Havelock North chiropractor Melissa Vetter censured, fined $20,000

A Havelock North chiropractor has been censured after a charge of professional misconduct. Photo / File

"Improved", "cough cough cough", "more falling!!!!" – these were among the "inadequate" notes taken by a Havelock North chiropractor on 7156 occasions over nine years.

Dr Melissa Vetter has been censured and fined $20,000 for professional misconduct, which occurred while she worked at Havelock North Chiropractic from 2007 to last year.

Yesterday the New Zealand Health Practitioners Disciplinary Tribunal released its decision on a charge of professional misconduct, which was heard in Napier on October 18. Dr Vetter did not defend herself.

She was charged with professional misconduct by a professional conduct committee (PCC) of the New Zealand Chiropractic Board, which alleged she conducted herself in an inappropriate and/or unprofessional manner on two matters.

The first referred to failing on numerous occasions to create clinical records for her chiropractic patients. The second matter was failing to record an adequate patient assessment on numerous occasions.

Over nine years between 2007 and 2016, there were 7156 instances in which a patient was seen by Dr Vetter, and no clinical notes were recorded.

Yesterday's decision states she admitted for the majority of patients she did not create any clinical record "whatsoever", despite acknowledging she had a professional responsibility to record a patient's progress.

Concerns arose around late 2013 or early 2014 about Dr Vetter.

On occasions she and colleague Dr John Hawtin would see each other's patients. He became concerned Dr Vetter's patients' notes did not contain sufficient information to enable him to do a proper assessment, or to continue with treatment.

He raised these concerns informally on several occasions.

It was also found a number of Dr Vetter's patient notes were incomplete, or "substandard", and did not contain enough information for Dr Hawtin to do a proper assessment.

In June 2014 he raised concerns she had not maintained or recorded any x-ray measurements, factors, or dosages for the previous year. In September, he provided emergency care to one of Dr Vetter's patients and found only one record containing the word "improved" for the previous eight appointments.

Other inadequate records of patients shared between the two included notes stating "on the improve", "much improved", "more falling!!!!", "cough cough cough", "gardening!!!!", "was hit in the jaw".

In December 2015 Dr Hawtin made a complaint to the Chiropractic Board about his concerns.

Yesterday's decision stated he said he had no understanding why Dr Vetter chose not to keep records, or to keep inadequate or substandard records. Their record-keeping system was electronic and readily available.

The tribunal said there had been a "clear failure" by Dr Vetter to create adequate clinical records, and to record adequate patient assessment.

"The severity of this aspect is aggravated by the fact that Dr Hawtin drew the inadequacies to Dr Vetter's attention but she did nothing to improve things," the decision states.

These failures placed patients at risk - including that she would be relying on her memory, or might not be addressing all of the questions she needed to for a proper consultation.

"There was malpractice and negligence on Dr Vetter's part in these failures and they constitute acts and omissions which bring discredit to her profession."

"Dr Vetter needs to know, and the profession needs to know, that failures of this kind place the public at risk and lower standards in the profession."

The tribunal ordered Dr Vetter be censured. It also ordered a number of conditions were to apply to Dr Vetter's practice.

These included supervision of Dr Vetter as a chiropractor for 18 months with the supervisor reporting to the Chiropractic Board at least three-monthly with express focus on note-keeping, and to take courses on note taking.

Dr Vetter was also ordered to contribute $20,000 towards the costs of the PCC and of the tribunal - $13,333 to the PCC and $6666 to the tribunal.

Dr Vetter left the centre in March 2016 to relocate her chiropractic practice to premises where she had already established a Pilates practice.

She was unavailable for comment yesterday.