The prosecution based its case on the assumption that Rose breached her duty of care to Vinne by either failing to look at the at the fundus or fundus images properly or by not “ even bothering to ” look at the images or carry out direct ophthalmoscopy . Rose ’ s defence claimed that she did view the fundus camera images but was shown images from a previous examination by mistake . They also claimed that she was unable to carry out direct or indirect ophthalmoscopy because Vinnie was showing signs of photophobia and was not cooperative .
Joanne Barker , Vinnie ’ s mum , gave evidence that Vinnie was not uncooperative during his eye examination and that photophobia was not mentioned . Additionally , the jury heard that there was no mention of an uncooperative patient or photophobia on the record card made at the time of the examination . They were also shown evidence that Rose did perform direct ophthalmoscopy on Vinnie ’ s siblings in separate examinations on the same day and that she recorded a result .
Some will say that Rose has been unfairly punished for a simple error of judgement . Others will say that her failure to spot obvious papilloedema
from either the fundus images or from ophthalmoscopy is so poor practice that is a gross dereliction of her duty of care to her patient and justifies the finding of criminal negligence .
Clearly it comes down to whether or not you believe Rose ’ s account of the circumstances . It appears the jury didn ’ t . They were perhaps more convinced by the inconsistencies in Rose ’ s account , such as recording findings for the retinal periphery when she admitted being unable to examine it than they were in the plausible defence that she was shown the wrong images .
So how concerned should we be that we might end up in a similar position ? None of us want to go through what Honey Rose has gone through . Not only does she have the death of one of her patients , a child , on her conscience , she has been unable to practise as an optometrist since the first fitness to practise interim hearing in September 2012 , she has a criminal conviction and , four years on , is still not at the end of the process , with further fitness to practise hearings and a possible criminal appeal still to come .
But this is the first criminal case relating to scope of practice against an optometrist since the profession
was founded by the Optician ’ s Act in 1958 . The number of complaints brought against optometrists every year is small relative to the number of eye examinations we carry out . According to the GOC , less than 1 percent of all 29,000 GOC registered optometrists and dispensing opticians are subject to complaints procedures at any time and less than 10 % of those are referred for formal hearings each year . 14 The chances of receiving a serious complaint are very low , and especially so if you adhere to good practice , following guidance from the College and the GOC .
Rather than worrying unduly about criminal prosecutions or even cases of fitness to practise investigations it is better to concentrate on providing the best possible care for our patients .
And for anyone concerned about the management of papilloedema in particular , below is a guide to the detection , referral and management of papilloedema .
Continued »
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14 etCETera | November 2016