Following a five-hour hearing, the Fitness to Practise Committee of the Medical Council concluded that there was no evidence of poor professional performance on the part of a Monaghan  doctor.

Patrick Connolly, a 69-year-old man in the early stages of Parkinson’s disease, attended the surgery of Dr Michael J Clarke, who has a practice in Castleblayney, Co Monaghan, on February 25th, 2011, complaining of soreness in his chest and neck.

He died approximately 12 hours after attending the surgery, having suffered a cardiac arrest.

Mr Connolly was driven to Dr Clarke’s practice by his daughter Rosaleen Sweeney, the hearing was told. Ms Sweeney said that her father was distressed on the way to the surgery and was rubbing his chest and neck and “wasn’t himself”. She also told the hearing that her father was in the early stages of Parkinson's Disease. He was taking medication but was otherwise in good health.

During the examination Dr Clarke, who has been a GP in Castleblayney since 1989 and is also a general-practice trainer, said he asked Mr Connolly a series of questions in order to clarify whether his discomfort was of a cardiac origin or some other origin.

He noted that Mr Connolly's blood-pressure records on previous visits had been normal for a man of his age and that he had not complained of symptoms such as shortness of breath or tightness in the chest.

Dr Clarke added that he conducted an examination of Mr Connolly's chest and noted gynecomastia -- a swelling of the tissue in the left breast. He did not carry out a cardiovascular examination.

He told the hearing: "In view of Mr Connolly's general wellbeing, his answers to questions and the findings of my examination, I concluded the symptoms were musculoskeletal in nature and I treated him for that."

Dr Clarke advised Mr Connolly to take paracetamol for the pain and referred him to a neurologist in Beaumont Hospital.

Prof Tom O’Dowd, who also gave evidence at the inquiry, said given that the patient did not have a history of cardiac problems and was experiencing breast tenderness, that it had been reasonable for Dr Clarke to conclude that the pain was musculoskeletal in origin.

That evening Mr Connolly suffered a cardiac arrest and died.

A postmortem revealed Mr Connolly had suffered a heart attack seven to 10 days before he died, described as a “silent event” by Simon Mills, appearing on behalf of Dr Clarke.

The Medical Council found that the allegation against Dr Clarke – that he had “failed to carry out any or arrange any adequate examination or investigation” of the patient – was not proven and found that the examination carried out by Dr Clarke was adequate.

It noted that two expert witnesses -- GP Dr Stephen Murphy and Professor Tom O'Dowd -- were satisfied that Dr Clarke's examination of the patient was adequate in all circumstances.

It was also noted that Dr Clarke had referred the patient to a neurologist.

Giving evidence, Dr Clarke said it was possible that the myocardial infarction may have shown up on an electrocardiogram.

Following a five-hour hearing, the Fitness to Practise Committee of the Medical Council concluded that there was no evidence of poor professional performance on the part of a Monaghan  doctor.

Patrick Connolly, a 69-year-old man in the early stages of Parkinson’s disease, attended the surgery of Dr Michael J Clarke, who has a practice in Castleblayney, Co Monaghan, on February 25th, 2011, complaining of soreness in his chest and neck.

He died approximately 12 hours after attending the surgery, having suffered a cardiac arrest.

Mr Connolly was driven to Dr Clarke’s practice by his daughter Rosaleen Sweeney, the hearing was told. Ms Sweeney said that her father was distressed on the way to the surgery and was rubbing his chest and neck and “wasn’t himself”. She also told the hearing that her father was in the early stages of Parkinson's Disease. He was taking medication but was otherwise in good health.

During the examination Dr Clarke, who has been a GP in Castleblayney since 1989 and is also a general-practice trainer, said he asked Mr Connolly a series of questions in order to clarify whether his discomfort was of a cardiac origin or some other origin.

He noted that Mr Connolly's blood-pressure records on previous visits had been normal for a man of his age and that he had not complained of symptoms such as shortness of breath or tightness in the chest.

Dr Clarke added that he conducted an examination of Mr Connolly's chest and noted gynecomastia -- a swelling of the tissue in the left breast. He did not carry out a cardiovascular examination.

He told the hearing: "In view of Mr Connolly's general wellbeing, his answers to questions and the findings of my examination, I concluded the symptoms were musculoskeletal in nature and I treated him for that."

Dr Clarke advised Mr Connolly to take paracetamol for the pain and referred him to a neurologist in Beaumont Hospital.

Prof Tom O’Dowd, who also gave evidence at the inquiry, said given that the patient did not have a history of cardiac problems and was experiencing breast tenderness, that it had been reasonable for Dr Clarke to conclude that the pain was musculoskeletal in origin.

That evening Mr Connolly suffered a cardiac arrest and died.

A postmortem revealed Mr Connolly had suffered a heart attack seven to 10 days before he died, described as a “silent event” by Simon Mills, appearing on behalf of Dr Clarke.

The Medical Council found that the allegation against Dr Clarke – that he had “failed to carry out any or arrange any adequate examination or investigation” of the patient – was not proven and found that the examination carried out by Dr Clarke was adequate.

It noted that two expert witnesses -- GP Dr Stephen Murphy and Professor Tom O'Dowd -- were satisfied that Dr Clarke's examination of the patient was adequate in all circumstances.

It was also noted that Dr Clarke had referred the patient to a neurologist.

Giving evidence, Dr Clarke said it was possible that the myocardial infarction may have shown up on an electrocardiogram.