London vet struck off for dishonesty and misleading clients

On 19 May 2009, the Disciplinary Committee (DC) directed that Kfir Segev, of the Medivet practice in Stanmore, London, should be removed from the Register, having found him guilty of serious professional misconduct for deliberately concealing from his clients that their dog was terminally ill, whilst at the same time recommending that she undergo expensive and unnecessary procedures.

The Inquiry, which began in November 2008, resumed in March 2009, and resumed again in May, lasted for nine days.

The Committee heard how, in November 2006, Mr Segev had been asked to treat Zoe, a greyhound lurcher, as she was completely lame on one leg and appeared to be in great pain. Mr Segev had not been the owners’ usual veterinary surgeon; indeed, Zoe had undergone treatment for a jaw tumour at a different practice the previous year.

Zoe was admitted for pain relief and further investigation, including blood samples and radiographs, and hospitalised overnight.

She received acupuncture the following day and, after a consultation between her owners and Mr Segev that evening, was then sent home, apparently pain-free.

Still showing occasional distress the next day, Zoe was hospitalised again for further assessment, before returning home again that evening.

The owners were, however, clear in their evidence that, over the course of several subsequent conversations with Mr Segev, he told them that there was no recurrence of the cancer from the previous year, and recommended Magnetic Resonance Imaging (MRI) scans and taking Fine Needle Aspirates (FNA).

Having become unhappy with Mr Segev’s treatment, advice and the cost of the recommended treatment, the owners then decided to return to their usual veterinary surgeon.

Examining the radiographs Mr Segev himself had taken, a diagnosis of metastatic neoplasia was immediately made, an opinion that was subsequently confirmed by an oncology specialist who recommended palliative care until euthanasia became necessary.

The Committee had to decide, firstly, whether Mr Segev was aware of the condition of Zoe’s lungs from the radiographs he took and, if so, whether he deliberately and dishonestly withheld this information from her owners; and, secondly, whether Mr Segev had recommended Zoe undergo an MRI scan and FNA and, if so, whether he knew that this was unnecessary and/or would not promote Zoe’s welfare.

The Committee noted Mr Segev’s evidence that he had recognised tumours shown in his own x-rays, and that Zoe’s condition was terminal, and that he had discussed this with the owners personally at the end of a lengthy consultation when Zoe’s leg pain and lameness were discussed.

This contrasted starkly with the owners’ account that Mr Segev had dismissed the details showing on the x-rays as ‘old scar tissue’.

The Committee rejected Mr Segev’s version of events as “wholly incredible”, preferring the owners’ evidence.

The Committee was also “astonished” that, knowing the dog’s condition, Mr Segev would embark on a long explanation of the bony anatomy of the dog and possible causes of leg pain (which was already resolving with analgesia and rest), before explaining to the owners that the earlier cancer had spread and Zoe’s condition was hopeless.

This “obvious and overwhelming diagnosis” had not been recorded in the contemporaneous clinical records which instead “focused on examinations, procedures, tests and medication for which charges could be made”. The only reference to lung lesions appeared to have been added later.

After carefully considering all the evidence before it, the DC found the first allegation proved, in that Mr Segev lied to Zoe’s owners about the recurrence of her cancer by dishonestly representing the radiographs that he took of her chest.

The second allegation, that he did in fact know the additional diagnostic work he recommended was unnecessary and would not promote Zoe’s welfare, was also found proved.

Mr Segev’s contention that he was simply responding to the owners request for further information and possible tests to diagnose Zoe’s condition was therefore rejected. Expert witnesses for the College stated there was no point in subjecting a dog with terminal cancer to FNAs and MRI scans, the latter being an “eccentric proposal”.

In view of the Committee’s findings, Mr Segev himself then admitted that he was guilty of serious professional misconduct, a viewpoint with which the Committee unanimously agreed, stating: “We take the view that Mr Segev’s conduct amounted to a serious dereliction of the fundamental duty of trust between a veterinary surgeon and his clients.

"The reputation of the profession is inextricably linked to its approach to financial matters, and trust is easily lost when there is abusive behaviour. Mr Segev was guilty of such behaviour.”

Announcing the Committee’s decision on sanction, DC Committee Chairman Mrs Alison Bruce said: “We entirely accept that unequal power exists between the veterinary surgeon and the client, and it behoves the veterinary surgeon to exercise that power in a true, wise and proportionate manner.

“We have found Mr Segev to have been deliberately dishonest, not only with his clients, but with the College and this Committee. In so acting, he has betrayed the owners’ trust, brought the profession into disrepute, and his recommended course of treatment would potentially have jeopardised the welfare of an animal entrusted to his care.

“We are not persuaded that the sanction of suspension is sufficient to uphold the good name of the profession and protect the public interest.”

Mrs Bruce then directed that Mr Kfir Segev be removed from the Register.