Hepatitis outbreak GP struck off

The outbreak occurred at Finchley Alternative Medical Centre

A GP has been struck off for the second time after admitting his clinic's poor hygiene control caused an outbreak of Hepatitis B.

The case has fuelled worries that doctors guilty of misconduct have found it too easy to resume practice.

GMC Professional Conduct Committee chairman Professor Denis McDevitt told Dr Madhusudhan Shivadikar: "You had a responsibility to ensure that the procedures carried out accorded with the long-established principles of good medical practice. You failed to do so.

"Your approach to basic medical procedures was highly irresponsible, and put yourself, your patients, and staff at risk from serious communicable diseases.

You demonstrate a cavalier approach to the most basic medical procedures

Professor Denis McDevitt, GMC

"You demonstrate a cavalier approach to the most basic medical procedures. Your reckless conduct put the safety of patients at serious risk."

Dr Shivadikar, appearing before the General Medical Council (GMC) on a charge of serious professional misconduct, was previously struck off the medical register in the 1970s for performing illegal abortions.

He had also been given an 18 month jail sentence for carrying out the illegal operations.

However, he was reinstated to the medical register by the GMC a year later - the minimum period of erasure.

In recent months, the minimum period before a doctor can apply to rejoin the medical register has been increased to five years.

Dr Shivadikar had admitted to the latest GMC hearing that there was no "proper infection control" at his clinic, the Finchley Alternative Medical Centre in north London.

Used needles and other types of clinical waste were not properly disposed of, he admitted.

As many as 30 patients were infected with the potentially deadly virus after being treated with an unproven procedure called autohaemotherapy.

This involves reinjecting people with their own blood in pressure points around the body after mixing it with a saline solution.

The hearing heard that among the patients who contracted hepatitis B were:

• a 17-year-old girl who had made several trips from Newcastle to be treated for chronic knee pain
• a pensioner who had been advised to seek alternative remedies after doctors could not find a cure for his swollen tongue and lips

Medically untrained

Ms Barnfather said Dr Shivadikar's medically untrained daughter Miriam performed autohaemotherapy on 80-90 people between July 1997 and February 1998.

The patients underwent autohaemotherapy

She said it was "extremely fortunate" that none of the doctor's victims had been infected with HIV.

Both the 70-year-old doctor and his daughter Miriam were also found to be infected with Hepatitis B.

When Barnet Health Authority launched an Incident Control Team to investigate the outbreak of Hepatitis B they discovered patients' records kept by Dr Shivadikar were blood-stained or incomplete. Other records were missing.

Ms Barnfather said blood-stained clinical waste from the clinic was left to be collected by dustmen.

The hearing also heard that in March 1978 Dr Shivadikar was sentenced to 18 months in prison at Leicester Crown Court after carrying out illegal abortions on two women.

One of the women, known only as Miss K, who paid £100 for the "operation", had to spend a number of days in hospital where she was "seriously unwell" from a septic abortion.

In 1979, Dr Shivadikar was struck off the medical register for his crime, but less than a year later, in March 1980, he was reinstated.

Dr Shivadikar admitted a number of medical blunders including failing to take appropriate measures to prevent himself, staff, patients and others from being exposed to the risk of serious communicable diseases.

He also accepted that he failed to keep adequate records of his patients and that he had misled the Incident Control Team set up by Barnet Health Authority by failing to disclose that his daughter performed skin breaching procedures and not keeping adequate records of his patients.

He had denied that these mistakes amounted to serious professional misconduct, and did not comment as he left the hearing.

British Medical Association chairman Dr Ian Bogle said: "The public and the medical profession will be heartily relieved that this doctor has been struck off.

"His bizarre methods and appalling lack of hygiene control are disgraceful.

"This man is clearly a public health menace.

"It is essential that he is not allowed to slip through the net by continuing to work as an acupuncturist.

"Unlike medicine, acupuncture is not regulated by statute.

"In our report on acupuncture, published in July, we recommend that all doctors and acupuncturists are immunised against Hepatitis B which is a highly contagious communicable disease."