Kielye L Mitchell
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The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 14 June 2019.
On 8 March 2016, during the course of your employment as a Paramedic for East of England Ambulance Service, you attended Patient A and:
1. During your assessment of Patient A you did not identify and/or document on the Patient Care Record (PCR) that Patient A had a rash.
2. You walked Patient A to the front door, despite her low blood pressure.
3. Despite Patient A’s symptoms, you did not:
a) transport Patient A to hospital under blue light conditions; and/or
b) pre-alert the hospital prior to your arrival.
4. You did not inform and/or record informing the hospital of the deterioration in Patient A’s condition.
5. You did not consider and/or record on the PCR a differential diagnosis or diagnoses.
6. You did not undertake and/or record on the PCR any, or any adequate observations and / or vital signs monitoring after 18.10 hrs.
7. You did not record adequate information on the PCR in relation to Patient A’s deteriorating condition.
8. You inaccurately documented on the Patient Care Record that Patient A's condition was unchanged at handover.
9. You did not adequately convey the severity of Patient A’s condition to hospital staff and / or record on the PCR your discussions with hospital staff.
10.You actions as described at particulars 1 to 9 constitute misconduct and/or lack of competence.
11.By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
1. The Panel was satisfied on the basis of the documents contained in the service bundle that the Registrant had been properly served with the notice of hearing by email dated 5 October 2022 in accordance with the Rules. Confirmation of delivery of that email was received on the same date.
2. The HCPC made an application for the hearing to proceed in the Registrant’s absence on the basis that the Registrant had voluntarily absented herself from the hearing and had waived her right to attend. In support of that application Ms Khorassani referred the Panel to an email dated 21 September 2022 from the Registrant to the HCPC in which she stated that she had childcare issues and was happy for the hearing to proceed in her absence. There was a further email of today’s date, 16 November 2022, in which the Registrant informed the HCPC that she would not be attending today’s hearing.
3. The Panel took into account the HCPTS’ Practice Note on “Proceeding in the Absence of the Registrant” and accepted the advice of the Legal Assessor. The Panel noted that the Registrant had signed a Voluntary Removal Agreement and had not applied for an adjournment. The Panel was satisfied that the Registrant did not wish to attend the hearing and was content for it to proceed in her absence. In all the circumstances, the Panel determined that it is in the public interest and the Registrant’s interests for the hearing to proceed today in the absence of the Registrant.
4. The Registrant is a Paramedic registered with the HCPC. She was employed by the East of England Ambulance Service NHS Trust. At the time of the events set out in the Allegation, the Registrant had worked as a Paramedic for around 16 years.
5. The Registrant was stationed at Colchester Ambulance Station. On the morning of 8 March 2016, Person B (Patient A’s husband) contacted 111 to report that his wife, an otherwise healthy 60-year-old, was unwell. An ambulance was dispatched to her home address. The Registrant attended with her colleague (SH) and transferred Patient A to hospital. Patient A died in the early hours of 9 March 2016. Following a complaint by Person B, the hospital and the Ambulance Service conducted internal investigations. Person B also referred the matter to the HCPC in December 2016. In summary, the case against the Registrant was that she had failed to adequately record or monitor Patient A’s deteriorating condition, which was a form of sepsis, and that she failed to take certain actions.
6. The Registrant attended the substantive hearing, which took place on 6 February 2019 and 13-14 June 2019, and gave evidence. All factual particulars (1-9) of the allegation were found to be proved.
7. The Registrant’s actions or omissions for all but the first two particulars were found to amount to misconduct. Whilst acknowledging that there were extenuating circumstances outside the Registrant’s control, in that there were unusual delays in admitting Patient A to the hospital on the day, the original panel was troubled by the Registrant’s lack of understanding and awareness regarding her own failure to see that Patient A was demonstrating obvious and worsening signs of cyanosis, which was a red flag indicative of circulatory compromise. The panel found that the Registrant’s failings contributed to denying Patient A timely care.
8. The original panel expressed concern about the Registrant’s lack of initiative in documenting Patient A’s deterioration and her lack of insight into her own conduct and the effect this had had on Patient A and her family. The original panel also had concerns about her apparent lack of regard for the impact on others and her lack of remorse. She blamed other staff and minimised her own responsibility. She had not undertaken any reflection apart from one occasion in 2016. There was therefore a risk of repetition. The panel thus found impairment on both personal and public interest grounds.
9. The original panel reconvened to consider sanction on 13-14 June 2019 and took account of the Registrant’s apology to the family of Patient A in a reflective piece, together with evidence of courses she had undertaken and positive testimonials from senior colleagues. A Suspension Order of 12 months duration was determined to be the appropriate and proportionate sanction. The panel indicated that a period of suspension would enable the Registrant to provide the further evidence that would assist a reviewing panel.
10. The Suspension Order was subsequently reviewed at hearings on 1 June 2020, 1 June 2021 and 9 June 2022. On each occasion the reviewing Panel found that the Registrant’s fitness to practise remained impaired having regard to both the personal and public components of impairment. On each of the first two reviews the Suspension Order was extended for 12 months. At the third review the Suspension Order was extended by a further 6 months.
11. Following the third Substantive Order Review, the Registrant informed the HCPC that she had no wish to practise as a Paramedic in the future. There followed a discussion about a possible disposal of the proceedings by way of a Voluntary Removal Agreement (VRA) as confirmed in a telephone attendance note of the HCPC Case Manager dated 14 June 2022.
12. On 14 June 2022 the HCPC Case Manager emailed the Registrant with information about the VRA process and attached a copy of the Consent Guidelines for Registrants and the Consensual Disposal Request Form.
13. On 19 June 2022 the Registrant returned the signed pro-forma form.
14. At today’s hearing the Panel received the VRA signed by the Registrant and dated 15 November 2022.
The Panel’s decision
15. The Panel today was provided by the HCPC with a bundle of documents containing the record of the substantive hearing and the subsequent review hearings, correspondence between the Registrant and the HCPC with regard to her request for voluntary removal and the signed VRA. In addition, the Panel had the benefit of a skeleton argument of Maryam Khorassani on behalf of the HCPC dated 1 November 2022, on which Ms Khorassani elaborated in her oral submissions.
16. The Panel had regard to the HCPTS’ Practice Note on “Disposal of Cases by Consent” and accepted the advice of the Legal Assessor.
17. The Panel first considered whether the proposed resolution of these proceedings would provide the appropriate level of public protection. The Panel took into account that the VRA was equivalent in its effect to a striking off order, which would prevent the Registrant from applying to be re-admitted to the Register for at least 5 years. In the unlikely event of an application for re-admission, she would be required to undertake a significant period of updating her professional skills and knowledge. The Panel was satisfied that the public would thereby be adequately protected.
18. The Panel further considered whether the proposed resolution of these proceedings would be detrimental to the wider public interest. In this context, the Panel noted that the allegation against the Registrant had been fully considered and determined at the substantive hearing at which there had been a finding of current impairment and the imposition of a Suspension Order. The need to maintain proper professional standards was thereby upheld and public confidence in the profession and the Regulator maintained. This was followed by three substantive order reviews.
19. In all the circumstances, the Panel today was satisfied that a member of the public, properly informed as to the circumstances of the case, would be satisfied that the Voluntary Removal Agreement is an appropriate and proportionate disposal of the matter, that it addresses any public protection and wider public interest issues and is in the Registrant’s own interests.
20. The Panel was also satisfied that the Registrant had given her informed and unequivocal consent to the disposal of the proceedings by way of Voluntary Removal.
21. The Panel therefore consented to the disposal of these proceedings by Voluntary Removal, approved the proposed VRA and revoked the current Suspension Order.
The Registrar is directed to revoke the current Suspension Order and to remove the name of Mrs Kielye Mitchell from the Register with immediate effect.
No notes available
History of Hearings for Kielye L Mitchell
|Date||Panel||Hearing type||Outcomes / Status|
|16/11/2022||Conduct and Competence Committee||Voluntary Removal Agreement||Voluntary Removal agreed|
|09/06/2022||Conduct and Competence Committee||Review Hearing||Suspended|
|01/06/2021||Conduct and Competence Committee||Review Hearing||Suspended|
|13/06/2019||Conduct and Competence Committee||Final Hearing||Suspended|