Interim Orders

The Interim Orders Panel made the following orders at its meeting on 19 August 2008:

New Cases

Name

AKANO, Chinatu

Registration No.

6061365

Field of practice

General Practice

Place of practice

South Wales

Type of order

The Panel considered the case of Dr Akano and determined to suspend his registration for a period of 18 months from 19 August 2008 to 18 February 2010.

 

Name

GEORGE, Ray

Registration No.

5197347

Field of practice

Cardiology

Place of practice

Wolverhampton

Type of order

The Panel considered the case of Dr George and determined to suspend his registration for a period of 18 months from 19 August 2008 to 18 February 2010.

 

Name

ZIERER, Rainer Otto

Registration No.

6128819

Field of practice

General Practice

Place of practice

London

Type of order

The Panel considered the case of Dr Zierer and determined to suspend his registration for a period of 18 months from 19 August 2008 to 18 February 2010. This hearing was held in public and the Chairman announced the following determination:

“Mr Howard: The Panel has noted that Dr Zierer is neither present nor represented here today. The Panel has determined that based upon the submissions made by you, the proof of delivery of notice of today’s hearing from Mission Express dated 30 July 2008 and the email dated 12 August 2008 from Dr Zierer that the General Medical Council (GMC) has acted in accordance with Rules 26 and 40 of the General Medical Council (Fitness to Practise) Rules 2004.  The Panel is therefore satisfied that it is able to continue in the absence of the doctor, pursuant to Rule 31 of the Rules.

At the start at these proceedings the Panel considered a written request from Dr Zierer that this hearing should be heard in public. The Panel also considered your submissions on this point. The Panel agreed to Dr Zierer’s request and this hearing was held in public.

The Panel has carefully considered all the information before it today, including the submissions made by you on behalf of the General Medical Council (GMC), and the documentation provided.
 
In accordance with Section 41A of the Medical Act 1983, as amended, the Interim Orders Panel has determined that it is necessary for the protection of members of the public, in the public interest and in Dr Zierer’s own interests to make an order suspending his registration for a period of eighteen months. 

The Panel has noted the letter dated 9 July 2008, received from Dr A, Medical Director at Lambeth PCT. This raised concerns about the performance of Dr Zierer. Concerns had been expressed to Dr A by Nottingham PCT re Dr Zierer’s prescribing for 5 patients during September 2007. As a result Lambeth PCT commissioned an independent review of prescribing, recording and clinical treatment of a sample of patients treated by Dr Zierer. A report was commissioned by Dr B on behalf of Lambeth PCT in November 2007 and undertaken by C Associates. Fifty sets of notes were selected by the review team and were randomly chosen from surgeries conducted by Dr Zierer between 4 – 21 September 2007. Forty seven sets of records were reviewed in detail and the remaining sets of records related to appointments where the patient had not attended. The report raised the following concerns:

  • Brief and inadequate notes made by Dr Zierer;
  • Difficulty in establishing the reasoning behind the treatments administered by Dr Zierer;
  • Treatments administered did not appear rational and were in conflict with established UK practice;
  • Little evidence that Dr Zierer had referred to and used the information in the patient notes during consultations;
  • No evidence that Dr Zierer had considered on-going long term conditions when seeing patients;
  • Insufficient evidence that Dr Zierer had discussed changes in prescribing with patients.

Dr Zierer also failed to respond to correspondence from Lambeth PCT about these concerns and their intention to remove him from the Performers List. The PCT in their letter of 18 March 2008 to Dr Zierer also raised concerns that if Dr Zierer practises as a GP in the United Kingdom he should have adequate insurance cover. They requested details of Dr Zierer’s details of cover whilst practising in the United Kingdom and the cover he would have if he were to practise here in the future.

On 22 July 2008 the GMC wrote to Nottingham City NHS Primary Care Trust requesting further information concerning Dr Zierer. Dr D, Medical Director at Nottingham City NHS Primary Care Trust responded to this request in a letter dated 25 July 2008.

The concerns raised by Nottingham PCT related to the following areas of practice:

  • Prescribing of high dosages of medication;
  • Failure to link with local colleagues;
  • Lack of understanding about local care pathways;
  • The diagnosis and treatment of epilepsy without referral.

On 28 July 2008 the GMC wrote to Dr Zierer to advise him that the Registrar had decided that he should have an assessment of his professional performance in accordance with Rule 7 (3) and Schedule 1 of the General Medical Council (Fitness to Practise) Rules 2004.

The Panel has borne in mind that it is not its function to make findings of fact or decide on the veracity of the allegations.  The Panel has, however, given such weight as it considered appropriate to the allegations.

The Panel was in particular very concerned about the information before it today regarding Dr Zierer’s prescribing and potential risk to patient safety arising from that.

The Panel is satisfied that in all the circumstances there may be impairment of Dr Zierer’s fitness to practise which poses a real risk to members of the public or may adversely affect the public interest or his own interests and, after balancing his own interests and the interests of the public, an interim order is necessary to guard against such a risk.

The Panel has taken account of the issue of proportionality and has balanced the need to protect members of the public and the public interest against the consequences for Dr Zierer of making an interim order against his registration. 

The Panel first considered an order for conditions but determined that, in the light of the wide-ranging and potentially serious nature of the allegations, conditions would be insufficient to protect adequately patients, the public interest and confidence in the medical profession.  Whilst the Panel notes that its order has removed Dr Zierer’s ability to practise medicine in the UK, it is satisfied that the order of suspension is a proportionate response. 

In deciding on the period of eighteen months, the Panel has taken into account the uncertainty of the time needed to resolve all the issues in this case.

The order will take effect today and will be reviewed within six months, or earlier if necessary.  

Notification of this decision will be served upon Dr Zierer in accordance with the Medical Act 1983, as amended.”

 

Review Cases

Name

ALBAYATI, Ali Kamal

Registration No.

6033503

Field of practice

General Practice

Place of practice

Surrey and Sussex

Type of order

The Panel reviewed the order made on 23 April 2008 imposing conditions on Dr Albayati’s registration and directed that the conditions be varied for the remainder of the duration of the order until 22 October 2009.  The conditions are as follows:

  1. He must notify the GMC promptly of any professional appointment he accepts for which registration with the GMC is required and provide the contact details of his employer.
  2. He must allow the GMC to exchange information with his employer or any organisation for which he provides medical services.
  3. He must inform the GMC of any formal disciplinary proceedings taken against him, from the date of this determination.
  4. He must inform the GMC if he applies for medical employment outside the UK.
    1. He must confine his medical practice to National Health Service hospital posts, where his work will be supervised by a named Consultant or Associate Specialist.
    2. He must seek a report from his supervisor for consideration by this Panel, prior to any review hearing of this Panel.
  6. He must not undertake any locum posts of less than two months duration.
  7. He must only undertake out of hours work or on call duties at a level of supervision approved by his supervising consultant or supervising associate specialist.
  8. He must inform the following parties that his registration is subject to the conditions, listed at (1) to (7), above:
    1. Any organisation or person employing or contracting with him to undertake medical work
    2. Any locum agency he is registered with or applies to be registered with (at the time of application)
    3. Any prospective employer (at the time of application)

 

Name

MEHREZ, Ismail

Registration No.

3444595

Field of practice

General Practice

Place of practice

West Bromwich

Type of order

The Panel determined to maintain the order of conditions imposed on Dr Mehrez’s registration (currently due to expire on 10 March 2009). The conditions are as follows:

  1. He must notify the GMC promptly of any professional appointment he accepts for which registration with the GMC is required and provide the contact details of his employer.
  2. He must allow the GMC to exchange information with his employer or any organisation for which he provides medical services.
  3. He must inform the GMC of any formal disciplinary proceedings taken against him, from the date of this determination.
  4. He must inform the GMC if he applies for medical employment outside the UK.
  5. He must seek a report from the persons advising the GMC in relation to his fitness to practise, for consideration by this Panel, prior to any review hearing of this Panel.
  6. He must cease work immediately if the person(s) advising the GMC in relation to his fitness to practise recommend that he does so.
  7. He must keep his professional commitments under review and limit his medical practice in accordance with the recommendations of the person(s) advising the GMC in relation to his fitness to practise.
  8. He must comply with the existing arrangements with his PCT for the supervision and mentoring of his general practice work.
  9. He must not undertake any out-of-hours work or locum work.
  10. He must inform the following parties that his registration is subject to the conditions, listed at (1) to (9), above:
    • Any organisation or person employing or contracting with him to undertake medical work.
    • Any prospective employer (at the time of application).
    • The PCT in whose Medical Performers List he is included, or seeking inclusion at the time of application.

 

 

Name

FARQUHARSON, Malcolm

Registration No.

1309449

Field of practice

General Practice

Place of practice

Kent

Type of order

The Panel reviewed the order made on 27 June 2007 imposing conditions on Dr Farquharson’s registration, and directed that the order be revoked with effect from 19 August 2008.

 

Name

DOSHI, Harish

Registration No.

2227511

Field of practice

General Medicine

Place of practice

Essex

Type of order

The Panel determined to maintain the order of conditions imposed on Dr Doshi’s registration (currently due to expire on 8 April 2009). The conditions are as follows:

  1. He shall limit his medical practice to the completion of written reports in relation to insurance, mortgages and medical claim forms which do not require him to have either verbal or physical contact with any patients.
  2. He shall notify all employers and all prospective employers or contractors, whether for paid or voluntary employment for which registration with the GMC is required, of the matters under consideration by the GMC. In the case of prospective employers or contractors, this notification must be given at the time of application.
  3. He shall inform, in writing, the IOP Secretariat of the GMC before undertaking any work for which registration is required.

 

Name

SHIRALKAR, Vinod Mukundrao

Registration No.

2318604

Field of practice

General Practice

Place of practice

Wirral

Type of order

The Panel determined to maintain the order of suspension imposed on Dr Shiralkar’s registration (currently due to expire on 18 March 2009).

 

Name

OBIEKWE, Margaret Ngozi

Registration No.

3627631

Field of practice

General Practice

Place of practice

London

Type of order

The Panel reviewed the order made on 6 March 2008 imposing conditions on Dr Obiekwe’s registration, and directed that the order be revoked with effect from 19 August 2008.

 

Name

MACHIN, Clive

Registration No.

1630378

Field of practice

General Practice

Place of practice

Norwich

Type of order

The Panel determined to replace the order of conditions imposed on Dr Machin’s registration, with an order of suspension (currently due to expire on 20 June 2009).