Corrupt or incompetent psychiatrist?

Hi everyone, new member hoping to bounce some ideas if possible.

My brother suffered a head injury in the mid nineties, which took a lot for him to get over. In 2012 he was out running when a previously banned driver tried to run him over as he was on a quiet back lane. He was forced to jump into a ditch to avoid the car. He had some minor physical injuries but emotionally it triggered him. We learned that previous head injury patients have a predisposition to developing a trauma response such as PTSD in the event of a second insult. Over the course of the following 2 years he struggled to cope before eventually breaking down at work after he aborted an attempt to drive into the back of a truck "to make it all stop".

We secured immediate mental health crisis team help through our health insurer who eventually diagnosed chronic PTSD, anxiety and depressive states complete with emotional numbing and anger problems. He was declared 'at risk' due to his suicidal ideation and his impulsivity. He was medicated on anti-depressants and prescribed an anti-psychotic to help with his irritability. He was diagnosed using the Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), GAD 7, CORE, HADS and PHQ , CAPS being the gold standard in PTSD diagnosis.

Ultimately 6 specialists collectively formed a cohesive package of evidence and opinion, using the International Classification for Diseases (ICD), DSM IV and appropriate psychometric diagnostic systems. The insurer for the driver that tried to run him over disliked this assortment of diagnoses so demanded another 'impartial' psychiatrist in London, some 70 miles away, should be involved who would produce a joint expert report deciding the outcome of the case.

With incomplete medical records this psychiatrist interviewed my brother for 45 minutes, conducting no psychometric testing at all. 6 weeks later he reported that my brother

'met no specific criteria for any major depressive illness, anxiety disorder or PTSD'.

The insurer collapsed the claim offering him no damages.

Concerned and suspicious we went on to ask this psychiatrist for his session notes by way of a legal Subject Access Request. The psychiatrist refused. We involved the Information Commissioners Office who investigated and ruled he was in breach of data protection law, stating he should immediately comply. Still he refused.

We instructed a solicitor to obtain the session notes and instead of complying this psychiatrist instructed his own solicitor to prevent disclosure. It took 1 year of fighting with the threat of obtaining a court order before we finally obtained his session notes.

The content was disturbing. Transcribed from his hand writing the psychiatrist had written the following:

•Sacked – couldn’t cope/concentrate – more distracting environment.

•Same problems there struggling – employer made adjustments ok for a few months, still too much.

•Tried EMDR – no help, frontal lobe damage.

•Mood – variable, been more aggressive.

•More unstable/frustration. Being tailgated, rammed another car. Arrested, fighting on road.

•Sleep ok on citalopram 40mg + Aripiprazole 5mg (to control anger)

•Energy (Down) on meds but ok at home

•Libido not great.

•Felt UNCLEAR hopeless.

•Not driven since 7/2015 Worried he will deliberately drive into someone.

•Anxiety – Panic when out worried will react – Aggressive / argumentative.

•Unpleasant dreams – (evasive)

•Flashbacks when sees black car, other drivers face + sight of his leg close to him + vivid recall of ‘death threat’.

•Avoids riding bicycle on road since #.

•Avoids running on road since #.

•Went UNCLEAR ago – nasty experience – unhelpful workmen, ashamed of his reaction.

•Can’t cope children noise etc.

•Violent (crossed out) Not physically violent at home – verbally aggressive – no UNCLEAR.

•Hits own head (twice) in last UNCLEAR – frustration. No self UNCLEAR.

•A few suicides in family – on male side 4 UNCLEAR 200 years (3 generations)

•Started to have panic attacks – UNCLEAR for head injury 18/12 – 2 years.

•Tense agitated here today.

•Affect – tense, can smile but very down sense of humour.

•Feels ashamed UNCLEAR friends etc. Supported by wife.

•Used to be the life & soul but now since index # struggles to leave house.

•Problems trusting – no capacity to be hurt again. She does shopping – all the external things – trying to address this.

•“I can’t take any more”.

It would seem he had recorded a wealth of adverse data but had simply reported to legal third parties and the insurers that my brother had perfect mental health, not even suffering with any depressive disorders. This in a patient who had aborted a suicide attempt less than 12 months earlier.

It is clear he spent 1 year fighting to hide his actual observations as they didn't support or correlate with what he reported to the legal teams. Disgusted we have written to the insurers demanding answers as to why their doctor appears to have deliberately misreported and misdiagnosed my brother, a highly vulnerable individual.

We have also reported the situation to the General Medical Council, they are following a path of general inquiry but I am yet to be persuaded that they will take this seriously. We will see.

So, to throw this matter out to anyone reading do you have any thoughts as to how this psychiatrist has behaved? Would you be equally concerned this doctor has abused his position of trust and made demonstrably false statements about his patient? Are there any medically qualified professionals with thoughts regarding the ethical implications of putting the desires of the paying insurer over the wellbeing of a vulnerable patient? It's a terrible predicament, if there is interest in this story I'll add updates as and when we hear from the insurer or the GMC.

Many thanks to anyone reading.

0 likes, 1 reply