Issue 51 - The Complaints Committee Report
The Board reviewed and determined 34 complaints made against veterinarians between April and October 2019. Of these, 26 complaints were dismissed. Five veterinarians were found guilty of unsatisfactory professional conduct with four of these receiving a caution and fine and three receiving a caution only. One veterinarian was found guilty of professional misconduct, reprimanded and fined.
One complaint was withdrawn by the complainant after receiving the veterinarian's response.
Unsatisfactory professional conduct
One veterinarian was cautioned and fined after being found guilty of unsatisfactory professional conduct in breach of Veterinary Practice Act 2003 (s 35(k)) - lack of skill, judgement and care - when failing to consider other possible causes of continued inappetence in a dog presenting with gastrointestinal signs that was continuously treated with maropitant. Repeated treatment with maropitant (Cerenia) - for example, every day for several days - is not recommended unless a definitive diagnosis has been made and diseases that require treatment other than antiemetics, including obstructive GI disease, have been ruled out.
Maropitant is a potent antiemetic and can mask clinical signs, therefore delaying the diagnosis of a GI obstruction, particularly if the patient is only treated symptomatically and no further diagnostics are pursued. Some animals will continue to vomit "through" the maropitant, but this is not always the case.
A second veterinarian was cautioned and fined after being found guilty of unsatisfactory professional conduct in breach of Veterinary Practice Act 2003 (s 35(k)) - lack of skill, judgement and care - in that he performed a partial amputation of a cat's tongue without the informed consent of the person responsible for the care of the cat. The partial glossectomy was performed at the same time as a dental procedure, yet no contact and communication took place with the client regarding this surgery prior to it being carried out. Where practical and before providing veterinary services, the client must be informed of the likely extent and outcome of any treatment or procedure. The veterinarian in question's records were also considered to be in insufficient detail to enable another veterinarian to continue treatment of the cat.
A third veterinarian was cautioned after demonstrating a lack of skill, judgement and care in the restraint of an aggressive patient. Anxious and aggressive patients present a significant health and safety concern for veterinarians and options to lessen anxiety and the cost and risks associated with them should be discussed with clients.
A fourth veterinarian was cautioned after failing to assess the neurological status of a dog (initially presented with spinal pain) prior to discharge. The major problem leading to this complaint was a lack of communication, including a lack of formal hand over and hospital protocol procedures. These deficiencies were consequently all identified and addressed by the veterinary hospital involved.
A fifth veterinarian was cautioned because his records were in insufficient detail to enable another veterinary practitioner to continue the treatment of a dog. Discharge instructions and communication with the client form important parts of a clinical record.
A veterinarian was found guilty of professional misconduct, reprimanded and fined after operating on a 19 week old dog for the purpose of preventing the dog from being able to bark in breach of the Prevention of Cruelty to Animals Act 1979 (POCTA) (s 12(1)). The veterinarian performed this procedure without being provided with:
- a copy of an order issued under the Companion Animals Act 1998 (s 21) requiring the owner of the dog to prevent it from engaging in nuisance barking, and
- a statutory declaration from the owner of the dog to the effect of the following:
- all reasonable steps other than the operation, have been taken, without success, to prevent the dog engaging in nuisance barking
- unless the operation is performed, the dog will be destroyed.
The legislation is very clear about the steps that need to be followed in order for a debarking procedure to be performed on a dog. Failure to follow these steps is both a breach of POCTA and the Code of Professional Conduct in that it is not in accordance with current standards of practice (cl 4).
The veterinarian additionally did not make a detailed record of the consultation, procedure and treatment of the pup, and these records were not in sufficient detail to enable another veterinary practitioner to continue the treatment of the animal.
New staff to handle increased complaint numbers
The number of complaints received by the Board continues to steadily increase. The reasons for this may include the increased numbers of veterinarians and companion animals being treated, societal attitudes, and increased expectations of clients.
With the increase in complaints received by the Board against veterinarians, the Board resolved to employ an additional staff member to aid in the processing and investigation of these complaints. We congratulate and welcome Dr Kate Drew, veterinarian and lawyer, on her appointment as Complaint Support Officer.
Mary Lydamore remains the first port-of-call for all veterinarians and complainants through the complaints process, in her role as Deputy Registrar and with her training in counselling.
Veterinarians can be assured that each complaint continues to be fully investigated by the Complaints Committee (a sub-committee of the Board) who then make a recommendation to the full Board, where the ultimate outcome of a complaint is determined.
Medical records are the primary source of information regarding an animal’s care if a complaint against a veterinarian is investigated. Medical records should be made as soon as practicable, and this is defined as the contemporaneous record. Medical records should also include a record of client communications and the substance of those communications.
Record-writing may sometimes feel onerous, but contemporaneous records provide veterinarians with the best form of defence against allegations made in a complaint.
The Board requires that any alteration or addition to a medical record should be identified as to when that addition or alteration is made. An audit of any medical record with respect to alterations and additions may be requested in the investigation of a complaint.