Grimsby Vet Struck Off for Serious Professional Misconduct

LONDON, January 14, 2011 - The Disciplinary Committee of the Royal College of Veterinary Surgeons
has this week directed that the name of a Grimsby veterinary surgeon should
be removed from the RCVS Register, having found him guilty of serious
professional misconduct for advising and undertaking surgical procedures
without sufficient clinical grounds or considering alternative treatment
options; failing to obtain the informed consent of his clients; undertaking
procedures outside his area of competence; failing to refer or discuss the
option of referral to a specialist; and, failing to provide his patients with
adequate pain relief.

Mr Joseph Lennox Holmes, of Waltham Veterinary Clinic, Grimsby, faced
nine charges relating to two separate complaints, at a two-week hearing in
October which resumed this week [10 January].

These complaints concerned four consecutive staphylectomies and a
tracheostomy that Mr Holmes performed on Jake, a Cavalier King Charles
Spaniel owned by Ms Marsden; and, the dental treatment he gave to three
Persian cats called Dream Topping, Charlie Brown and Henry, together with the
advice he gave to their owner, Mrs Auckland.

On 25 October 2007, Mr Holmes performed a staphylectomy on Jake during
dental surgery. He gave the Committee various reasons why he thought the
procedure was necessary; however, the Committee accepted the opinion of two
expert witnesses Professor Dan Brockman, a specialist in soft tissue surgery
at the Royal Veterinary College, and Mr Andrew Ash, the senior veterinary
surgeon at a 17-vet small animal practice, that there were insufficient
clinical grounds for such a surgical procedure to be undertaken. The
Committee also found Mr Holmes had not adequately considered other
treatments, or obtained fully informed consent from Jake's owner for this
procedure.

Mr Holmes performed further staphylectomies and a tracheostomy on Jake, a
procedure described by Professor Brockman as "by definition, high risk and
best performed by a specialist." He did not consider referral, or inform Mrs
Marsden that such referral was an option. Nor did he provide sufficient
aftercare or pain relief. Following these surgeries, Jake was euthanased .

In the second complaint, Mr Holmes performed dental extractions on two
cats, Dream Topping and Henry, and advised removing teeth from a third,
Charlie Brown, in October 2008. The Committee, however, accepted the view of
expert witness Mr Ash and Dr David Crossley, RCVS Recognised Specialist in
Veterinary Dentistry, that the dental extractions performed, and the advice
given, were not justified on the available clinical evidence. The Committee
also found that Mr Holmes did not discuss alternative treatment options with
Mrs Auckland, or obtain her informed consent. In the case of Dream Topping,
consent was sought after the cat had been sedated for an unrelated procedure
and Mrs Auckland had felt under pressure to consent.

Mr Holmes had also relied on anaesthesia-inducing drugs to provide
analgesia for the dental extractions, without any other form of pain relief.
The Committee agreed with the expert witnesses that this was wholly
inadequate.

The Committee found many aggravating factors in both cases, including
actual injury to animals from unnecessary surgery, and a serious breach of
the trust in which Mr Holmes' clients had placed in him to make the welfare
of their animals his primary consideration. His repeated misconduct had been
sustained over a period of time in the face of a previous adverse finding of
the Committee in 2006.

It also found that Mr Holmes failed to appreciate when a case was outwith
his experience, and had continued his course of action despite Jake's
deterioration; he had not considered referral or accepted that others in the
profession might know more than he did; in formulating clinical practice and
policies, he made no reference to peer-reviewed literature or continued
professional development; and, his use of outmoded drugs and medicines
intended for human use was of concern, as was his lack of appreciation of the
need for adequate pain relief when performing painful surgical procedures.

Towards the end of the hearing, Mr Holmes said in mitigation that he
regretted unreservedly any adverse effects that his treatment had had on the
animals concerned, and that he now realised that his long history of working
alone had allowed him to become professionally isolated, to become
over-confident in the value of his own experience and rather "set in his
ways".

Having given serious consideration to postponing judgment, subject to
undertakings from Mr Holmes, Disciplinary Committee Chairman Mrs Caroline
Freedman said: "We are mindful that the sanction which we apply must be
proportionate to the nature and extent of the misconduct found proved and
must balance the public interests against the interests of the Respondent.

"We are, however, also mindful of Mr Holmes' conduct during the previous
11 1/2 days of the hearing, during which time his every action was vigorously
defended and no insight whatsoever was shown."

The Committee also considered suspending Mr Holmes from the Register. "In
view of the serious and long-term nature of the conduct found proved in the
charges, we do not feel that it is appropriate that Mr Holmes should be
permitted to return to the Register without further assessment of his efforts
to update his knowledge," said Mrs Freedman, before concluding: "The only
appropriate sanction in each case is that the Registrar be directed to remove
Mr Holmes' name from the Register."

NOTES FOR EDITORS

    1. The RCVS is the regulatory body for veterinary surgeons in the UK and
       deals with issues of professional misconduct, maintaining the register
       of veterinary surgeons eligible to practise in the UK and assuring
       standards of veterinary education.

    2. RCVS disciplinary powers are exercised through the Preliminary
       Investigation and Disciplinary Committees, established in accordance
       With Schedule 2 to the Veterinary Surgeons Act 1966 (the 1966 Act).
       The RCVS has authority to deal with three types of case:

       a) Fraudulent registration
       b) Criminal convictions
       c) Allegations of disgraceful professional conduct

    3. The Disciplinary Committee is a constituted judicial tribunal under
       the 1966 Act and follows rules of evidence similar to those used in a
       court of law.

    4. The burden of proving an allegation falls upon the RCVS, and the RCVS
       must prove to the standard that the Committee is sure.

    5. A respondent veterinary surgeon may appeal a Disciplinary Committee
       decision to the Privy Council within 28 days of the date of the
       decision. If no appeal is received, the Committee's judgment takes
       effect after this period.

    6. It is a criminal offence contrary to section 19 of the Veterinary
       Surgeons Act 1966 to practise as a veterinary surgeon unless
       registered in the RCVS Register of Members. Further information,
       including the charges against Mr Holmes, and the Committee's findings
       and decision on sanction, can be found at
       www.rcvs.org.uk/disciplinary.

    For more information please contact:

    Claire Millington, Royal College of Veterinary Surgeons
    +44(0)20-7202-0783 / c.millington@rcvs.org.uk

For more information please contact: Claire Millington, Royal College of Veterinary Surgeons, +44(0)20-7202-0783 / c.millington at rcvs.org.uk