Gynaecologist is struck off for misconduct in his treatment of four patients

一位妇科医生因在治疗四名病人时行为不端而被开除

Clare Dyer

克莱尔·戴尔

The BMJ

英国医学杂志

A locum consultant in obstetrics and gynaecology who was accused of a catalogue of clinical failings has been struck off the UK medical register after he repeatedly expressed contempt for the proceedings and declined to attend when his former patients were testifying.

一名妇产科临时顾问被控出现一系列临床失误，他已被从英国医疗名册上除名，原因是他多次表示蔑视诉讼程序，并拒绝在他以前的病人作证时出庭。

Malay Haldar, who qualified in India in 1987, was charged at a medical practitioners’ tribunal with misconduct in his treatment of four patients while working as a locum in Harlow in 2016 and in Birmingham in 2018.

马来人哈尔达于1987年在印度取得资格，他于2016年在哈洛和2018年在伯明翰担任临时工作期间，在医疗从业者法庭被指控在治疗四名病人时行为不当。

He carried out a perineal reconstruction on a hysterectomy patient when she had explicitly refused it, explaining that she was a widow and not interested in a sex life. It left her with difficulty in passing urine normally. She reported him to police.

他对一位子宫切除患者实施了会阴重建术，当时她明确表示拒绝，解释说她是寡妇，对性生活不感兴趣。这使她很难正常排尿。她向警方举报了他。

While performing a laparoscopic ovarian cystectomy on a patient with severe endometriosis, he mistakenly removed part of her ureter and was found guilty of inadequate pre-op consultation and poor decision making in managing the bleed. The patient, a nurse, later described her shock at the quality of her care.

在对一位患有严重子宫内膜异位症的患者进行腹腔镜卵巢囊肿切除术时，他错误地切除了她的部分输尿管，并被发现术前咨询不足和出血处理决策失误。这位病人是一名护士，她后来描述了她对自己护理质量的震惊。

In another case he performed an instrumental delivery and episiotomy without informed consent, during which he was found guilty of several failings, including conducting the delivery without adequate precautions.

在另一起案件中，他在未经知情同意的情况下实施了器械分娩和会阴切开术，在此期间，他被认定犯有若干过失，包括在没有采取适当预防措施的情况下进行分娩。

A fourth patient was left with leaking faeces and loss of bowel control after Halder carried out a forceps delivery without an episiotomy. She was operated on without adequate pain relief and suffered a 3rd degree tear and postpartum haemorrhage. Haldar failed to recognise the haemorrhage or the tear in a timely manner, or the fact that he had put a suture in her rectum. He failed to call for assistance or escalate her care. He was also found to have said to her that if he had met her sooner, she would have been having his baby.

第四个病人在Halder不做会阴切开而进行产钳分娩后，出现了大便漏出和大便失控的情况。她在没有充分缓解疼痛的情况下进行了手术，并遭受了三度撕裂和产后大出血。Haldar没有及时意识到出血或撕裂，也没有意识到他在她的直肠缝了一条缝。他没有向她求助，也没有加强对她的照顾。他还对她说，如果他早点见到她，她就会怀上他的孩子。

The tribunal held that Haldar’s record keeping was deficient in all four cases. Three of the patients gave witness statements describing their trauma and psychological suffering but Haldar did not attend on those occasions. “The explanation he gave for his absence appeared to relate to his inability to countenance those witnesses in his presence,” said Angus Macpherson, chairing the tribunal. “In short, during the factual enquiry, Dr Haldar maintained his position of not accepting any part of the GMC case at all.”

法庭认为，Haldar公司在所有四个案件中的记录保存都有缺陷。其中三名病人提供了证人证词，描述了他们的创伤和心理痛苦，但Haldar没有出席这些会议。法庭主席安格斯·麦克弗森说:“他对自己缺席的解释似乎与他无法在他在场的情况下支持那些证人有关。”“简而言之，在进行事实调查期间，Haldar医生坚持他的立场，即完全不接受GMC案件的任何部分。”

Haldar attended only part of the hearing and did not give evidence, but instead bombarded the medical practitioners’ tribunal service and the GMC with emails throughout his proceedings, said Macpherson. “The only consistent behaviour he demonstrated was outrage that the case was brought against him by the GMC,” he said.

麦克弗森说，霍尔达只参加了部分听证会，没有提供证据，但在整个诉讼过程中，他用电子邮件轰炸了医疗执业者法庭服务和GMC。他说:“他唯一表现出的一贯行为是对GMC对他提起诉讼的愤怒。”

After the tribunal had made findings on the facts, it was told by the GMC of a previous disciplinary case in Australia, where Haldar received a caution in 2011 for what Macpherson called “very similar failings.”

在法庭对事实作出裁决后，GMC告诉它之前在澳大利亚发生的一起纪律案件，Haldar在2011年因麦克弗森所说的“非常类似的过失”而受到警告

Haldar’s clinical failings “could be capable of remediation,” said Macpherson. “However, Dr Haldar has not shown any insight nor appetite to tackle them. Moreover, the evidence before the tribunal does not suggest that he has begun to appreciate the nature and extent of his misconduct.” Macpherson added, “Dr Haldar’s conduct and behaviour is fundamentally incompatible with that of a registered medical practitioner.”

麦克弗森说，Haldar的临床缺陷“可能是可以补救的”。“然而，Haldar博士并没有表现出任何解决这些问题的洞察力和胃口。此外，审裁处收到的证据并不显示他已开始认识到自己行为失当的性质和程度。“麦法新补充说:”Haldar医生的行为与注册医生的行为根本不相符。“

The erasure will take place after 28 days unless Haldar appeals.

删除将在28天后进行，除非Haldar提出上诉。