By Grant Smith

A FIFE GP who put three patients’ lives at risk and verbally abused her colleagues has been ordered to work under supervision for 18 months and stay away from her former workplace.

Dr Suguna Narayana was told by the General Medical Council that her conduct had “fallen seriously below the standard of a reasonably competent GP” and had been “inappropriate, unprofessional and contrary to the principles of good medical practice.”

She twice prescribed patients medicine they should not have been given and failed to send another person, who turned out to have deep vein thrombosis (DVT), for specialist assessment.

She claimed one member of staff at the Leven health centre was a “racist bitch” and swore at another colleague during a meeting.

She also sent an abusive text message to a fellow doctor and after leaving the practice she returned one day to tell a receptionist, “You are nothing but a little bitch and you are going to get it.”

Dr Narayana had worked at the Victoria Road centre with Drs David Sinclair and J. Douglas Ross. Interim restrictions were placed on her in 2006 by the GMC and a full hearing of the case began in April. An edited version of the judgment has just been released.

In explains that problems began in late 2004, with Dr Narayana repeatedly indicating she did not trust the practice manager. She claimed to have evidence of racism, but never produced it.

Soon after the GP saw two patients, one with chronic obstructive pulmonary disease (COPD) and the other with allergies and breathing problems, and prescribed both with a beta blocker.

The GMC’s fitness to practise panel said, “Both these patients had a history of asthma or bronchospasm (the tightening of the muscles around the airways). The use of beta blockers such as propranolol is contraindicated in such patients. In prescribing propranolol your actions fell seriously below the standard of a reasonably competent GP and put the patients’ lives at risk.”

In January 2005, Dr Narayana was told by Dr Sinclair to leave the practice and seek help from her own GP. A meeting of the health centre’s partners was held a couple of weeks later, at which she again claimed a lack of trust in the practice manager, without offering any “rational reason or explanation.”

Around the same time, she sent a text message to Dr Ross saying, “You are an ar**.”

Having returned to work in March, Dr Narayana twice saw a patient with swollen legs. No diagnosis was made the first time and the second she diagnosed cellulitis. On both occasions her record-taking was inadequate. The GMC found she should have referred him for specialist assessment and treatment.

The patient was seen by Dr Ross a few days later and admitted to hospital with suspected deep vein thrombosis, later confirmed. Again, Dr Narayana’s conduct had put the patient’s life at risk, the fitness to practise panel decided.

In August the doctor had attended a meeting with Dr Ross and the practice administrator and swore at them both. Later that month she improperly accessed Dr Sinclair’s confidential medical records.

Then in December, by which time Drs Sinclair and Ross took the view that she had resigned from the partnership, she tried to change the operation of the practice’s bank account so her signature would be needed on all cheques.

The panel also found that during May/June 2006, Dr Narayana had once visited the practice to abuse a receptionist and had forwarded various items of irrelevant post there.

In their judgment they said, “With regard to the prescribing of propranolol and the treatment of the DVT patient, the panel finds that your performance in late 2004 and early 2005 was deficient in that it was serious and repeated and put patients’ lives at risk.

“The panel believes that you have not gained a sufficient degree of insight into your failings, particularly in the use of propranolol in patients with airways disease.

“Therefore, the panel has found that your fitness to practise is impaired by reason of your deficient professional performance.”

There was also a finding of misconduct in relation to her behaviour towards her colleagues at the health centre, which the panel described as “deplorable.”

They imposed a total of 22 conditions on Dr Narayama for the next 18 months to “adequately safeguard patients and the public.”

These include having a medically qualified workplace supervisor, who will meet her frequently to review her work and can order her to stop work.

She will also have to undertake remedial training in medical record-keeping and prescribing for COPD and asthma.

She is banned from entering Leven health centre except in a life-threatening medical emergency and she cannot communicate with Drs Sinclair and Ross, or any of their employees, except through a solicitor or other third party.

Dr Narayana has been working as a salaried GP with another doctor since October 2006. No problems have been reported with her clinical care, attitude or behaviour during this period, the GMC said.