Lincolnshire vet reprimanded for poor aftercare

The Royal College of Veterinary Surgeons (RCVS) Disciplinary Committee has issued a reprimand to a Lincolnshire-based veterinary surgeon while finding no misconduct against another in a hearing relating to allowing a dog to remain at practice overnight without adequate monitoring and/or post-operative aftercare. The hearing for the two respondents – Julia Louise Creese MRCVS and Elizabeth Sing May Law MRCVS – took place between Tuesday 18 June and Wednesday 26 June 2019. There were three charges against Creese, all pertaining to the period between 1 July 2016 and 8 November 2017. The first charge was that Creese failed to ensure that there were adequate systems and processes in place for out of hours’ care for in-patients. The second charge was that she publicised that the practice had “24 hour care provided by our vets at our practice” and/or “Care 24/7 for your pets” on its website, which suggested that staff were present at the practice 24 hours a day when they were not, making the claim “dishonest and/or misleading”. The third charge was that she failed to ensure that the owners of Kiwi, a German Shepherd/Wolfhound-cross dog, were informed about arrangements at the practice for out of hours’ care for in-patients. There was one charge against Law which stated that, having performed surgery to Kiwi on 7 November 2017 to address gastric dilation volvulus (GDV), she failed to obtain informed consent to the entirety of the surgical process and management, to include post-operative aftercare. It also states that she failed to provide adequate analgesia before, during or after the surgery; failed to provide appropriate and adequate fluid therapy; failed to offer an appropriate and adequate post-operative care plan and/or post-operative transfer to another practice; and failed to inform the owners that there would be nobody present at the practice to provide post-operative monitoring and aftercare for approximately seven hours during the night of 7 to 8 November 2017. Finally the charge states that Law allowed Kiwi to remain at the practice overnight from 12:30am to 07:45am on 8 November 2017 without adequate monitoring or post-operative aftercare. Creese denied all the charges against her while Law admitted she had failed to obtain informed consent; failed to offer an appropriate and/or adequate post-operative care plan; failed to inform the owners that there would be nobody present at the practice; and allowing Kiwi to remain at the practice overnight without adequate monitoring and/or post-operative aftercare. However, she denied that she failed to provide adequate analgesia and fluid therapy to Kiwi. After hearing evidence, the committee considered that the practice did have in place systems and processes for out-of-hours care for in-patients and there was no evidence of repeated or ignored failures of these systems and processes. Therefore all charges against Creese were dismissed. All charges against Law were proved, except for failing to provide adequate analgesia during the perioperative period. It considered whether the admitted and proven charges against Law amounted to serious professional misconduct. It was found that she promptly and accurately diagnosed GDV, and performed the necessary emergency surgery. The committee considered that the charges related to a single isolated incident and that Law has had an unblemished career to date. They also noted that Law had made open and frank admissions as to the majority of the charges. The committee found that the conduct of Law set out in the majority of the charges did not amount to serious professional misconduct. However, allowing Kiwi to remain at the practice overnight without monitoring or post-operative aftercare did amount to serious professional misconduct. In deciding the question of sanction Jane Downes, who chaired the committee and spoke on its behalf, said: “The committee does not consider that there is a risk that the respondent is likely to leave an animal overnight after major surgery again, without ensuring that it is checked during that time, and, as such, the Committee considers that there is no future risk to the welfare of animals so far as the respondent is concerned.” Law was reprimanded in relation to the finding of serious professional misconduct but was not given a warning.