A consultant dermatologist who misdiagnosed psoriasis did not do a blood test before prescribing drugs, a medical fitness-to-practise inquiry has been told.
Dr Adam Jacobus Smith (65) is facing in excess of 100 allegations of poor professional performance, or professional misconduct, in relation to 12 patients who attended the Whitfield Clinic, Waterford, from 2006 to 2009.
Yesterday was the 21st day of the hearing which is one of the longest to come before the Medical Council.
Questioned about his examination of a wheelchair- bound patient , identified as “L” in January 2011, he said a diagnosis of the blistering skin condition pemphigus vulgaris “didn’t enter my head at all”.
Of his failure to do blood tests before prescribing Stelara, he said he relied on the patient’s word that recent blood tests had been fine. Dr Smith said he prescribed Stelara to treat the presumed psoriasis, a monthly injection that costs €12,000 a year, before it had been licensed here, adding: “We are allowed to prescribe off-licence.”
He relied on the fact that the drug was approved in the US and said that he was “not the only dermatologist in Ireland to prescribe Stelara”.
