The Royal College of Veterinary Surgeons (RCVS) Disciplinary Committee has directed that a veterinary surgeon be removed from the Register after he carried out total hip replacements (‘THR’) on four dogs which did not uphold the animals’ health and welfare This was also done without consulting with their owners about alternatives (including more conservative treatment options) and gaining their informed consent to carry out the procedures.
The hearing for Dr Marthinus Ryk Botes took place between 10 and 14 January 2022 and there was a total of nine charges against him. The charges related to performing (or recommending) inappropriate total hip replacements on five dogs without adequate investigation and without getting informed consent from the owners.
One of the charges also related to a failure to keep adequate, clear and detailed clinical records in relation to the five dogs. The full charges can be found on the disciplinary page of the RCVS website.
Dr Botes denied charges one and two, which related to a Labrador Retriever named Cola, but admitted charges three to nine and that these charges amounted to disgraceful conduct in a professional respect (also known as serious professional misconduct).
Both the College’s and Dr Botes’ counsel requested that charges one and two be dismissed as Cola’s owner did not attend the hearing to give evidence and so would therefore not be available to be cross-examined and an application would have had to been made to rely on her written witness statement. The Committee considered that, while there was another written witness statement and an expert opinion report in respect of charges one and two, it would be in the public interest to dismiss these charges based on the submissions from both the College and Dr Botes’ counsel. The Committee therefore found charges one and two not proved, but, following Dr Botes’ admissions, found charges three to eight proved, as well as charge nine in relation to charges three to eight.
In considering whether the admitted charges amounted to serious professional misconduct both individually and cumulatively, the Committee considered an expert report from Professor John Innes, RCVS specialist in small animal surgery (orthopaedics) and Mr Midgley, RCVS advanced practitioner (small animal orthopaedics). They also considered that Dr Botes had admitted both to the charges and the fact that they amounted to serious professional misconduct.
Ian Arundale, chair of the Committee, said: “In coming to its decisions, the Committee took into account Professor Innes’ opinions that it was not reasonable for Dr Botes to have carried out the THR without sufficient investigation into Kilo’s pain; that the THR undertaken in respect of Sora was not in the animal’s best interests; and that it was ‘entirely unnecessary’ to recommend the THR in respect of Penny.
“In addition, the Committee has found that both THRs performed in respect of Daisy were not in her best interests. Thus, in the Committee’s view, Dr Botes’ actions and omissions did not ensure the animals’ health and welfare.”
The Committee took into account that the THRs in question were a source of financial gain, that Dr Botes’ conduct was repeated over a considerable period of time and that he was in an increased position of trust and responsibility because of perceived expertise in small animal orthopaedics and its education. However, the Committee took into account, as a mitigating factor, that Dr Botes has indicated some insight into some aspects of the charges in his written communications to the College, in his witness statement dated 29 December 2021, and in his admissions at the start of this inquiry.
The Committee subsequently found all the factual matters proved to amount to serious professional misconduct.
The Committee then considered what would be an appropriate and proportionate sanction and in doing so heard from several character witnesses including Dr Midgely, who was put forward as Dr Botes’ proposed supervisor if the committee agreed to a postponement with undertakings.
When making their decision of whether the surgeon should be removed from the Register, the Committee also took into account the fact that Dr Botes had been suspended from the Register in 2008 for six months after his conduct in relation to the care of a dog that had been involved in a road traffic accident was found to amount to serious professional misconduct.
The Committee considered a postponement of judgment with undertakings, which was submitted by Dr Botes’ counsel. However, the Committee took the view that a postponement on the basis of undertakings would not be appropriate in this case. This was because the failings were not in limited aspects of practice but were wide-ranging, covering the basic and fundamental requirements of any veterinary surgeon.
In the Committee’s view, this would mean nothing less than direct supervision, where Dr Botes’ practice was directly monitored on a day-to-day basis would be sufficient to protect animals and clients, and to uphold the wider public interest. It would be impracticable to formulate undertakings capable of effectively addressing these issues.
The Committee also noted that the disgraceful conduct was serious and there was a pattern of sustained and persistent misconduct. The Committee therefore did not believe that no further action, a reprimand or a warning were appropriate or proportionate outcomes.
The Committee further considered whether suspension was appropriate but concluded that there was a real risk of repetition of the behaviours outlined in the charges, and so the Committee was unable to conclude that Dr Botes would be fit to return to practice after a period of suspension.
The Committee therefore decided to direct that Dr Botes should be removed from the Register indefinitely. In coming to this decision, the Committee carefully applied the principle of proportionality and took into account the impact of such a sanction on Dr Botes both professionally and financially, and took into account his witness statement in this regard.
Ian Arundale added: “In light of the gravity of the conduct, and all of the factors taken into account, any lesser sanction would lack a deterrent effect and would undermine public confidence in the profession and the regulatory process. Removal was the only appropriate and proportionate sanction.”
Dr Botes has 28 days from being notified of his being removed from the Register to lodge an appeal with the Privy Council.
The Committee’s full findings can be viewed on the RCVS website’s discplinary page.