A consultant dermatologist, accused of poor professional performance and professional misconduct against a number of patients, is facing a fitness to practise inquiry.
A hearing of the Irish Medical Council has opened in Waterford and heard allegations against Dr Adam Jacobus Smith, 65, whose address is given as Co Kilkenny.
The complaints are being made by the Munster Dermatology Group.
Dr Smith has worked as a consultant dermatologist in the Whitfield Clinic in Waterford, Aut Even hospital in Kilkenny, and Barringtons Hospital in Limerick.
The public hearing is expected to last three days and involves 12 patients.
The hearing was told that Dr Smith was born in Zimbabwe (then Rhodesia). He became a naturalised South African and qualified as a doctor in 1973. He practised as a dermatologist for 22 years and came to Ireland in 2002 when he worked as a locum in Sligo General Hospital. He went to Holland for a time before registering with the Irish Medical Council in 2005 as a specialist in dermatology.
The 12 patients at the centre of the allegations came under the care of consultant dermatologists, who are members of the Munster Dermatology Group, after being treated by Dr Smith. Seven of the patients are expected to give evidence in these public hearings.
The allegations include that Dr Smith failed to diagnose certain conditions in a number of patients; failed to take skin biopsies in certain cases; failed to take adequate patient history; failed to provide adequate treatment; failed to take blood tests; failed to arrange adequate follow-ups; and sometimes failed to "apply appropriate standards of clinical judgement".
The first patient who gave evidence was a man in his 60s from west Waterford who went to Dr Smith privately in November of 2008 with a rash on his left leg. The man, known as Patient A, said it would have been four months before he would have seen a consultant in Waterford Regional and that was why he went privately.
He said Dr Smith examined him for "three or four minutes" but said there was no conversation between him and the doctor, that he didn't ask him any questions, and that when he asked him what was causing the rash, the doctor said he would write to his GP.
He was later diagnosed with calciphylaxis by consultant dermatologist Dr John Burke in Cork University Hospital, a rare skin disorder, after a biopsy. The rash subsequently cleared up with different medication.
Gabriel Gavigan, Senior Counsel for Dr Smith, said his client had a different version of events. Mr Gavigan said his client could not have diagnosed the calciphylaxis or ordered a biopsy as he wanted to first ensure there was no skin infection, which is why he had ordered an MRSA swab.
A second patient, a retired garda sergeant from Waterford, went to see Dr Smith privately after he had been told there was a waiting list of 16 months to see a consultant publically. The patient - referred to as Patient B - had a rash on his chest. He told the hearing that Dr Smith had not said a lot and did not explain to him what he thought might have been wrong with him.
In cross-examination, Counsel for Dr Smith, on behalf of his client, again differed with the evidence given.
In both cases, Dr Smith is alleged to have had poor professional performance.
Another witness, Dr Gillian Gibson told the hearing there was "collective concern" among members of the Munster Dermatology Group about patients who had been seen by Dr Smith and her own concern in Patient B's case was that Dr Smith did not order a skin biopsy.
