Doctor approves poor professional performance when prescribing oral contraceptive to two high-risk patients

A Cork-based doctor who was the subject of a complaint about prescribing oral contraceptives to two older, high-risk patients and advertising himself as a gynecologist despite no authorization from the Irish medical authorities, has been found guilty of professional malpractice and Bad professional has been cleared of charges. performance.

Orota Sanoka, who practices at our clinic Sanoka in Cloghain Business Park, Co., Cork, was the subject of a seven-day investigation by the Irish Medical Council (IMC) earlier this year.

The IMC’s Fitness to Practice Committee today issued its ruling that three charges of poor professional performance against Dr Sanoka in the care of two patients were not proved beyond reasonable doubt.

Concerns about Dr. Sanoka, Carriglin, were expressed by doctors at Owenbeau Medical Center in Cork, where the two patients appear normally.

The investigation heard that Dr. Sanoka prescribed Yasmin, an oral contraceptive, containing both estrogen and progesterone, on March 31, 2016 to a 47-year-old woman known as hypertensive patient A, who was not a smoker. There was one too.

She was also accused of prescribing Yasmin to treat an ovarian cyst in a 60-year-old woman with high blood pressure and high cholesterol, known as Patient B, on November 23, 2015. Woman for further examination of an ovarian mass.

Looking at her medical history, Patient A’s family physician, Imier McCarthy, told interrogation that she was “astonished and concerned” for the woman’s welfare, upon hearing that she had been prescribed Yasmin by Dr.

Dr McCarthy said he advised Patient A to stop taking the drug because she was over 35 and a smoker, which put her at increased risk of blood clots and high blood pressure.

Her practice colleague, Carolyn Wallace, outlined how she was unhappy at being asked by Patient B to write a prescription for Yasmin because it was “inappropriate for those over 50”.

Wallace said Yasmin was not the right choice for treating cysts in post-menopausal women.

However, Dr. Sanoka claimed that he had prescribed oral contraception as a treatment for the patient’s ovarian cysts as an alternative to invasive surgery.

In explaining his findings, the committee’s chairman, Paul Harkin, stated that there was conflicting evidence between the expert witnesses of the IMC and Dr. Sanoka as to whether it was appropriate to deviate from the guidelines regarding the use of the combined contraceptive pill given the circumstances of both patients. was.

Mr Harkin said the committee was not satisfied that it could in any case detect poor professional performance beyond reasonable doubt, given the conflict in evidence.

He said the committee was also concerned that the guidelines were not an appropriate reference to determine the case, as they were designed for combined contraceptive pill prescriptions for contraceptive use, not heavy or prolonged menstruation. For the treatment of bleeding.

“All expert witnesses acknowledged that there are circumstances where it may be appropriate to deviate from the guidelines,” Mr Harkin said.

Professional performance cannot be tarnished by deviating from such guidelines, he added.

On Sanoka’s alleged failure to refer Patient B to see a counsellor, the Committee held that the facts of the allegation were not proved as it was not clear whether such a referral was warranted.

Mr Harkin explained that Patient B had declined Dr Wallace’s offer of a separate referral because she was traveling to Poland and said she could have a follow-up consultation with a gynecologist in Poland.

He also noted that Dr. Wallace had said that it was not routine practice to refer patients for gynecological examination as a standard procedure after they reached menopause.

Dr Sanoka told interrogation that he was undergoing treatment for Patient B as he had another scheduled appointment before traveling to Poland.

He was also cleared of a separate allegation of professional misconduct on a posting on his clinic’s website on March 22, 2017. The posting stated that she was a highly respected specialist in Gynecology, Obstetrics and Andrology when she was not listed in the register of the IMC. Administer specialist medicine.

Dr Snoka, a Polish citizen who qualified as a doctor in 1987, has been certified to practice in Ireland since October 2012, where he operated a clinic in Woodfield, Station Road, Blarney, Co., Cork until last year. did.

She told interrogation that she had a degree and diploma in gynecology and was the author of several publications used for training doctors in Poland.

However, Dr Sanoka said she has been unable to register as a consultant in Ireland due to changes in the Polish medical register system.

The committee said it had not heard any expert evidence regarding the allegation and that there was no basis to find that Dr Sanoka’s conduct was abusive or degrading or was seriously below the standards expected of doctors.