Struck off: Spanish radiologist guilty of misconduct

A U.K. medical tribunal has found a Spanish radiologist guilty of making two serious errors and subsequent dishonesty while working as a locum in a large London hospital. The doctor will now be erased from the register, pending an appeal period.

Dr. Claudia Lorena Martinez Higueros graduated in general medicine and surgery in Madrid in 2008, before completing a doctorate in clinical trials at the University of London between 2010 and 2012, according to a tribunal that concluded on 19 April 2024. She worked as a clinical lecturer and fellow in vascular and interventional radiology (IR) at the Royal College of Surgeons of Ireland between July 2017 and June 2018 and was employed at Guy's & St. Thomas's NHS Foundation Trust, London, as a senior clinical fellow from June 2018 to February 2019. She was also an honorary fellow at St George's University Hospital.

According to the official documents obtained on 29 April by from the Medical Practitioners Tribunal Service (MPTS), Martinez Higueros worked as a locum interventional radiologist at the Chelsea and Westminster Hospital NHS Foundation Trust on a six-month contract from September 2019 to February 2020. This was her first consultant post, so her work was supervised.

MartĂ­nez Higueros' errors occurred while she was a locum at the Chelsea and Westminster Hospital.MartĂ­nez Higueros' errors occurred while she was a locum at the Chelsea and Westminster Hospital.

On 12 December 2019, a Serious Incident Report was raised about Martinez Higueros's treatment of Patient A, a 73-year-old woman who attended the emergency department on 10 December 2019. The patient complained of worsening shortness of breath, had a history of congestive cardiac failure and breast cancer, and was unable to cope at home, according to MPTS tribunal chair Claire Lindley.

A chest CT scan confirmed a left-sided pleural effusion. Martinez Higueros was told to perform a diagnostic left pleural aspiration, but instead, she performed a therapeutic right-sided pleural drainage. She also failed to obtain adequate clinical information to determine the intended purpose of the aspiration before undertaking the drainage or to discuss the decision to change the procedure with the referring clinicians or another IR colleague.

According to Lindley, "It is alleged that Dr. Martinez Higueros then failed to update or explain the reason for her decision to carry out the drainage during a ward meeting with colleagues later that day, and also failed to apologise to Patient A for performing the drainage rather than the aspiration."

After the ward meeting, Martinez Higueros added an addendum to the radiology information system (RIS) stating "Medical team contacted." When she made that addendum, she "meant it to convey that she had contacted the medical team to discuss her decision to perform the drainage. It is alleged that she did not make that contact and that this action was therefore dishonest."

On 6 February 2020, a second Serious Incident Report was raised in respect of Martinez Higueros's treatment of Patient B, a 58-year-old man who presented at the emergency department on 22 December 2019 with a five-day history of frank hematuria, feeling nauseated and feverish. He had a history of renal stones, the MPTS tribunal chair noted.

Patient B underwent a urogram CT scan on 7 January 2020. It showed bilateral indeterminate renal cysts, and he was referred for MRI to determine the nature of these cysts. His MRI took place on 15 January 2020 and was reported by Martinez Higueros as showing a Bosniak category III right upper renal cyst and a solid left lower pole lesion. Patient B then attended the urology outpatient clinic on 27 January 2020, where he was informed of the MRI results.

The radiologists reviewed the CT and MRI scans and agreed that the left renal lesion was suspicious for malignancy and recommended biopsy. They documented that the patient was waiting for a "LEFT renal biopsy." Martinez Higueros undertook the renal biopsy procedure on Patient B. In her report following the procedure she stated that ultrasound confirmed solid component of the upper right renal pole lesion, setting out that it was the right-sided lesion that was biopsied. The histopathology report following the procedure also stated that the biopsy was from the right side.

At a subsequent meeting about the case, Martinez Higueros "was dishonest in some of her responses during that meeting, Lindley stated. Also, Martinez Higueros made an addendum entry to a RIS report: "The solid lesion identified and biopsied is on the lower pole of the left kidney." Further, on or around 2 March 2020, she asked the histopathology department to amend the histopathology report for the biopsy to state: "''Specimen location should be left renal lesion' ... Dr. Martinez Higueros knew that this information was untrue and that both these actions were therefore dishonest."

Speaking at the tribunal on behalf of Martinez Higueros, David Morris, counsel, stated that his client accepted she had been found guilty of misconduct and it was inevitable that a finding of impairment would follow. He confirmed Martinez Higueros accepted the findings of dishonesty and was not seeking to overturn the tribunal's decision. Morris noted that Martinez Higueros had attended a course related to self-reflection and developing insight, professionalism for doctors, and probity for doctors. He said his client had continued to practice since the incidents, with no concerns raised.

Martinez Higueros was a locum consultant in vascular and IR at East Kent Hospitals University NHS Foundation Trust from March 2020 and October 2020, and she has been employed as a substantive consultant interventional radiologist at Northampton General Hospital NHS Trust from October 2020 to the present, according to the MPTS tribunal chair.

The tribunal members make independent decisions about a doctor’s fitness to practise medicine in the U.K. More information about tribunal members are available on the MPTS website. Martinez Higueros’ hearing took place from 26 June to 14 July and 8 to 11 August 2023, and from 15 to 19 April 2024.

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