Miss Ruramayi Runzirwayi

Profession: Operating department practitioner

Registration Number: ODP37945

Interim Order: Imposed on 18 Mar 2019

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 02/11/2021 End: 17:00 05/11/2021

Location: This hearing will be taking place virtually

Panel: Conduct and Competence Committee
Outcome: Adjourned

Please note that the decision can take up to 5 working days to be uploaded onto the HCPTS website. Please contact one of our Hearings Team Managers via tsteam@hcpts-uk.org or +44 (0)808 164 3084 if you require any further information.

 

Allegation

Whilst registered as an Operating Department Practitioner (ODP37945):

1. On 14 August 2018, whilst working for the Heart of England NHS Foundation Trust, you were:

a) Seen holding the Bain breathing circuit near your face with the nitrous oxide and oxygen flowmeters turned on, on more than one occasion.

b) Seen holding the Bain breathing circuit with your mouth closed around the patient end of the circuit.

2. On 12 February 2019, whilst working for Oxford University Hospitals NHS Foundation Trust, you were seen holding the anaesthetic circuit attached to the anaesthetic machine with the oxygen and nitrous oxide flowmeters turned on.

3. On 13 February 2019, whilst working for Oxford University Hospitals NHS Foundation Trust, you were send holding the anaesthetic circuit in your hand/s with high flow oxygen and nitrous oxide flowing.

4. You have a physical and/or mental health condition as set out in Schedule A.

5. The matters described at 1 - 3 above constitute misconduct.

6. By reason of your misconduct and/or health your fitness to practise is impaired.

Finding

Decision:

1. The Panel was expecting to commence the final hearing of the HCPC’s Allegation against the Registrant, Ms Ruramayi Runzirwayi, a registered Operating Department Practitioner at 10:00am on Tuesday 2 November 2021. The Hearing was scheduled to commence at 10:00am and had been listed for four days. The Allegation is a “dual allegation”, involving contentions that the Registrant’s fitness to practise is impaired by reason of misconduct and her health. As the referral has been to the Conduct and Competence Committee the primary focus of the Panel’s enquiry in relation to substantive matters if matters had proceeded as expected would have been on the misconduct elements of the Allegation.

2. There was no indication in the papers that were made available to the Panel in advance of the hearing whether the Registrant intended to participate in the Hearing which is being conducted remotely by video conferencing. However, the Panel was informed before 10:00am when they met in private that the Registrant had communicated with the HCPC on Monday 1 November 2021, the day before the commencement of the Hearing, to say that she intended to participate. The Panel was subsequently told that, by an email sent just before the Hearing was due to commence, the Registrant stated that she had been unable to obtain time off work and she ‘would be free to attend from around 3:30pm…’ Further details of statements made by the Registrant concerning her intention and ability to attend the hearing are included in the chronology below.

3. Instead of commencing the case at 10:00am on Tuesday 2 November 2021, the Panel allowed time for discussions to be had and for instructions to be taken by the HCPC Presenting Officer. Shortly before midday the Panel convened in public to open the case. It began by deciding that there had been good service of a Notice of Hearing as the email sent to the Registrant on 30 July 2021 satisfied the service rules that had been amended to deal with circumstances arising from the current pandemic. As there had been good service of the Notice of Hearing, the Panel had jurisdiction to consider the case, including the question of whether a direction should be made under rule 11 of the procedure rules governing Conduct and Competence Committee hearings that the Hearing should proceed in the absence of the Registrant. The Presenting Officer applied for further time to take instructions. The Presenting Officer subsequently applied for a

direction that the Hearing should proceed in the absence of the Registrant.

4. Logically, whether the Hearing should proceed in the absence of the Registrant was an issue that had to be decided before any other issue could be addressed.

5. The Panel accepted the advice of the Legal Assessor it received in relation to proceeding in the absence of the Registrant. It also had regard to the HCPTS Practice Note on the topic. Accordingly, it accepted that the valid Notice of Hearing, although necessary, was not a sufficient reason to direct that it proceed. What was required was that the Panel should be satisfied that it would be fair to proceed with the hearing in the Registrant’s absence. There were two significant issues that the Panel considered were the most important in deciding if the hearing should proceed. They were:

• The history of the Registrant’s engagement in the fitness to practise process, and in particular whether her absence from this Hearing could properly be categorised as a voluntary waiver of her right to participate.

• A potential conflict of interest on the part of a member of the Panel.

These being discrete issues, they will be explained separately.

Engagement in the process and voluntary waiver of right to participate.

6. In 2020 there was some engagement by the Registrant in the process. She co-operated with the HCPC with regard to the obtaining of a report from a medical practitioner and she engaged with the medical practitioner in a long consultation conducted remotely. The Panel was also told that the Registrant had made contact with the HCPC’s Solicitors in October 2020 to enquire when the final hearing would be held.

7. The Registrant’s engagement in 2021, however, has been minimal. In particular, the Panel was informed that:

• A Preliminary Hearing was held in April 2021 and the Registrant did not engage in it.

• On five occasions between 5 May 2021 and 16 August 2021, the HCPC’s Solicitors sent emails to the Registrant variously asking for confirmation that they could send the Hearing bundle electronically and chasing replies to earlier emails.

• A further email was sent by the HCPC’s Solicitors on 8 September 2021, and that resulted in the only response from the Registrant before Monday 1 November 2021. On 10 September 2021 the Registrant replied to the Solicitors stating that she had been busy and had suffered ill health.

• The Solicitors sent further emails on 14 September 2021 and 28 September 2021, asking for confirmation that the Registrant had received the password that would enable her to access the electronic hearing bundle. No response was received from the Registrant.

• On 12 October 2021, the Hearings Officer who has attended this Hearing sent an email to the Registrant. The Hearings Officer introduced herself and the hearing dates were prominently reproduced in the email. Various suggestions were made by the Hearings Officer that would have assisted a person intending to participate in the Hearing. No response was made by the Registrant to this email.

• At approximately 1:39pm on Monday, 1 November 2021, an email was received from the Registrant indicating an intention to participate. Approximately an hour later two statements were sent by the Registrant, and she stated that she was awaiting further statements that she would forward.

• At 8:39am on Tuesday, 2 November 2021, the Registrant sent an email stating that unfortunately changes had been made to her work schedule and she would not be able to attend the commencement of the case. At 9:11am the Registrant sent a further email which included the statement, “I would be free to attend from around 3.30pm ….”.

8. As the Panel’s consideration of the application to proceed in the Registrant’s absence was rapidly approaching the time (3:30pm) when the Registrant indicated she would be free to attend, the Panel adjourned in order to reconvene at 3:30pm in the hope that the

Registrant would by that time be participating in the Hearing. In the meantime, at 2:20pm, the Hearings Officer made a telephone call to the Registrant and left a voicemail telling her that the Panel would be reconvening at 3:30. At 2:41pm the Hearings Officer sent an email to the Registrant with the same information and also again including the link she could use to connect to the Hearing. The Hearings Officer made a further attempt to telephone the Registrant at approximately
3.35 pm, but the telephone was not answered. By the time the Panel adjourned for the day on Tuesday, 2 November 2021, the Registrant had not sought to join the Hearing and no response had been received from her to either of the Hearings Officer’s messages. Indeed, by 10.00 am on Wednesday 3 November 2021 (the second day of the Hearing) there had still been no response from the Registrant.

9. To summarise, in 2021 there had been no meaningful engagement, apart from a mere assertion on the day before a four-day hearing that had been scheduled and notified to the Registrant more than three months ago, of an intention to attend. When she stated that changes to a work schedule made it impossible to join the Hearing from the commencement, that assertion was not accompanied by an explanation of what efforts the Registrant had made to be able to participate, or when she had made those efforts. Furthermore, the Registrant did not attend at the late stage of the first day when she said she would be able to, and she gave no explanation as to why. In the judgement of the Panel these are circumstances that could permit a finding that there had been a voluntary waiver of the right to attend.

Potential conflict of interest

10. The electronic hearing bundle was made available to the Panel a week before the commencement of the Hearing, on Tuesday 26 October 2021. The Operating Department Practitioner (“ODP”) Panel member was working that day but accessed and read the Hearing bundle the following day. It was when he read the bundle on Wednesday 27 October 2021 that he discovered that there were HCPC witnesses who are known to him. There had been nothing in the information that had been communicated to him before that time that either did alert him or should have alerted him to the problem about to a potential conflict of interest. The ODP Panel member is employed by the same NHS Trust as two witnesses whom the HCPC intend to call to give evidence in relation to the incidents that are alleged to have occurred on 14 August 2018, and which are the subject of particulars 1(a) and (b) of the

HCPC’s allegation. Furthermore, he has had professional contact with both of them.

11. The ODP Panel member immediately raised the issue with the HCPTS the following morning (Thursday 28 October 2021) but by that time it was not possible to substitute another ODP panel member in the time available before the scheduled commencement of the Hearing.

12. The ODP Panel member’s knowledge of both witnesses is confined to his professional life. He could not be called a personal friend of either. His professional contact with Witness 1 has been neither significant nor recent. However, his professional contact with Witness 2 has been significantly greater and is on-going. They have meetings three or four times a week and being employed at the same level in the Trust and having matching areas of responsibility, they attend other events where they meet.

13. The Panel understands that the question of conflict might have been mentioned to the Registrant in recent communications, but it does not understand there to have been a full explanation of the connection between the ODP Panel member and the witnesses.

14. The Presenting Officer submitted that the history of the Registrant’s engagement that has been outlined above should lead the Panel to conclude that there had been a voluntary waiver by the Registrant of the right to participate in the Hearing. Furthermore, she submitted that the Panel could properly resolve the issues of potential conflict, amendment of the Allegation and a Hearsay application relating to an absent witness without having submissions from the Registrant on those issues.

The Panel’s Decision

15. Were the case to proceed, the Panel is satisfied that there would be no likelihood of the ODP Panel member exhibiting actual bias as a consequence either of his knowledge of the two witnesses or because of his employment. However, the Panel is of the clear view that this is case in which there is a realistic possibility that a fully informed and fair-minded bystander would be concerned by the closeness of the professional relationships. For present purposes it is sufficient for the Panel to say that in circumstances where the Registrant is not aware of the full circumstances of this issue, and for that reason will not have had a proper opportunity to consider what, if anything, she would wish

to say about the matter, it would not be proper to proceed with the case in her absence. To do so would mean that the Panel would have to decide this issue without her having the opportunity to make representations. It is for this simple reason that the Panel declines to direct that the Hearing should proceed in the absence of the Registrant.

16. In reaching its decision, the Panel paid careful attention to the submissions made by the Presenting Officer but came to the conclusion that notwithstanding the lamentable history of engagement, it would not be proper for the Panel to resolve the potential conflict of interest issue without the Registrant having an opportunity to address it. This is despite the fact that the history of engagement suggests the Registrant might choose not to take up that opportunity.

Conclusion

17. The consequence of the Panel’s decision that the Hearing should not proceed in the absence of the Registrant is that it must be adjourned to be re-listed for hearing on a future date. The Panel makes no directions in relation to the manner of that re-listing save to say that as the substance of the case was not commenced, the Panel Chair and/or the Lay Panel member may (but are not required to) participate in the reconvened hearing. To remove the need for the issue of the potential conflict to be addressed, the Panel is of the view that the current ODP Panel member should not be selected to sit on the reconvened hearing.

18. As for the Registrant and future engagement by her, that is a matter for her decision and judgement. She cannot be required to engage or participate. The Panel would, however, urge her to take the view that if she wishes to engage and participate, she should do so fully and at an early stage, and also to communicate with others, particularly when she is asked to respond. Furthermore, if the Registrant wishes to produce evidence to be considered by the panel conducting the case, that evidence should be produced not less than 28 days before that future Hearing in accordance with the directions that have been and will again be communicated by the Notice of Hearing.

Order

No information currently available

Notes

Final hearing of the Conduct and Competece committee took place virtually 2-3 November 2021 and was adjourned with no evidence heard. A new hearing will be scheduled in due course.

Hearing History

History of Hearings for Miss Ruramayi Runzirwayi

Date Panel Hearing type Outcomes / Status
25/04/2022 Conduct and Competence Committee Final Hearing Struck off
18/02/2022 Conduct and Competence Committee Interim Order Review Interim Suspension
02/11/2021 Conduct and Competence Committee Final Hearing Adjourned
02/09/2021 Conduct and Competence Committee Interim Order Review Interim Suspension
09/06/2021 Conduct and Competence Committee Interim Order Review Interim Suspension
08/03/2021 Conduct and Competence Committee Interim Order Review Interim Suspension
14/12/2020 Investigating Committee Interim Order Review Interim Suspension
03/06/2020 Investigating Committee Interim Order Review Interim Suspension
14/01/2020 Investigating Committee Interim Order Review Interim Suspension
13/09/2019 Investigating Committee Interim Order Review Interim Suspension