board update - Veterinary Practitioners Registration Board of Victoria

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COMPLAINTS CASE STUDIES CASE STUDY 1 : Unauthorised treatment (euthanasia) The complainant states that the cat gave birth to one kitten and became distressed with difficulty delivering other kittens. The cat was presented to a veterinary practitioner and was admitted for medication to induce labour. The complainant left the kitten with the cat to feed and was informed if medication did not work surgery would be required. The veterinary practitioner quoted up to $400 and explained that payment options were available. The complainant declined this offer due to the costs involved. The veterinary practitioner arranged for the complainant to surrender the cat if surgery was required so that it could either be re-homed after surgery or euthanised. The veterinary practitioner directed the owner to reception to surrender the cat leaving the practice to determine its fate if the injection was unsuccessful. The complainant agreed to this. Some hours later the complainant discovered the treatment had not been successful and the cat was to be euthanised as permission for re-homing it had not been granted by the clinicians. The veterinary practitioner states that a friend of the complainant’s was spoken to, advising the outcome, and they gave permission for euthanasia. The complainant states the veterinary practitioner spoke to him over the telephone, not his friend. He gave authorisation for euthanasia for the cat. The complainant later discovered that the kitten had also been euthanised. The next day the veterinary practitioner told the complainant’s friend that the kitten was euthanised with the cat because it was assumed the complainant was not interested in it. The veterinary practitioner had not spoken to the complainant regarding options for the kitten and the complainant was upset that it had been euthanised without consent. The nurse informed the veterinary practitioner that the surrender form was signed for both the cat and the kitten. The veterinary practitioner could not find the form as it is filed separately by number and there is no connection made to the clinical records in accordance with the practice’s current policy. An informal hearing was held into the matter. There was concern that the veterinary practitioner did not obtain permission or a consent form for euthanasia of the day-old kitten. The veterinary practitioner was found to have engaged in unprofessional conduct and was cautioned as follows:- • To seek clear identification of the person you speak to over the phone when seeking permission for euthanasia • Ensure that you fully discuss costs, options for treatment or euthanasia for all animals with the owner • To ensure permission is granted in each and every case for euthanasia and other veterinary treatments The veterinary practitioner was also counselled as follows:- • To be responsible for ensuring that all appropriate documents are signed by the owner of an animal and that the owner understands the content of the documents • Consider the practice’s protocols and take responsibility to ensure they are adequate in each case • Familiarise yourself with hospital procedures involving the surrender of animals • Fulfil the requirements of the Board’s guidelines in particular Guideline 8 and Guideline 10 • Ensure that copies of consent forms are given to the owner The veterinary practitioner admitted to the panel that consent for the euthanasia of the day old kitten was not obtained. The Panel determined that the veterinary practitioner did not seek specific instructions regarding the future of the kitten and as a result, the veterinary practitioner did not comply with Guideline 10.3 in that there was apparently no consent form signed for the euthanasia of the kitten. The veterinary practitioner stated the kitten was not considered at the time the person on the phone was spoken to when consent for euthanasia for the cat was given. At this time the kitten was not mentioned by either party. Also at the time of the initial consultation the veterinary practitioner believed the conservative treatment would be successful and, therefore, the future of the kitten was not considered. The Panel accepted the veterinary practitioner’s explanation that the cat’s admission form for treatment was discussed with the complainant, the form had been signed and a copy was given to the owner. However, the veterinary practitioner stated this was the first time they had personally organised a surrender form for an animal, was not familiar with its appearance or fully aware of procedures. Page 4 of 8
BOARD UPDATE VOL. 29, no 3 Summer 2005 The responsibility of the paper work was left to the hospital receptionist. The Panel determined that as the veterinary practitioner did not find the surrender form for the cat that this form may not have existed and the veterinary practitioner was only relying on the verbal opinion of the veterinary nurse that it did exist. The veterinary practitioner stated that the practice information booklet does not mention surrender forms and it is not usual practice to give a copy to the owner. The Panel determined that the protocols at this practice were inadequate and required changes to be in line with the Board’s guidelines in that they must ensure that the details of owners and their pets are linked to the surrender form and that all information is retrievable. The Panel found that there was a difference of opinion in what actually occurred during the phone call when consent for euthanasia was given and could not make a determination on that matter. The Panel found that the veterinary practitioner did not obtain clear identification of the caller when authorisation for euthanasia of the cat was obtained. Whilst it is understood that such a young kitten was not viable without its mother or a surrogate lactating queen, the Panel found that this had not been communicated to the owner who could not necessarily be expected to have this knowledge. CASE STUDY 2: Unauthorised treatment The complainant took a Heeler cross dog to see a specialist veterinary practitioner for a consultation regarding a ruptured cruciate ligament. The dog was examined, confirming diagnosis and whilst the veterinary practitioner was explaining the problem and possible surgical options to the complainant, he asked a vet nurse to take the dog outside. The complainant assumed this meant to enable the dog to relieve herself. After consultation and costs of surgery were explained the complainant informed the veterinary practitioner she would discuss the options with her husband and went to retrieve her dog. The dog’s leg had been shaved and tubing had been inserted and taped over. The dog was taken home but was unable to stand or walk until the next morning. The complainant was very upset that this happened as no agreement had been made that surgery was to be performed at that time. The veterinary practitioner stated that the dog was referred for assessment and to provide accurate diagnosis so that appropriate surgical options could be offered. On examination the dog was found to have a left anterior cruciate ligament rupture. In addition, thickening and discomfort involving the right knee was discovered. Light sedation with morphine and acepromazine was given to facilitate more accurate examination. This is the veterinary practitioner’s usual procedure for strong breed dogs with problems such as these. The drugs chosen were used as they have a less depressant effect on heart and circulatory function. The drawback is that they last up to 4 hours. The veterinary practitioner did not agree that the dog was catheterised or that any expectation was placed upon the complainant in regard to the dog having surgery immediately. The dog was difficult to restrain and the veterinary practitioner determined sedation was required in order to accurately assess the situation. An informal hearing was held into the matter. There was concern that the veterinary practitioner did not obtain consent from the client for administration of analgesia and sedation to the dog. The veterinary practitioner was found to have engaged in unprofessional conduct and was cautioned as follows:- • That a signed consent form should be obtained for procedures involving administration of drugs for sedation and analgesia • Clients should be provided with a copy of the signed consent form and that it should be ensured that they understand its contents • That it should be specified in patient clinical records the type of drug administered, its dose and time of administration • That clients are made aware of the effects and possible side effects of drugs and of any after care required The Panel found the veterinary practitioner admitted to administering the morphine and acepromazine to the dog without prior consent from the complainant. The Panel understood the veterinary practitioner’s reasons for examining the dog with sedation and analgesia and agreed that for this type of dog this would be the best way to establish an accurate diagnosis. The Panel accepted the veterinary practitioner’s statement that it is usual practice to obtain signed consent forms for procedures and this case was an isolated incident. The Panel found that the veterinary practitioner did not clearly communicate the procedures to the complainant causing misunderstanding and distress to the complainant. The Panel accepted the statement that the dog was not catheterised or being prepped for surgery. The dog’s foreleg may have been clipped to administer the drugs of sedation and analgesia intravenously. Page 5 of 8
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board update - Veterinary Practitioners Registration Board of Victoria

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