Mrs Sandhya Yatham Venkataramana

Profession: Dietitian

Registration Number: DT24759

Interim Order: Imposed on 25 May 2017

Hearing Type: Voluntary Removal Agreement

Date and Time of hearing: 10:00 08/10/2020 End: 17:00 08/10/2020

Location: This hearing is being held virtually.

Panel: Conduct and Competence Committee
Outcome: Hearing has not yet been held

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Allegation

Whilst registered as a Dietitian and during the course of your employment at Aintree University Hospital:

1. In relation to Patient 1, on 3 October 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Did not record the type of insulin being used;

c. Recorded that Patient 1 had multiple diabetes related co morbidities when there was no clinical indication of and/or diagnosis for these conditions;

d. Did not explain the role of blood glucose monitoring in assisting self-management of Patient 1’s condition;

e. Documented an agreed plan which was not appropriate for Patient 1’s individual needs and circumstances;

f. Gave inappropriate advice with regards to Carbohydrate portions;

g. Did not maintain adequate records.

2. In relation to Patient 4, on 5 December 2016, you:

a. Gave inappropriate advice with regards to Patient 4’s intake of:

i) fluid
ii) protein

b. Did not take into account Patient 4’s kidney failure when formulating a diet plan.

3. In relation to Patient 5, on 10 October 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Did not discuss Patient 5’s recent weight gain;

c. Did not discuss alternative carbohydrate sources when restricting fruit intake;

d. Did not discuss carbohydrate requirements for evening meal to help prevent pre breakfast hypoglycaemia;

e. Did not prioritise carbohydrate awareness in view of Patient 5’s recent diabetic ketoacidosis.

4. In relation to Patient 6, on 10 October 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Gave advice prior to weighing Patient 6;

c. Inappropriately advised Patient 6 that his bloods were “good” when his HbA1c was high;

d. Did not provide adequate dietetic advice in relation to:

i). prevention of hypoglacemia and/or

ii). treatment of hypogleacemia.

e. Did not provide adequate advice regarding appropriate meals.

5. In relation to Patient 7, on 10 October 2016, you;

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Did not consider the Service User’s medical plan until the conclusion of the consultation and/or consider Diabetes Mellitus medical updates until the conclusion of the consultation;

c. Did not address Patient 7’s hypoglycaemic reading of 2.8mmol/l;

d. Documented an agreed plan which was not appropriate for Patient 7’s individual needs and circumstances.

6. In relation to patient 8, on 10 October 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Did not recognise and or discuss the possibility that Patient 8’s weight loss could be due to high glucose levels;

c. Gave inappropriate advice in that you;

i). told Patient 8 not to worry about Body Mass; and
ii). told Patient 8 to focus on nutrition support.

d. Did not discuss appropriate use of Oral Nutrition Supplements to minimise hyperglycaemia;

e. Did not provide adequate and/or appropriate dietetic advice in relation to Carbohydrate intake.

7. In relation to Patient 8, on 12 December 2016, you:

a. Gave inappropriate advice in relation to:

i). insulin
ii). snacks

b. Gave incorrect advice in relation to the energy content of milk;

c. Did not communicate appropriately with Patient 8.

8. In relation to Patient 9, on 14 November 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Did not explore and /address Patient 9’s hypoglycaemic symptoms;

c. Did not explore and/or address how Patient 9 treats his hypoglycaemic incidents;

d. Gave inappropriate advice regarding a target for HbA1C levels;

e. Incorrectly documented that a nocturnal hypoglycaemic incident could be the cause of rebound pre- breakfast hypoglycaemia and/or did not suggest a dietary plant to prevent this.

9. In relation to Patient 10, on 19 September 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Did not explore and/or address the reasons for Patient 10’s weight loss of over 6 kilograms in one year;

c. Demonstrated poor clinical reasoning in that you did not associate low HbA1c with the possibility of undetected hypoglycaemic incidents;

d. Did not provide adequate and/or appropriate dietetic advice in relation to Carbohydrate intake;

e. Did not address and/ or respond appropriately to patient 10’s understanding of hypoglycaemic incidents;

f. Did not address and/ or respond appropriately to patient 10’s understanding of basal insulin.

10. In relation to patient 11, on 19 September 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Gave inappropriate and/or unclear advice in relation to Patient 11’s blood glucose levels;

c. Gave inappropriate advice in relation to Patient 11’s fruit intake;

d. Documented an agreed plan which was not appropriate for Patient 11’s individual needs and circumstances.

11. In relation to Patient 13, on the 21 November 2016, you:

a. Did not calculate Body Mass Index and/or record a Body Mass Index calculation;

b. Did not provide adequate and/or appropriate advice in relation to Patient 13’s diagnosis of:

i). diabetes
ii). pancreatitis;

c. Did not provide adequate and/or consistent advice in relation to grams of:

i). carbohydrates
ii). insulin.

12. In relation to Patient 15, on 27 September 2016, you:

a. Did not assess and/or record assessing diet until approximately half way through the consultation;

b. Did not provide adequate and/or appropriate dietetic advice;

c. Did not communicate appropriately with Patient 15;

d. Made an inappropriate comment in that you said that Patient 15 was “lucky as many diabetics do not have legs” or words to that effect.

13. The matters set out in particulars 1 – 12 amount to misconduct and/or lack of competence.

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

 

Finding

No information currently available

Order

No information currently available

Notes

No notes available

Hearing History

History of Hearings for Mrs Sandhya Yatham Venkataramana

Date Panel Hearing type Outcomes / Status
08/10/2020 Conduct and Competence Committee Voluntary Removal Agreement Hearing has not yet been held
13/07/2020 Conduct and Competence Committee Interim Order Review Interim Conditions of Practice
20/02/2020 Conduct and Competence Committee Interim Order Review Interim Conditions of Practice
12/08/2019 Conduct and Competence Committee Interim Order Review Interim Conditions of Practice
16/05/2019 Investigating Committee Interim Order Review Interim Conditions of Practice
19/02/2019 Investigating Committee Interim Order Review Interim Conditions of Practice
23/10/2018 Investigating committee Interim Order Review Interim Conditions of Practice
24/07/2018 Investigating committee Interim Order Review Interim Conditions of Practice
25/04/2018 Investigating committee Interim Order Review Interim Conditions of Practice
02/02/2018 Investigating committee Interim Order Review Interim Conditions of Practice