Yesterday, a Health Practitioners Disciplinary Tribunal online hearing was held to decide the penalty for Dr Nelson Nagoor after he was found proven to be negligent and of bringing the medical profession into disrepute at a hearing held in Invercargill last month.
The charges were brought before the tribunal in relation to Dr Nagoor’s treatment of Invercargill man Joshua Linder between April and August, 2019.
Included in the sentence was a $5000 fine, censure and a three-month suspension.
If Dr Nagoor, who is now retired and living in South Africa, returns to New Zealand, he will have to work under supervision for 18 months, with the cost of his supervisor being met by him. He will also not be able to practise as a sole practitioner for a period of three years and he will have to undergo assessment from the Medical Council health committee to assess he is fit to practise.
He was also ordered to pay 35% of the costs of prosecution, estimated to be $26,000.
Ms Douglass also recommended the decision be relayed to the appropriate medical council in South Africa. Dr Nagoor was working at Nga Kete Ma Tauranga Nga Paonamu Charitable Trust’s He Puna Wai ora Wellness Centre (Nga Kete) in Invercargill when Mr Linder went to see him about a mole on his back on April 5, 2019.
On April 12, Mr Linder returned to Nga Kete where Dr Nagoor excised the lesion which was sent to a laboratory.
A histology report stating it was an invasive primary melanoma with a subtype of superficial spreading melanoma was sent back to Nga Kete on or about April 17.
Dr Nagoor recorded the results as superficial spreading melanoma in Mr Linder’s clinical records and did not contact him to discuss the results.
There was no further documentation of further action or follow-up in his clinical notes.
On April 30, when Mr Linder directly asked Dr Nagoor if he had cancer, the doctor replied "no cancer".
On August 2, Mr Linder met with Dr Nagoor again, there was no referral made and no further discussion about treatment.
It was not until September 27, 2019, when Mr Linder was seen by another doctor at Nga Kete for a growth under his arm, that he was referred for specialist treatment.
Mr Linder died from cancer in June this year.
Yesterday in her submissions, director of proceedings lawyer Jane Herschell was seeking cancellation of Dr Nagoor’s medical registration.
"It was inconceivable and unacceptable that Dr Nagoor had incorrectly read the histology report relating to Mr Linder."
An aggravating feature was Dr Nagoor’s failure to engage with the Health and Disability Commission throughout its investigation, Ms Herschell said.
Dr Nagoor had still not sent an apology to the family, despite the Health and Disability Commission requesting him to do so, she said.
Dr Nagoor’s lawyer Adam Holloway said cancellation of his medical registration would be out of proportion to what had occurred.
"Dr Nagoor has apologised for his actions, he’s acknowledged the mistake that he made but in my submission we do not want to be moving towards a situation where clinical errors are cause for the most severe penalties to be meted out."
Just because he had retired and was no longer living in the country, was not good enough reason for cancellation of his registration, Mr Holloway said.
Instead the tribunal should impose conditions that if Dr Nagoor returned to New Zealand he would have restrictions around what he could and could not do.
After delivering its decision yesterday, Ms Douglass acknowledged Mr Linder’s family — both their attendance at the hearings and the evidence they had put forward.
"I hope the disciplinary process will bring some closure to these matters that have occurred."
