Mrs Blessing Chabvamurambo

Profession: Radiographer

Registration Number: RA64282

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 14/09/2016 End: 12:00 14/09/2016

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

During the course of your employment as a Radiographer at the Dudley Group NHS Foundation Trust, you:

1. On or around 10 April 2013:

(a) In respect of Patient A:

(i) Removed her arm brace when it was not safe to do so;

(ii) Did not note from Patient A’s records that the fracture had occurred recently;

(iii) NOT PROVED

(iv) NOT PROVED

(b) In respect of Patient B:

(i) Produced a chest x-ray which was not of diagnostic quality;

(ii) Sent the x-ray mentioned in 1(b)(i) to PACS;

(iii) Did not re-xray Patient B;

(iv) Did not advise colleagues at handover that Patient B would need to be re-x-rayed.

(c) In respect of Patient C:

(i) NOT PROVED

(ii) NOT PROVED

2. On or around 12 July 2012, did not carry out appropriate identity checks with the result that you x-rayed the wrong patient.

3. The matters set out in paragraphs 1 and 2 constitute misconduct and/or lack of competence.

4. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Finding

Preliminary Matters

Service

1. The Panel considered that on the documentation before it the Registrant had been given proper notification of this hearing in accordance with the Rules. A Hearing Notice, dated 12 August 2016 and a further Notice dated 2 September 2016, notifying the Registrant of a change of time of the hearing, were sent to the Registrant’s registered address informing her of the time, date and venue of this hearing.

Proceeding in Absence

2. Ms Akintobi applied for the hearing to proceed in the Registrant’s absence. She submitted that there has been no contact with the Registrant following the notice of hearing. She submitted the Registrant has not applied for an adjournment and there is therefore nothing to indicate that she would be likely to attend if the matter were to be adjourned.

3. The Panel had regard to the HCPC Practice Note on proceeding in absence and it has also accepted the advice of the Legal Assessor.  The Legal Assessor referred the Panel to the Court of Appeal case of GMC v Adeogba [2016] EWCA civ 162.

4. The Panel considered that it is appropriate to proceed in the absence of the Registrant. This is a mandatory review of the order which is due to expire on 14 October 2016. The Registrant has been properly served with the Notice for today’s hearing and she has not sought an adjournment. The Panel noted that the Registrant had also been sent the Notice of Hearing by email. In particular, the Panel noted that she had engaged at the previous hearing, therefore she would be familiar with the process.  The Panel considered in the absence of any information from the Registrant there was no good reason to adjourn the matter.

5. The Panel concluded that the Registrant has voluntarily absented herself from these proceedings today. It also considered that it would be in the interest of justice and fair to proceed with the hearing.

Background

6. The Registrant was employed as a band 5 Radiographer in the X-ray department of Dudley Group NHS Foundation Trust (the Trust) from 2010 until her resignation in June 2013. She worked mainly evening and night shifts. The matters found proved raised concerns regarding patients which occurred 10 April 2013 and an earlier clinical incident which occurred in July 2012.

7. On or around July 2012, the Registrant was working a night shift. At approximately 04.00 she received a portable X-ray request for a child who was due to be taken to the Emergency Department by another member of staff for the X-ray.  The Registrant attended the department and found a child who appeared to match the description as stated on the X-ray request. The Registrant made partial identity checks and the child was X-rayed.  The Registrant returned back to the X-ray department and she later received a telephone call querying why the child had not been X-rayed as per the request. The Registrant had X- rayed the wrong patient. In respect of this matter the Registrant completed a clinical incident report.  The matter was considered at a disciplinary hearing and the Registrant was issued with a final warning.

8. On 10 April 2013, the Registrant was working an evening shift, which was due to finish at midnight. Sometime around 11.45 Patient A was sent for an X-ray by the Emergency Assessment Unit. The patient had a spiral humeral fracture, which was approximately one week old at the time.   This was detailed on the X-ray request form.  She was wearing an arm brace, which was made of fabric with a Velcro fastening. The Registrant removed the arm brace to X-ray the arm.  Another Radiographer, began her shift shortly before midnight and joined the patient and the Registrant in the X-ray room.  The Registrant then finished her shift.

9. During the shift on 10 April 2013, at approximately 21:00, the Registrant was called on to a ward to X-ray Patient B. She attended and completed a portable X-ray towards the end of her shift. In respect of Patient B, another Radiographer later spoke on the telephone to a doctor, who expressed that he was not happy with the X-ray image he had received of Patient B.  The image was re-requested.  That Radiographer subsequently reviewed the original X-ray image and established that it was taken by the Registrant.  The image was of no diagnostic quality. He had not been informed by the Registrant that Patient B’s X-ray would need to be redone.

10. The concerns in relation to patients were investigated and a disciplinary hearing was scheduled. Prior to the hearing, the Registrant resigned.

11. The matter was considered by a fitness to practise panel which commenced in November 2014 and was concluded in March 2015. A number of matters were found proved and that Panel concluded that the Registrant’s fitness to practise was impaired by reason of lack of competence. That panel imposed a Conditions of Practice Order for a period of 18 months.

Decision

12. This is a review under Article 30(1) of the Health and Social work Professions Order 2001 of the Conditions of Practice Order. The Panel took into account all documentary evidence before it and the submissions made on behalf of the HCPC. The Registrant had not made any submissions and was not present or represented.

13. The Panel took into account the documentary evidence before it.  It considered the submissions of Ms Atkintobi and it accepted the advice of the Legal Assessor.

14. In coming to its decision the Panel took account of the Indicative Sanctions Policy and the HCPC’s Standards of conduct, performance and ethics.

15. The Panel first considered whether the Registrant’s fitness to practise remained impaired. To this extent it had regard to the public interest and whether the Registrant’s conduct was remediable, whether it had been remedied and the risk of repetition.

16. The previous panel considering this matter stated that:
“The Panel considered that the Registrant’s lack of competence is remediable. However, it considers that the deficiencies identified have yet to be remedied. The Registrant has failed to identify in what way she has addressed her lack of competence and how the failings would not be repeated in the future. The reference provided by the Registrant is of limited value in that it describes her as ‘neither better nor worse’ than other Radiographers. The Registrant has not provided any evidence to demonstrate that she had ensured that her skills as a Radiographer are up to date and that the areas identified in this case would not be repeated.”

17. That panel accepted that her admissions  to  a  number  of  the  particulars,  and  her  concessions  during  the course of her evidence in respect of certain aspects of the case. It considered that this demonstrated a degree of insight. However, it went on to conclude that:

“in the absence of any evidence of remediation, that the Registrant’s lack of competence posed a risk to patients and that a finding of current impairment was required to maintain public confidence in the profession and to uphold proper standards of conduct and behaviour”’

18. This Panel carefully considered the documentation provided to it. There is no evidence from the Registrant that she has remedied the deficiencies identified in her practice. Further, there is no evidence of her compliance with the conditions that were imposed upon her. The Panel were therefore left with no alternative but to conclude that the Registrant has yet to remedy her failings.

19. In considering whether the Registrant’s fitness to practise remains impaired, the Panel took into account the public interest which includes protection of service users, maintenance of public confidence in the profession and declaring and upholding the standards of conduct and behaviour.

20. The Panel was of the view that the Registrant’s fitness to practise remains impaired. She has yet to demonstrate that she has remedied the failings that were identified by the previous panel. A finding of current impairment is required to protect patients, maintain confidence in the profession and to uphold proper standards of conduct and behaviour.

21. In concluding that the Registrant’s fitness to practise remains impaired, the Panel went on to consider what order would be appropriate and proportionate.

22. The Panel noted, a sanction is only to be imposed to the extent that it is required to protect patients and to maintain a proper degree of confidence in the registered profession and this regulatory process.

23. The Panel determined that to take no action would be insufficient given that the Registrant has yet to demonstrate that she had remedied the failings identified in this case. The Panel considered that a Caution Order would not afford patients   any degree of protection.

24. The Panel then went on to consider a Conditions of Practice Order. It considered that given the HCPC has heard nothing from the Registrant for 18 months and that her registered address remains in Australia, the Panel considered that conditions of practice are not practicable or workable. Given that the Panel does not know what the registrant is doing it concluded that to maintain such an order was neither practical nor realistic. The Panel has concluded that it could not formulate practical or workable conditions.

25. The Panel considered that the appropriate and proportionate order would be a Suspension Order for 12 months. Such a period of time would enable the Registrant to engage with the HCPC and demonstrate her commitment to remaining on the HCPC register as a Radiographer.

26. The Panel concluded that a Suspension Order for a period of 12 Months was appropriate and proportionate. 

27. Any future reviewing panel may be assisted by:

• Evidence of the deficiencies, highlighted by the previous panel, having been remedied

• Engagement with the HCPC

• Evidence of continuing professional development.

• References from an employer

Order

The Registrar is directed to suspend the registration of Mrs Blessing Chabvamurambo for a period of 12 months on the expiry of the existing order.

Notes

This order will be reviewed before its expiry.

Hearing History

History of Hearings for Mrs Blessing Chabvamurambo

Date Panel Hearing type Outcomes / Status
13/09/2017 Conduct and Competence Committee Review Hearing Struck off
14/09/2016 Conduct and Competence Committee Review Hearing Suspended