Mr Carl W Fisher

Profession: Paramedic

Registration Number: PA01254

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 01/03/2018 End: 12:30 01/03/2018

Location: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

During the course of your employment as a Paramedic for East Midlands Ambulance Service NHS Trust (‘the Trust’):

1. Not proved.

 

2. On 7 June 2015, you did not undertake an adequate assessment of, and/or adequately complete a Patient Report Form for, Service User A, in that you did not undertake and/or record the following:

a) Not proved.

b) Not proved.

c) Blood Sugar assessment;

d) Pain management assessment;

e) Pupil assessment;

f) Secondary observations;

g) Not proved.

h) A full Neurological assessment;

i) Chest examination;

j) Abdominal examination;

 

3. On 7 June 2015, you did not complete a Patient Report Form for Child A;

 

4. On 7 June 2015, you did not arrange for the following to be conveyed to hospital:

a) Child A;

b) Service User A;

 

5. On 7 June 2015, you did not complete a safeguarding referral in relation to Child A;

 

6. On 24 June 2015, you did not complete a Paramedic Clinical Assessment to an adequate standard;

 

7. Your actions described in particulars 1 to 6 constitute misconduct and/or lack of competence;

 

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

Finding

Preliminary matters:

1. The Panel was satisfied that the Registrant had been served with notice of today’s hearing in accordance with the Rules.

2. Mr Mason made an application for the Panel to proceed with the hearing in the absence of the Registrant. The Panel was provided with a copy of a telephone attendance note relating to a conversation between the Case Manager and the Registrant on 26 February 2018. The Registrant informed the Case Manager that he had retired from practice on medical grounds in July 2016 and that he would not attend this review hearing. The Registrant had not applied for an adjournment or provided any information as to why the hearing should be adjourned.

3. The Panel took into account the HCPTS Practice Note on Proceeding in the Absence of a Registrant and accepted the advice of the Legal Assessor. The Panel decided to proceed with the hearing in the absence of the Registrant on the following grounds:
• having regard to the telephone attendance file note, the Panel was satisfied that the Registrant had voluntarily absented himself from the hearing and waived his right to attend;
• the Registrant had not attended today’s hearing, despite being advised by the Panel at the final hearing that his attendance at the review hearing would be desirable;
• the Panel was satisfied that the Registrant would be unlikely attend at a future date if the hearing were to be adjourned;
• this is a mandatory review and it must take place before the expiry of the existing Order.

Background:

4. The Registrant is a Paramedic. At the material time, the Registrant was employed by (EMAS), with whom he had been employed for more than 20 years.

5. In 2014/2015, the Registrant had two periods of sickness absence: 8 February 2014 to 8 July 2014 and 2 January 2015 to 14 May 2015.

6. On 15 June 2015 the Leicester Royal Infirmary (“LRI”) contacted EMAS regarding Service User A and her baby, Child A, who had both attended LRI. Child A had been diagnosed with a fractured skull.

7. It was discovered that the Registrant had attended to Service User A and Child A approximately one week earlier, on 7 June 2015, when Service User A had fainted whilst holding Child A in her arms. The Registrant had discharged Service User A and Child A at the scene.

8. A Serious Incident investigation was initiated, which ascertained that the Registrant had responded to the incident in a solo fast response vehicle following concerns that Child A had been dropped.

9. The Patient Report Form (PRF) completed by the Registrant in relation to Service User A was found to be deficient in a number of respects.

10. A Paramedic Clinical Assessment of the Registrant was conducted on 24 June 2015, which the Registrant did not complete to an adequate standard.

11. These concerns were reported by the Registrant’s employer to the HCPC, resulting in the current proceedings.

12. The Registrant did not attend, and was not represented at, the final hearing which took place on 27-28 February 2017. The Panel found  the allegation proved in relation to each of the particulars set out above. The Panel determined that the proven facts constituted misconduct and that the Registrant’s fitness to practise was currently impaired.

13. By way of sanction the Panel imposed a Suspension Order for 12 months, having regard to the seriousness of the misconduct and the lack of remediation. The Panel advised the Registrant that a future review Panel would be assisted by:
• the Registrant’s attendance;
• evidence of training and remediation;
• testimonials relating to current paid or unpaid work
• a piece of reflective writing addressing:
(i) the effect of the Registrant’s conduct on the vulnerable service users he dealt with;
(ii) any specific training the Registrant would need to undertake to return to practise.

Decision:

14. The Panel was provided by the HCPC with a bundle containing the previous decision of the Panel at the final hearing.

15. There was no new information from the Registrant, who had not engaged with the HCPC since the final hearing, except to notify the HCPC Case Manager on 26 February 2018 that he would not attend the review hearing, that he had retired from practice on medical grounds in July 2016  and had no further information or documentation to submit.

16. On behalf of the HCPC Mr Mason submitted that the Registrant’s fitness to practise remains impaired.

17. The Panel took into account the HCPTS Practice Note on Impairment of Fitness to Practise and accepted the advice of the Legal Assessor.

18. The Panel noted the serious nature of the Registrant’s misconduct relating to the incident on 24 June 2015, the observation of the Panel at the final hearing that he lacked sufficient insight into the seriousness of the incident and the risk of repetition.

19. In light of the Registrant’s failure to engage with the HCPC since the final hearing, save by way of the telephone conversation referred to above, the Panel concluded that his fitness to practise remains impaired. In the absence of evidence as to remediation, there would be a risk of repetition of the Registrant’s misconduct with consequent risks to the public and professional colleagues. Public confidence in the profession and the Regulator would be undermined if the Panel determined that the Registrant’s fitness to practise is no longer impaired.

20. In deciding what sanction, if any, would be appropriate, the Panel took into account the HCPC’s Indicative Sanctions Policy.

21. The Panel decided that it would not be appropriate to take no further action, given the serious nature of the Registrant’s past failings, the lack of remediation and the potential risk to the public.

22. A Caution Order would not be appropriate because it would not place any restriction on the Registrant’s ability to practise.

23. A Conditions of Practice Order would not be appropriate as the Registrant had retired from practice in July 2016 and had made it clear that he did not intend to practise in the future. The Panel determined that such an Order would be unworkable.

24. The Panel considered whether to impose a further Suspension Order. A Suspension Order would protect the public. However, the Registrant had not used the currency of the existing Suspension Order to take  any of the steps recommended by the Panel at the final hearing to remediate his practice. In his telephone conversation with the HCPC Case Manager on 26 February 2018, the Registrant stated that he had not practised as a Paramedic since 2015 and had retired on medical grounds in July 2016. The Panel inferred that the Registrant had no intention to return to practise as a Paramedic.

25. The Panel concluded that the Registrant did not intend to remediate his practice or to engage any further with his Regulator. In the circumstances, no useful purpose would be served by giving him any further opportunity to do so. It would not be in the interests of either the Registrant or the public to prolong these proceedings by imposing a further Suspension Order when, in all likelihood, the Registrant’s fitness to practise would remain impaired.

26. In the all the circumstances, the Panel decided that the only appropriate remedy at this stage was to impose a striking off order which will come into effect on the expiry of the current Suspension Order.

 

Order

Order: That the Registrar is directed to strike the name of Mr Carl W  Fisher from the Register upon the expiry of the existing order.

Notes

The order imposed today will take effect on the expiry of the current Interim Suspension Order on 28 March 2018. 

Hearing History

History of Hearings for Mr Carl W Fisher

Date Panel Hearing type Outcomes / Status
01/03/2018 Conduct and Competence Committee Review Hearing Struck off
27/02/2017 Conduct and Competence Committee Final Hearing Suspended