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Friday, June 01, 2007

Vets in Court: Charges Cleared in Fracture Case; Non-vet Witnesses Testimony Not Relevant

LONDON, ENGLAND (May 31) -- The Disciplinary Committee of the Royal College of Veterinary Surgeons last week dismissed a case against a veterinary surgeon having found that her actions during the treatment of an injured horse did not amount to serious professional misconduct.

Margarida dos Santos Correia MRCVS was practising at the Lady Dane Veterinary Centre in Faversham, England at the time of the incident. She was attending a Thoroughbred gelding called Prune that had a puncture wound on his hind leg, causing increasingly severe lameness, swelling and seepage.

The charge faced by Dr Correia was that, having identified that Prune was severely lame in his left hind leg and that it might be fractured, she caused Prune to be transported some 50 miles to a referral centre, without providing adequate physical support.

During the hearing the Committee heard that when Dr Correia first examined Prune, she had not ruled out a fracture, but decided that cellulitis from the puncture wound was more likely. It was alleged by lay witnesses that she did not examine the horse properly three days later and that, prior to transportation, she again failed to palpate the leg properly.

The Committee, however, preferred Dr Correia's evidence that she examined the leg properly on all three occasions; further, it accepted that a lay witness could easily have mistaken stance-related distortion for displacement.

The Committee stated that it was sure there was neither a detectable limb fracture, nor visible distortion to show that a fracture had occurred; it noted the opinion of both expert witnesses that this was not unusual in a non-displaced unicortical fracture and that sometimes, even with the benefit of a radiograph, it could be an impossible fracture to detect. It agreed that Dr Correia's diagnosis of cellulitis was consistent with the symptoms presented at the time.

Professor Derek Knottenbelt MRCVS, expert witness for the RCVS, described the case as a very difficult one for Correia - a "young and relatively inexperienced veterinary surgeon" - to face so early in her career. He stated that, "cellulitis is far and away more common than tibial fracture," adding, "[Correia] made a genuine error of judgment that she is unlikely to make again".

The Committee heard that Dr Correia had spoken by telephone with a senior colleague who had agreed with her diagnosis, but had not been talked through the protocol for transporting a horse so injured. It found it a "matter of great regret" that this colleague did not see fit to examine Prune himself, before allowing him to be moved.

Both experts agreed that transportation in 'Robert Jones' bandages with splints applied by an inexperienced person such as Correia possibly could result in more harm than good. Neither Correia's senior colleague, nor the equine referral clinic, had suggested to Dr Correia that she employ any such protective procedure.

Alison Bruce, chairing the Disciplinary Committee, said: "We wholeheartedly concur with the expert witness for the Respondent, Professor Tim Greet FRCVS, when he concludes in his report that: 'Under such circumstances, it is my opinion that Dr Correia's actions could not, at any time, be construed as demonstrating seriously deficient professional care, nor was her conduct disgraceful in a professional respect.' The case is dismissed."

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