Tribunal reprimands doctor, orders conditions on registration

20 Nov 2015

The State Administrative Tribunal of Western Australia (SAT) has reprimanded, fined and ordered conditions to be imposed on the registration of Dr Ross Jose a general practitioner.

The Tribunal found he engaged in unsatisfactory professional performance for his care of a 23-year old patient at the birth of her first child, who was still-born.

The SAT approved the mediated settlement between the Medical Board of Australia and Dr Jose.

The Board alleged, and Dr Jose conceded, that the doctor had failed to adequately interpret a cardiotocography (CTG) , contact a specialist obstetrician to review the patient, attend the hospital to review the CTG he ordered, complete an adequate handover and maintain adequate clinical notes.

An autopsy did not identify the cause of the baby’s death.

Dr Jose had managed the patient who was 40 weeks and 3 days pregnant during her pregnancy and when she presented to Rockingham General Hospital (Hospital) on 6 November 2014. A midwife reviewed the patient, who complained of reduced fetal movements and irregular movements, and arranged a CTG which showed decelerating fetal heart-rate. Dr Jose liaised with midwives over the course of the afternoon. The midwives reported concerns about the results of the CTG and asked him to urgently review the patient in person.

• Dr Jose admitted that: at a consultation with the patient at about 1.15 pm, and after being advised by a midwife that the patient's CTG was ‘non-reactive with isolated decelerations’, he had failed to identify that an earlier CTG was abnormal or might indicate fetal compromise, when the CTG indicated there were serious concerns 
• he should have contacted a consultant obstetrician to urgently review the patient and consider if her baby should be delivered 
• he should have returned to hospital to examine the patient at 3pm after the midwife called him again and reported that a second CTG was ‘non reactive with reduced variability’, and that he should have reviewed the second CTG himself and again called a consultant obstetrician to urgently review the patient and consider delivering her baby 
• he had failed to maintain adequate clinical notes about his care of the patient on that day, and did not document an adequate clinical management plan for her and 
• failed to adequately handover the patient's care to the consultant obstetrician he had called in and did not personally meet the consultant obstetrician on the ward to hand over the care and management of the patient.

Dr Jose admitted that he engaged in unsatisfactory professional performance. Reflecting the mediated settlement, the tribunal reprimanded Dr Jose, fined him $2,000, and ordered conditions be imposed on Dr Jose’s registration in relation to indirect supervision and further education. Dr Jose agreed to pay the Board $17,000 in costs.

The tribunal decision is published on the SAT website.

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