A doctor who acted as an official medic at British Eventing (BE) competitions despite the fact his licence to practise had been withdrawn has been struck off the official medical register.

Following a General Medical Council (GMC) investigation, the Medical Practitioners Tribunal Service ruled that the behaviour of Alexandros Charitou was “fundamentally incompatible with continued registration”.

“He has acted dishonestly and shown a blatant disregard for regulatory safeguards which are put in place to protect patients,” the tribunal panel wrote in its report.

“He has also failed to acknowledge his misconduct, demonstrated a total lack of insight and potential for remediation and shown no remorse. The tribunal has therefore determined that erasure is the only sufficient sanction which would protect patients, maintain public confidence in the profession and send a clear message to Dr Charitou, the profession and the public that his misconduct constituted behaviour unbefitting and incompatible with that of a registered doctor.”

The tribunal had heard that the GMC told Dr Charitou of its formal decision to withdraw his licence to practise, on 10 March 2015. But from March to June 2016, he worked as a doctor at BE events, telling the BE national safety officer he did have a licence.

Injured riders

Among the events concerned were Whitfield and Borde Hill horse trials, at both of which he treated riders who had suffered falls.

The Whitfield rider, patient A, fell during the showjumping warm-up in April 2016, sustaining concussion and an injured knee. As an NHS ambulance “declined to attend”, the rider was taken to hospital in a friend’s car, with a qualified ambulance technician, with Dr Charitou’s permission.

Patient B complained of severe lower back pain after a fall during the showjumping warm-up at Borde Hill in May 2016. Dr Charitou said she had exacerbated a pre-existing back condition, gave her painkillers and said she could go home but should see her GP the next day.

The rider’s pain did not lessen and she was later taken to hospital, where she was diagnosed with an unstable lumbar vertebral fracture and was “urgently transferred” to another hospital for spinal surgery.

The tribunal found Dr Charitou had failed to arrange for patient A to be transferred to hospital immediately, and in an ambulance with appropriately trained personnel.

It was also found that the doctor had failed to immobilise patient B, or arrange for her to be taken to hospital immediately. He also failed to give her adequate relief for her pain, which she described as “100 times worse than childbirth”, or appropriate advice.

Dr Charitou was not present or represented at the tribunal hearing, but BE’s national safety officer said he had worked with him at “quite a lot of events” and had “never had any concerns”.

A BE technical advisor added: “‘Before this incident, I respected Dr Charitou as a really good doctor. I trusted him when he worked on site and I would have put my life in his hands. I am aware of three occasions when there were very serious accidents and Dr Charitou was part of the medical team who dealt with the people who were injured.

“It is my view that if that medical team, including Dr Charitou, hadn’t been there to treat these people then they would have died.”

Reprehensible conduct

No previous concerns over Dr Charitou’s fitness to practise had been brought to the tribunal’s attention, but it found the doctor’s conduct “thoroughly reprehensible”.

“Further, the tribunal found that Dr Charitou also failed to provide an appropriate standard of care to patient A and patient B, two patients with potentially life-threatening injuries,” the report read.

“The tribunal is particularly concerned by Dr Charitou’s mismanagement of patient B. It considers that his failure to immobilise Patient B immediately following a fall from a horse and to arrange for her to be transported to hospital immediately could have had potentially catastrophic consequences for the patient, given that she had sustained a spinal fracture.

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“In the light of Dr Charitou being willing to treat patients in the knowledge that he did not have a licence to practise, he has demonstrated a wilful disregard of his responsibilities as a doctor.”

Unless Dr Charitou exercises his right to appeal, his name will be erased from the medical register 28 days after written notice was served on him.

BE CEO David Holmes said: “As the findings confirm, BE was deliberately and expressly mislead by Dr Charitou. When we became aware of Dr Charitou’s false information it was immediately reported to the GMC which initiated the investigation.

“Our processes regarding the confirmation of doctors’ licences to practise have since been reviewed and some changes to how doctors submit their licences have been implemented to further support the process.

“We would like to assure all our members that safety of both horses and riders is of the utmost priority at any BE fixture. It is with great regret that Dr Charitou’s actions impacted on two of our members and thank them for their support during the case.

“The selection and appointment of the event doctors and medical team are decisions taken by the event organiser, but the doctor, or doctors, and medical team selected must comply with British Eventing rules as laid out in Chapter 9 of the BE rulebook.”

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