which is admitted) and 1(a)(ii) are found proved.
158. As to the allegation that the Respondent failed to provide TJ with any or any adequate analgesia
after the operation, the Committee accepts that TJ was given an injection of Metacam, a NSAID,
after the operation, the analgesic effect of which would have lasted for about 24 hours. It is
admitted that no further analgesic was dispensed to Ms Ley when she collected TJ after the
operation. She said that she expressly asked the Respondent whether TJ would need any
painkillers, and the Respondent said that he would not, and would be fine. She did not say that
she was asked to return and there was no mention in the clinical notes of a re-examination if
required.
159. The Respondent admits that he did not send TJ home with any oral analgesics, but asserts that
he told Ms Ley to come back if there was a problem. He justified his decision not to prescribe
oral Metacam for post-operative analgesia if needed, because he was concerned about possible
serious gastro-intestinal side-effects.
160. Mr Robinson was of the opinion that the Respondent should have provided further post-operative
pain relief, and that it was unacceptable not to do so. He said that the risk of gastro-intestinal
side effects was infinitesimally small in the case of a young dog, with no history of adverse
reaction to NSAIDs.
161. Ms Ley and her partner Mr McGann both gave evidence that TJ was in discomfort after the
operation. TJ was in fact taken back to the Respondent on 19 June when the Respondent
injected a steroid for irritation to the skin and applied local anaesthetic cream but did not
prescribe analgesics.
162. Mr Harcourt-Brown considered that it was reasonable for a veterinary surgeon, who had
concerns about gastro-intestinal side effects, not to prescribe NSAIDs post-operatively, provided
that the client was told to bring the dog back to be checked for pain within 24 hours.
163. The Committee accepts the evidence of Ms Ley that she was told that TJ would not need any
pain relief, and was not told by the Respondent to come back if there was a problem. The
Committee rejects the Respondent’s account that he did tell her to come back. The Respondent
told the Committee that he had no clear recollections of oral conversations with clients. There is
nothing in TJ’s clinical notes to show that this advice was given.
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164. The veterinary surgeon members of the Committee agree with Mr Robinson’s view that it was
unacceptable for further post-operative pain relief, other than a single Metacam injection, not to
have been given to TJ, for the reasons he gave. Mr Harcourt-Brown’s opinion was subject to the
Respondent having advised a post-operative check to assess the need for further analgesia. This
did not happen. Accordingly, the Committee finds that the Respondent failed to give any
adequate analgesia to TJ post-operatively, and the allegation at 1(a)(iii) is found proved.
165. It is alleged that the Respondent, when asked by Ms Ley how the operation had gone, informed
her that everything was fine, when he ought to have known that he had not removed the anal
sacs, or was reckless as to whether he had removed them. It is not disputed that the
Respondent told Ms Ley that the operation had gone fine. The Committee accepts that the
Respondent believed at the time that he had removed the anal sacs, based on what he told Mr
Kaminski and Ms Sumpter. However, his evidence as to whether or not he checked the tissue
that he had removed from TJ to be sure that complete anal sacs had been excised was very
poor. He said it was his normal practice to do so, but he could not remember doing it on this
occasion. At one point, the Respondent appeared unsure whether he or Mr Kaminski had
performed part of the operation.
166. The Respondent’s account was unreliable.
167. Both experts agreed that inspection of the removed tissue would be good practice, and that the
presence or absence of complete anal sacs would have been evident on proper examination.
The veterinary surgeon members of the Committee are of the same view. The Committee
considers that the Respondent did not examine the tissue he had removed sufficiently well to
ascertain whether or not he had removed the sacs. It is sure that, if he had done so, he would
have realised that he had not succeeded in complete removal.
168. Accordingly, the Committee is sure that the Respondent ought to have known that he had not
removed the sacs. The Committee is not satisfied on the evidence that the Respondent acted
recklessly as alleged in this part of the charge. Accordingly, the allegation at 1(b) is found
proved, on the basis set out above.
169. It is alleged that the Respondent, prior to surgery, did not provide Ms Ley with advice as to the
available non-surgical alternatives to treatment, with the result that the Respondent did not obtain
her informed consent to the surgery. The Guide to Professional Conduct 2008, Part 2D
paragraph 21, states: ‘Informed consent, which is an essential part of any contract, can only be
given by a client who has had the opportunity to consider the options for treatment, and had the
significance and risks explained to them. Cost may also be relevant to the client’s decision’
170. Mr Harcourt-Brown, at paragraph 28 of his report, refers to this guidance, and states that, if the
Respondent did not discuss TJs case in the manner required by the Guide, he could not have
allowed her to give informed consent for an anal sacculectomy. No consent form has been
adduced in evidence, and Ms Ley could not remember whether she signed one. Ms Ley’s
evidence was that she was not told of any non-surgical options by the Respondent, and was not
told of any risks involved in surgery, apart from having been told the operation was “tricky”.
There is no evidence that she was told of the comparative cost implications. Non-surgical options
for a dog presenting with continuing anal gland problems, following three previous expressions of
25
the glands, could have included continued expression, the administration of antibiotics, and
flushing.
171. The Respondent asserted in his evidence that he would not advise flushing, because in his view
it was ineffective, and he would not advise antibiotics, because there was no evidence of
infection. In his rebuttal submissions sent to the College he stated, in relation to this complaint,
that he regularly used non-invasive approaches (ie flushing or antibiotic therapy) to treat anal
gland infections, but considered that the sacculectomy option was a reasonable, standard
approach to the case of TJ. When the apparent inconsistency in his evidence in relation to
flushing was drawn to his attention, he sought to resile from what he had written in his rebuttal
submissions.
172. In relation to the question of antibiotics and infection, in other rebuttal submissions, the
Respondent stated that the option to remove anal glands was based upon a persistent
requirement to express them, yielding a purulent infection. Again, when the inconsistency was
brought to his attention, he sought to resile from the statement about purulent infection.
173. The Respondent maintained that the question of informed consent was subjective. In the view of
the Committee, that assertion is plainly wrong, and wholly inconsistent with the guidance given
by the College’s Guide to Professional Conduct.
174. The Respondent did not suggest that he had in fact advised Ms Ley about the non-surgical
options, because it is clear that he would not have advised them. There is nothing in his clinical
notes to indicate the nature of the advice given. The Committee accepts Ms Ley’s evidence that
she was given no such advice. The College submits that the advice referred to in 1(c) must
necessarily have included advice as to the options for non-surgical treatment, the comparative
risks involved, and the cost of the options. The Respondent submits that the charge is confined
to giving advice as to the non-surgical options.
175. The Committee rejects the Respondent’s construction of this charge, and accepts the submission
of the College. The Committee is satisfied that the Respondent gave Ms Ley no advice as to the
available non-surgical treatment options, the comparative risks, or advice as to cost. This was in
clear breach of of the Guide to Professional Conduct Part 2D paragraph 21. The Committee,
therefore, finds that the Respondent did not obtain Ms Ley’s informed consent to the
sacculectomy. Accordingly, the allegations at 1(c) and 2 are found proved.
176. The allegation of failing to make and maintain adequate records of the management of TJ, must
be looked at in the light of the guidance given in the Guide to Professional Conduct at Part 2D,
paragraph 18, which states: “Case records should include details of examination, treatment
administered, medication prescribed and/or supplied, radiographs, the results of any diagnostic
or laboratory tests and advice given to the client. It is prudent to include notes of telephone
conversations, fee estimates or quotations, consents given or withheld and contact details”.
177. The clinical notes made by the Respondent in relation to TJ are minimalist at best, and fail to
record anything about the nature of the advice given to the client, the nature of any examination
carried out, the results of that examination, whether or not the glands were expressed on 15
June 2009, and with what result, whether the dog’s temperature was taken, evidence of
presence or absence of purulence, details of the anaesthetic given and advice as to post-
26
operative care. In the view of the Committee the notes concerning the management of TJ were
plainly inadequate, and were not in accordance with the guidance given in the College’s Guide to
Professional Conduct.
178. Accordingly, the allegation at 1(d) is found proved.
Charge 3 (Smith/Tufty)
179. All the allegations in relation to Tufty are governed by the general allegation that the Respondent,
on 20 and 21 July 2009, failed to provide adequate professional care and/or failed to have regard
to animal welfare in that, during the admission to his practice of Tufty, he failed in the ways
alleged.
180. There are no charges in relation to what happened on Saturday 18 July 2009, when Tufty was
seen by Mr Kaminski, X-rayed, found to have a fractured sternum, given medication, including
drugs in two syringes to be administered by the owners at home, and instructions to return to the
Respondent’s practice first thing on Monday morning with a view to possible surgery.
181. There is a dispute between Mr Kaminski and the Respondent as to whether the responsibility for
Tufty was transferred from Mr Kaminski to the Respondent on Monday 20 July 2009. Mr
Kaminski said that he left a note on the Respondent’s desk for him to pick up on Monday
morning explaining what had happened on Saturday, and what might be required for further
treatment of Tufty, in particular a decision as to whether to operate on Tufty’s fractured sternum.
The Respondent denies finding such a note.
182. Mr Kaminski maintained that, as from Monday morning, Tufty was in the care of the Respondent,
and that he was not allowed to give any treatment without the Respondent’s authority. He said
that he tried to get the Respondent to discuss the case, look at Tufty’s X-ray and decide what
needed to be done, but the Respondent was always too busy.
183. The Respondent asserts that Tufty was always Mr Kaminski’s case, and that he would not
interfere in a case being handled by a fellow veterinary surgeon, except to offer a second opinion
if asked, or if he saw something being done incorrectly.
184. The Committee does not find it necessary to resolve this dispute. It intends to approach this
charge on the basis that Tufty was an in-patient at the Respondent’s practice on 20 and 21 July
2009, and that the relevant allegations relate to whether the Respondent, as owner and principal
of the practice, failed to ensure that Tufty received proper care and treatment whilst there.
185. The Respondent was made aware that Tufty was in the practice and that he was required to view
an X-ray. He recalled seeing Tufty in a particular cage, and said that he looked poorly. He said
that he became aware that Mr Kaminski had administered some subcutaneous fluids, antibiotics
and analgesics on Monday morning.
186. There is no doubt that when Tufty was admitted on 20 July he was dehydrated and unwell. Mrs
Smith’s husband, a retired veterinary surgeon, had told Miss Smith to draw this to the attention of
the practice on Monday morning. Mr Kaminski said that he gave Tufty subcutaneous fluids on
Monday. What else, if anything, was done is wholly unclear from the evidence.
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187. The Respondent observed that, during the Monday, Tufty was looking depressed in his cage and
was not eating or drinking. Tufty was left in the practice alone overnight, and was found to be in
a rather worse state by Mr Kaminski on Tuesday, when he noticed for the first time some necrotic
skin on Tufty’s chest.
188. The Respondent told the Committee that he was the last to leave the premises on an evening,
and always checked on the animals that were being left overnight. If he found something amiss
he would deal with it. He could not remember anything as to the state of Tufty on Monday
evening.
189. Mr Kaminski was not able to give any cogent evidence as to any monitoring of Tufty, or any basic
checks or tests on his condition that he or anyone else had carried out on either Monday or
Tuesday. On both days, the Respondent was at the practice and was aware that Tufty was in a
poorly condition but did not look at the X-ray until mid-Tuesday and did not at any time examine
Tufty.
190. When Tufty was taken to White Lodge on Tuesday afternoon, he was severely dehydrated and
presented with an abscess on his chest which had burst. He was in an appalling condition and
seriously unwell.
191. The experts were of the same view that the treatment and care of Tufty whilst at the
Respondent’s practice was wholly unacceptable. The Respondent refused to accept any
responsibility for the lack of care and attention given to Tufty, and continued to hold the view that
Mr Kaminski was to blame.
192. Having heard the evidence of Mr Kaminski and the Respondent, the Committee considers that
there was no reliable evidence of any system in place for ensuring the adequate monitoring and
care of animals admitted to the practice. Standard Operating Procedures were mentioned, but
the Respondent could give no accurate or reliable evidence as to what they specified in terms of
the care of hospitalised patients. There are no hospital sheets, clinical notes or other records
detailing what, if any, care or treatment Tufty received whilst an in-patient. The only
documentary evidence that Tufty was an in-patient is a non-itemised invoice for “hospitalisation”
in the sum of £25 plus VAT, which was prepared when Miss Smith said that she was removing
Tufty from the practice. There were no other records relating to Tufty for Monday 20 or Tuesday
21 July 2009.
193. The Committee considers that, in order to provide adequate professional care to animals
admitted as in-patients to the practice, and to ensure animal welfare, the Respondent, as
principal and owner, had an obligation to ensure that proper systems were in place to monitor the
condition of animals admitted to the practice, and to ensure that the systems were being
complied with. This must include identifying members of staff who were required to inspect
animal in-patients, specifying an inspection regime at regular intervals, making provision for
reporting any problems to a veterinary surgeon, and providing care and treatment. Adequate
records of the management of in-patients must be kept.
194. In this case, the obvious inference to be drawn from the evidence, including the condition of Tufty
when admitted to White Lodge, is that after receiving subcutaneous fluids on admission, he
received no or no adequate monitoring at the Williton practice. It is undisputed that Tufty was
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dehydrated when admitted on Monday morning, and was still dehydrated when admitted to White
Lodge on Tuesday afternoon, as well as being very weak and with a necrotic abscess on his
chest.
195. The Committee rejects the Respondent’s attempts to cast all blame for what happened to Tufty
on Mr Kaminski. The Respondent had overall responsibility for the way in which his practice was
run, and for ensuring that all animals admitted received proper care. He refused to acknowledge
that, or any other, responsibility for Tufty, when giving his evidence.
196. The Committee is satisfied so that it is sure that the Respondent failed to ensure that Tufty’s
condition was adequately monitored, and failed to ensure that he received any adequate volume
of fluids. Accordingly, the allegations at 3(1)(a) and (d) are found proved.
197. So far as the abscess is concerned, the Committee is left unsure by the evidence as to when the
abscess should have been detected, such that it was necessary to ensure that it was adequately
treated. The Committee allows the likelihood that the abscess burst only after Tufty was taken
from the Respondent’s practice, and whilst in transit to White Lodge.
198. The Committee considers that the abscess should probably have been discovered and detected
through proper monitoring much earlier, but it is unable to be sure. Accordingly, the allegations
at 3(b) and (c) are not proved.
199. So far as the allegation of failing to make and maintain records in respect of the management of
Tufty, the Committee considers that the Respondent, as owner and principal of the practice, was
under an obligation to ensure that there were proper records in respect of Tufty’s management.
In this case, there were no records of any description kept by the practice in relation to the
management of Tufty, which is in breach of the College’s Guide to Professional Conduct
regarding case records.
200. The Committee considers that the Respondent was responsible for the absence of any clinical
records relating to an in-patient at his surgery. Again, it is not acceptable for him to blame Mr
Kaminski entirely for the absence of records.
201. The Committee also notes that the Respondent produced in evidence a document that he had
recently compiled, which was said to detail what he had been doing on 20 and 21 July 2009. It
included an entry stating “Tufty clinical notes entered by Hutber retrospectively for Kaminski (re
18th to 22nd July 2009)”. No such notes have been produced to the Committee. The only notes
in relation to Tufty relate to the treatment carried out on Saturday 18 July by Mr Kaminski.
202. The Committee is satisfied that the allegation in relation to the failure to maintain adequate
records in respect of Tufty is established. Accordingly, the allegation at 3(e) is found proved.
Charge 4 (the Lang complaint)
203. This charge alleges that the Respondent failed to treat Mrs Lang with due courtesy and respect
and/or brought the veterinary profession into disrepute, in that, while in the waiting room, and in
the presence of other staff and members of the public, he spoke and acted as alleged. The
Committee has to decide whether it has been proved to the requisite standard that the
29
Respondent acted as alleged, and, if he did, whether he thereby failed to treat a client with due
courtesy and respect, and/or brought the profession into disrepute.
204. The Committee has considered with care the evidence of Mrs Lang and Mrs Hadleigh for the
College and the evidence of the Respondent. Mrs Lang gave evidence that she made notes of
what happened in manuscript a week or two after the incident on 12 June 2009. These notes
were attached to her witness statement, and were typed up to form the basis of her complaint to
the College on 9 July 2009. Her witness statement was made on 20 July 2010, but essentially
records what appeared in her original notes. Mrs Lang includes in her manuscript notes a
comment that “I have never been treated or spoken to like that by anyone in my life. Total
arrogance and lack of consideration for his clients or animal’s needs.”
205. It is significant that Mrs Hadleigh was not known to Mrs Lang prior to the incident on 12 June
2009. Mrs Hadleigh was so appalled by what she had seen and heard that she offered to be a
witness if required. Her recollection of events supported Mrs Lang’s account, but was not
identical. The Committee considers that the minor differences of recollection add credence to
their respective accounts, and indicate that they have not collaborated. The Committee has no
doubt that Mrs Hadleigh was appalled by what she witnessed.
206. The Respondent accused Mrs Lang of being rude and using expletives, which she denied. He
admitted using the word “verbal”. He admitted gesticulating, but not making the ‘quacking duck’
gesture described by Mrs Lang. Mrs Hadleigh described his gestures as waving his hands
around aggressively. Mrs Lang described the Respondent’s manner and tone as abrupt,
aggressive and intimidating.
207. The Respondent’s evidence in relation to this incident was unimpressive and unconvincing. He
denied that there was anything wrong or improper with the way he behaved. He admitted giving
Mrs Lang some facts about the problems in the practice caused by the previous owners. He
denied being derogatory about them.
208. The Committee does not find this denial credible, having regard to the numerous derogatory
remarks about the previous owners, which he expressed frequently in written material submitted
to the College.
209. The Committee considers that the Respondent’s evidence as to his behaviour on this occasion
was unreliable, and his recollection of the detail of this event poor. He sought to blame Mrs Lang
for being abusive and using expletives. The Committee rejects this.
210. The Committee found both Mrs Lang and Mrs Hadleigh to be reliable and truthful witnesses. It
considers that they are far more likely than the Respondent to remember the details of these
events, which plainly caused both of them to be appalled and upset by the Respondent’s
conduct. Accordingly, the Committee prefers without any doubt the evidence of Mrs Lang and
Mrs Hadleigh to that of the Respondent in relation to this incident.
211. The Committee finds that the Respondent did make the remarks alleged in 4(a)(i), (iii) and (iv),
and that his tone and manner were as described by the College’s witnesses.
212. The Committee observed the Respondent carefully in the witness box, and under crossexamination, he behaved in a manner which could be described as aggressive and intimidating.
30
213. The Committee is unsure on the evidence exactly what type of gesture the Respondent made
whilst talking about “verbal”, and does not find the allegation at 4(a)(ii) proved. The Committee
does not consider that the gesture is particularly relevant to the thrust of the main allegations.
214. The Committee is satisfied that the Respondent made the comments alleged in 4(b) and (c) and
did so rudely. The Committee considers that the Respondent thereby failed to treat Mrs Lang
with due respect and courtesy. It also considers that he thereby brought the profession into
disrepute, particularly having regard to the fact that the incident occurred in the waiting room of
the surgery in the presence of staff, and members of the public, one of whom walked out in
disgust. Accordingly the allegations in 4 are found proved, with the exception of allegation
4(a)(ii).
Charges 5 and 6 (the Walker complaint)
215. It is alleged that the Respondent failed to treat Mrs Walker, a client, with due courtesy and
respect and/or brought the veterinary profession into disrepute, by reason of what he said to her
during a phone call on 25 January 2010, as alleged. It is also alleged that he failed to make and
maintain adequate records in respect of his management of Bessie’s condition.
216. Mrs Walker was dissatisfied with the Respondent’s treatment of Bessie on 18 January 2010, as
set out above. She obtained a second opinion from Mr Gannon at White Lodge on 19 January
2010. As a result, she went back to the Respondent’s practice at Williton on 22 January 2010 to
complain, and ask for her money back for the Baytril tablets that the Respondent had prescribed
for Bessie on 18 January 2010. There was a heated telephone conversation between the
Respondent and Mrs Walker in the afternoon of that day, during which the Respondent said that
Mrs Walker was rude, and could not have her money back. On 25 January the Respondent rang
Mrs Walker again, and is alleged to have said what is specified in charge 5.
217. Mrs Walker’s witness statement is consistent with her letter of complaint to the College dated 16
April 2010. She gave her evidence clearly and had a good recollection of events.
218. The Respondent alleged that he had mentioned the possibility of Lyme Disease at the
consultation on 18 January 2010. Mrs Walker denied this, and said that the first mention of Lyme
Disease was during the second conversation on 25 January 2010. The Respondent’s evidence
about this conversation was neither credible nor reliable. From his oral evidence it became
apparent that he seemed pre-occupied with the risk of death to Bessie, not from Lyme Disease,
but from sub-clinical distemper of which there had been recent cases in the area.
219. The evidence of Mr Gannon, and the experts, and the opinion of the veterinary members of the
Committee, is that Baytril is not an appropriate drug for the treatment of Lyme Disease. The
Respondent claimed to have made a differential diagnosis of distemper or Lyme Disease on 18
January 2010, but this is not recorded in the clinical notes.
220. Mrs Walker said that the only diagnosis that she was given on that date was that Bessie ‘must
have some sort of infection’. Mrs Walker said that she found the Respondent’s manner during
the second telephone call to be aggressive, intimidating, threatening and bullying.
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221. The Committee has no doubt that Mrs Walker was robust with the Respondent during their
telephone discussions, because she was concerned about the welfare of her dog. She admitted
that she gave as good as she got.
222. However, the Committee has no hesitation in preferring Mrs Walker’s recollection of the relevant
conversation on 25 January 2010, and rejecting the Respondent’s discursive account.
223. The Committee is clear that, after he became aware that Mrs Walker had taken Bessie to
another veterinary practice, the Respondent should not have continued to speak to her about
Bessie’s condition and treatment, but should only have spoken to veterinary surgeons at the
other veterinary practice if he had concerns.
224. The Committee is satisfied that the allegations in charge 5 are proved.
225. The clinical notes of the consultation on 18 January 2010 are sparse in the extreme. There is no
mention of the differential diagnoses of Lyme Disease or distemper, or any other reason for
administering or prescribing the drugs given on that day. Mr Harcourt-Brown accepted that the
notes should have recorded any differential diagnosis in order to justify the treatment given.
226. Accordingly, the Committee is satisfied that the Respondent failed to make and maintain
adequate records in respect of his management of Bessie, and the allegation in charge 6 is
proved.
Charge 7 (the Milton complaint)
227. It is admitted that Mrs Milton was entitled to copies of the clinical records of her dog Jenny for the
purpose of her insurance claim with Direct Line. She asked for them in July 2009, and several
times in August 2009. In desperation, she was advised by Direct Line that she could complain to
the College. This she did on 26 August 2009. Mr Hepper of the College succeeded in getting
copies of Jenny’s historical notes from the previous owners of the Respondent’s practice in
September 2009. The Respondent did not contact Mrs Milton to say that she could have a copy
of the notes until November 2009. These facts are not in dispute. The Respondent blamed the
problem on his computer system, which was unable to access copies of historical records from
the time when the practice was owned by Bishopsgate.
228. The College submits that this is a problem for which the Respondent is culpable, because he
chose to change the clinical record system without determining whether he would be able to
access historical notes. The Committee accepts this submission, and considers that the delay of
four months on the part of the Respondent in providing copies of these records is inexcusable.
229. Accordingly, the Committee is satisfied that the Respondent behaved unprofessionally towards
Mrs Milton, and brought the veterinary profession into disrepute, by failing to provide her with
copies of Jenny’s clinical records as requested. Charge 7 is found proved.
Charge 8 (the Jazz complaint)
230. It is alleged that the Respondent failed to co-operate with professional colleagues in providing
copies of clinical records in respect of a dog called Jazz then in the care of Deane Veterinary
Practice in the ways set out in the charge.
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231. The only witness for the College was Mrs Bray, who had formerly been employed by the
Respondent as a receptionist, but subsequently was employed by the Deane practice. There
was a history of an employment dispute between Mrs Bray and the Respondent, the details of
which are unknown to the Committee.
232. Mrs Bray contacted the Respondent at his home in Hampshire, having obtained his telephone
number from the College. There is a dispute about what was said during the conversation, and
as to how it was said. In particular, there is a dispute as to whether Mrs Bray identified herself as
a receptionist at the Deane practice, or gave the surname of the client.
233. However, allegation 8(d) is that, after the telephone call, the Respondent failed to supply the
records or copies of the records. Mrs Bray did not know one way or the other whether the
records were ever supplied as requested. There was no other evidence on this point.
234. Accordingly, allegation 8(d) must fail, because the Committee is unable to be sure that the
allegation is correct. As to the remaining allegations, the Committee was satisfied that Mrs Bray
was attempting to do her best to assist the Committee.
235. However, the Committee notes that this telephone conversation took place in unusual
circumstances, with the Respondent being at home about 120 miles from his practice. It is
agreed that he said that, if it was urgent, he would drive to his practice and get the records. He
was told it was not urgent and he could send them by fax. In these circumstances, even if the
facts alleged in the particulars were made out, the Committee is not sure that the Respondent’s
conduct was sufficiently serious to amount to a failure to co-operate with professional colleagues.
Accordingly, the allegations in charge 8 are not proved.
Conclusion
236. In reaching the findings on the facts set out above, the Committee has considered with care the
oral evidence of 20 witnesses, including the Respondent, and their witness statements, the two
expert reports and the extensive material on which they relied, a large quantity of documentary
evidence, and extensive rebuttal material sent by the Respondent to the College. The hearing of
this case was adjourned part-heard after five days for a month, and then resumed for a further
four days. The Committee has read the transcripts of the evidence given during the first week,
which filled a lever-arch file. The Committee has considered and taken into account the
submissions of counsel at the conclusion of the case, which, in the case of the Respondent’s
submissions, ran to over twenty pages. The fact that much of this material has not been
specifically referred to in this decision does not mean that it has not been considered by the
Committee. The Committee regrets the length of this decision, but considers that the issues
raised in eight separate and unconnected complaints and sets of charges made it necessary to
deal with the decision on facts in some detail.
237. In summary, all the allegations of fact set out in the charges have been found proved, with the
exception of the allegation of recklessness in Charge 1(b), the allegations in Charge 3(b) and (c),
the allegation in Charge 4(a)(ii), and all the allegations in Charge 8, which are found not proved.
Disciplinary Committee
1 July 2013
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