A doctor who inhaled anaesthetic while on shift at a Tyneside hospital has been found fit to continue practising by a tribunal. Dr Ross McDowell had been working as an anaesthetist at the Royal Victoria Infirmary when, overnight on March 9 and March 10 2024 and on April 3 2024, he took a substance from the hospital's anaesthetics machines and administered it to himself.
Misconduct admitted
The doctor admitted both allegations at a Medical Practitioners Tribunal Service hearing between June 22 and July 3 this year. While the tribunal panel found that Dr McDowell's actions had amounted to misconduct, they found his fitness to practise was not impaired. The tribunal judgement has been published with reference to "confidential issues" removed.
The 2024 incidents came on the back of the medic receiving an earlier warning for a similar incident which occurred while working at Darlington Memorial Hospital in 2020. The tribunal judgment details how at that time he had "inhaled two doses of [an anaesthetic substance] while alone in an obstetrics theatre". He admitted this had been "stupid" and received a General Medical Council (GMC) warning which was in place for the year to August 2022.
Mitigation and tribunal findings
In mitigation, Tara O'Halloran, representing Dr McDowell, told the panel how her client had "always wanted to be open" with the GMC and the tribunal, to reflect the efforts he had made to get better and not to stigmatise him. Ms O'Halloran went on to submit, according to the tribunal documents, that: "Doctors are entitled to fairness of procedure, empathy and constructive approaches [redacted], and if the GMC do not start treating doctors more fairly and with greater care and compassion, they will find care and compassion leaving the profession."
The tribunal heard how on March 9 2024, Dr McDowell had been working at the RVI and had completed a bronchoscopy procedure along with a consultant known only as Dr B. This doctor then left the hospital at 10pm in the evening. Later that night, at around 1.30am, the tribunal heard how hospital staff had "attempted to contact Dr McDowell on his 'on call' device at 1.30am and 3am, but there was no response".
Incident details
The tribunal judgement continues: "He answered his phone at 3.10am and then came back to the ward, where he was handed the second 'on call' device. Nursing staff tried to contact both devices at 3.30am and 4am with no response. Dr McDowell answered the phone at 4.30am, but did not speak." Dr B was contacted by a hospital staff member, as they were concerned that they could not find Dr McDowell. Due to the level of concern, Dr B drove to the hospital.
At 4.55am, Dr McDowell arrived back on the ward and appeared incoherent and confused, was unsteady on his feet and did not know where he had been. He was taken to the emergency department on a trolley as a patient. He had very little memory of events between 11pm and 5am and denied taking any medication, alcohol or prescription or non-prescription drugs. Dr B recalls asking Dr McDowell whether he had done anything he should not have. In relation to this, Dr McDowell wrote in his own statement: "I lied to his face. He is a man liked and respected (still do) and when he offered help I refused due to a combination of fear, pride and ignorance."
Further incident and outcome
On April 3 that year, according to the tribunal judgement, Dr McDowell was found on two occasions in an empty anaesthetics room. In his own statement, he said on that evening he had gone for a break - initially to an on-call room. He added: "As soon as I entered the room, I knew that I wasn't going to stay there. As though motorised or on wheels I left and went to an empty anaesthetic room [XXX]. Again, I am unsure for how long I was there." That evening Dr McDowell admitted "inhaling from the anaesthetics machine" to one of the doctors who had found him, Dr A.
He was excluded from work in 2024 but "has since made the decision to leave anaesthetics and to retrain as a GP", the ruling explained. In the doctor's statement, he went on to say: "This was a serious breach of trust. I removed myself from clinical availability, impaired my own capacity to practise safely, and created a foreseeable risk to patients and colleagues who were entitled to expect that I was fit for duty."
Panel decision
In the tribunal judgement, the panel - featuring Duncan Toole, Mark O'Brien and Dr Helen McCormack - found: "The Tribunal considers that Dr McDowell's actions in March and April 2024, did amount to misconduct, because [redacted], he had made conscious choices [redacted]. Those choices were made only a year after the expiration of a GMC warning for similar conduct [redacted]. The Tribunal found that a member of the public who was informed of the wider context of Dr McDowell's conduct would have a great deal of sympathy [redacted]. However, his actions in March and April 2024 were a consequence of his decision making from August 2023 [redacted], and therefore a member of the public, looking at his behaviour in the round, would not consider his actions to be excusable or outside of his control."
However, the panel accepted Ms O'Halloran's submission that "Dr McDowell is fit to practise without restrictions and therefore poses no risk to patient safety". They added: "The Tribunal considered that a member of the public, informed of the full background, in particular the extent of Dr McDowell's insight and remediation into his actions [redacted], would not consider that a finding of impairment was necessary to protect and maintain public confidence in the profession and/or to maintain professional standards." Neither the Newcastle Hospitals NHS trust - which runs the RVI - nor the Northumbria Healthcare NHS Trust - which was Dr McDowell's employer, wished to comment.
