Doctor 'haunted' by boy's murder escapes suspension over inaction
A renowned paediatrician "haunted" by his failure to report the repeated abuse of a young boy later murdered by his stepfather has escaped suspension over his inaction.
The de facto father of the toddler was in 2014 sentenced to at least 20-and-a-half years in jail for inflicting hours of severe pain upon the child – who, along with his mother, cannot legally be identified – before killing him with a blow to the head during an attack in March 2008.
The NSW Civil and Administrative Tribunal this year heard the child's mother had brought the boy to see Campbelltown specialist Dr Richard Dunstan 12 times leading up to his death, raising concerns over unexplained bruising and bleeding.
But Dr Dunstan, who held an "exceptional reputation" among the community and his peers, repeatedly failed to notify child protection authorities, even after the woman raised fears that her partner was responsible for the attacks.
In a case brought by the Health Care Complaints Commission the specialist admitted there were multiple occasions that should have sparked concerns of physical abuse.
Dr Dunstan said he should have alerted the Department of Community Services, as it was then called, following a consultation in October 2006 in which the boy, then 14 months old, presented with facial haemorrhaging and tests could find no medical cause for his symptom.
"My failure to do so has haunted me since," Dr Dunstan said before the tribunal.
"I struggle often with guilt over my errors and my failure to protect this boy from harm. For that I am truly sorry."
The boy's mother initially told Dr Dunstan the injuries appeared to occur spontaneously and that she believed her son was hitting his head on his cot and other objects.
A skeletal scan, CT scans and haematological tests were undertaken, with Dr Dunstan maintaining his belief in what the woman had told him.
Following a second round of tests, the haematologist told Dr Dunstan to tell the Department of Community Services, as it was then known, that the injuries could have been from child abuse. Dr Dunstan prepared a letter but delayed sending it.
"It arrived at the Department on 23 July 2007. For various reasons the report was not investigated," the tribunal said.
When asked about his delay in reporting the matter to DOCS, he said he thought the system was "stressed" and "I thought I had an adequate explanation".
In June 2007 the mother brought the child to Dr Dunstan and told him that she and her partner were "under suspicion" and requested he provide her with a letter.
In it he wrote the boy's injuries were "unlikely to be caused by inflicted trauma".
The HCCC's expert witness, paediatrician Dr John Waugh, accused Dr Dunstan of colluding with the boy's mother to stymie a probe into the boy's injuries.
"The open letter the practitioner wrote at the mother’s request was an attempt to block investigation into possible non-accidental injury," Dr Waugh, director of paediatrics at Queensland's Caboolture Hospital, claimed.
"It seeks to exonerate the boyfriend."
Dr Dunstan denied the scathing assessment, and the NSW Civil and Administrative Tribunal found Dr Waugh's conclusions were "particularly unlikely" given Dr Dunstan's "exceptional reputation" and dedication over decades of practising.
He described the letter as an "error of judgment" and that he had no intention of misleading anyone.
"He said they were opinions that he 'honestly yet mistakenly held'," the tribunal said.
Dr Dunstan said he trusted the mother and, if anything, deemed her to be over-protective of her child.
"I met this family frequently and did not have any concerns about any form of abuse," he said.
In its July 2 decision, the tribunal found Dr Dunstan guilty of professional misconduct and reprimanded him.
Despite calls from the HCCC, the tribunal refused to suspend the specialist.
"It is clear that the adverse findings about his conduct in these proceedings are completely inconsistent with his character and his attitudes generally," the tribunal said.