Warts n aAll Seamus did not hesitate to throw his hat into the ring when he saw an advertisement

for his dream jobplacement in rural equine practice in the South. Despite serious competition , he was successful, and the following January he was to be found standing in a Galway livery yard, wishing he had applied for a position in the Southern Hemisphere instead, or at the very least invested in some top- quality thermals. He was examining a horse on behalf of a prospective buyer near London, although given the would-be purchasers description of the nag in question, he was surprised to be presented with something more along the lines of pit pony, than alatent future Derby winner.. Nevertheless, he Seamus performed his examination as meticulously as possible, despite the interference ofinterfering clouds of dried mud raised emanating from the subject, every time Seamus his hands brushed the its winter coat. Admittedly, his chilled bones , together with the attraction of a brew by the livery yards wood -burner, reduced his usual enthusiasm for the job, but he certainly satisfied himself that the beast was fit for purpose. He rang his distant client with the good news and departed the yard in the warm glow of the knowingknowledge he had a happy purchaser, no doubt assisted by the nip of something a bit special slipped into his coffee by an equally delighted vendor. Seamus hadnt given the examination another thought until, a month later, he received a call from the purchasers own vet, pompously explaining, in a rather plummy accent, that several masses had been detected in the inguinal region, as soon as the horse had made dry land, which had subsequently been confirmed as sarcoids. A batch of expensive Liverpool cream was en route, and he warned Seamus that the owner, a solicitor by trade, was very much on the warpath. Seamus was not particularly concerned considering sarcoids to be merelysimply skin blemishes or, at worst, irritating warts, and he could not recall their presence during his examination anyway. But then a formal letter arrived claiming the sarcoids must have been present on the day of the PPE and in view of the potential seriousness of these tumours the purchaser would certainly not have gone ahead with the purchase, if she had been made aware of their existence. Seamus facecomplexion blanchedbleached when he read the final paragraph, a bulleted list of the losses claimed. Although he considered the sarcoids a minor finding, the new owner clearly did not, as she was seeking a grossly exaggerated purchase price of the animal, first class shipping fees (on the QE2, it seemed by the sounds of it), a refund of the cost of the his PPE, and free lifetime treatment for the offending lumps. In all, over 30,000! Taking advice from his boss, Seamus rang the Society and was quickly reassured to hear how calm the consultant sounded , in the face of what had seemed to him to be very threatening

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correspondence. Better still, the Society offered to take up the good fight, leaving Seamus stress-free ready to enjoy the early blossoming Irish Sspringhis work once more. On request, he provided the Society with a detailed account of the methodical way in which he had carried out his PPE. Although he could not precisely remember having done so in this case, he assured the consultant that his normal approach involved feeling the skin over the areas in question. He added the caveat that this pony's deep winter coat was thick with mud shrewd and in deep winter coat, so any minor blemish might have gonego undetected. The PPE certificate was a joy to behold, filled out thoroughly in copperplate handwriting, suggesting a thorough , warts- and- all, rather than a reckless approach to the examination. The Society responded to the claim, emphasising that Seamus had carried out a comprehensive examination of the pony in awkward conditions and a PPE is recognised to be simply a snapshot of the health of a prospective purchase on one particular day. As sarcoids can manifest themselves without warning, they could easily have developed after Seamus involvement. On reviewing the letter, Seamus expressed his considerable satisfaction that the Society was prepared to stand up and defend his professional reputation, so firmly. The silence from the London was deafening and, after six months, the consultant rang Seamus to say that he was going to close the file. He surprised Seamus by congratulating him for making the Societys work so easy, explaining it was more than likely that it was hisSeamuss meticulous, well- documented , examination technique which had dissuaded the legally trained claimant from taking the matter any further. He also gave Seamus an important tip by explaining that whilst Irish purchasers and practitioners tend to be pretty laid-backbe pretty prosaic about sarcoids, their cousins over the water take a rather more purist e view! Something to bear in mind , whenever , examining horses for a distant purchaser. Climb Every Mountain Having qualified in Dublin, Kevin travelled the world fulfilling his ambitions to conquer various mountains, until he returned home to set up his plate close to his beloved peaks of Killarney. In his absence H, he noted that whilst the National Park had not changed a jot In his absence, running a veterinary practice had become rather more regulated iIn Ireland. He was vaguely aware of the Premises Accreditation Scheme (PAS) and the requirement to carry the appropriate cCertificate, so having perused the VCI website, he decided that Registered Veterinary Practice (RVP) status was good enough for his ambulatory farm practiceset-up. Business was good, as he was already well- known in the area, and clients started to ask him to look at their companion animals , on occasion. H, he even carried outperformed basic surgery on a makeshift operating table rigged up in his dispensing room. One morning, a

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routine procedure did not go quite to plan, as a bitch spay bled profusely and despite all his efforts to avert disaster, she died. The farmer took the loss philosophically enough, probably stimulated by the offer to cut a few hundred Euro from his account, although he did point out his wife might not be quite soas pragmatic as she loved that dog as a daughter. His premonition was correct as, four4 weeks later, a letter from the VCI arrived, arranging a visit by two Council inspectors, following a formal complaint made by the wife. On the day, Kevin chattered away freely, happily showing the inspectors around his facilities, fully expecting them, as fellow professionals, to sympathise over the acknowledged complications of spaying bitches in a rural practice.. Their main concern, however, was his apparent breach of the Veterinary Practice Act, as his decision to register as a RVP meant he shouldnt be performing any surgery at all at the premises. They issued him with an extensive list of improvements expected forthwith, and arranged a second visit a month later, to ensure everything was in place. Poor Kevin, he certainly had a mountain to climb, but he would need rather more equipment than his climber's the hammer. he would need would not be of the rock climbing variety. Ringing the Society for advice, he learnt that there were severalthey had reports of similar visits, and although Irish vets hadhave no doubt enjoyed a satisfying momenttouch of schadenfreude as their UK counterparts moaned about the bureaucracy and the tick- box nature of the RCVS Practice Standards Scheme (PSS), the boot was now well and truly on the other foot. In 2012, it became a cCriminal oOffence to practice in the Republic of Ireland other than from premises holding an active cCertificate issued under the Premises Accreditation Scheme (PAS). not least as Aany successful prosecution of any breach of the Act could or failure to abide by the rules of the scheme is a Criminal offence with successful convictions resulting in fines of up to 5,000 or even imprisonment for up to 6 months. Once released from gaol the Veterinary Council of Ireland will investigate and offenders may ultimately be sStruck oOff the Register. The RCVS PSS now appears rather gentlemanly byin comparison! Perhaps too late, Kevin learnt that he could have asked for a VDS claims consultant to be could have been present at the inspection, and he certainly leapt at the offer for representation at the revisit, before throwing himself into upgrading his facility. The story had a happy ending, as the inspectorate was more than satisfied with his efforts, allowing Kevin to return to climbing rather than carpentryin his spare time, the many peaks of Killarney, but he also not before he suggested the Society might like to bring the issue to the attention of the Irish membership. Big Brother Keiran had the impression he was being watched as he walked made his way through the parlour performing a procedure he had carried out semi-automatically, more times than he

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cared to remember, all his working life. This was one of the largest farm units on the books and he was keen to get to the end of the job. He had a ticket to Lansdowne Road for the following afternoon and a night out in Dublin afterwardsbeforehand that evening understandably attracted him more than the monotonous nature of his present task. He jumped out of his skin as two heads popped up at the a parlour window, one a red- faced individual withsporting a fine pair of binoculars, and t around his neck. The other, a bit shorter, with a clip board in hand. They were gesticulating to Keiran and, suspecting them to be twitchers in need of local knowledge, he walked over. It turned out that one was a veterinarian and the other a member of the DARD inspectorate, and he was surprised to learn the real reason for their presence was not to spot birds, but to investigate serious breaches of the TB- testing protocols. Kieran believed he followed a pretty decent practical protocol, honed after many years experience, albeit , not strictly complying precisely to the rulesapplying the letter of the law in to his technique. Who were these two y to comment on his intradermal tuberculin peas, as after all, when had this vetey last been found in the field with a set of TB guns? Having Pperhaps unwisely Kieran voiced his opinion on the impractical obligations the DARD imposedset on a poor practitioner, but the dynamic duo looked distinctly unimpressed and advised he would soon be receiving a letter from the Department. A formal- looking letter did indeed arrive from the DARD inviting Keiran to an interview at their offices, with the recommendation that he taketook professional advice. Realising, slightly too late, that the money he earned from TB testing played a significant role in putting food on his childrens plates and that the DARD had the power to remove his tester status, he picked up the phone to speak to one of the Societys consultants. The consultant listened to his sorry tale, including his acceptance that he his mind might have been day- dreaming about ODriscoll crossing the try line, rather than concentrating on his testing technique. She then explained that Kieran was not the first, nor would he be the last, to feel as if he had been summoned to the Headmasters study, but this was a process to be taken seriously. Kieran was relieved to learn that the Society would provide someone experienced to accompany him to a consultant for the interview, admitting he had been known to occasionally to be a littleget hot- headed in stressfultight situations. When the day arrived, the consultant accompanied Kieran, in, who had pulled out all the stops by donning his Sunday best, . He followed histhe pre-interview briefing admirably by adoptingsticking to a contrite approach, accepting he had perhaps not performed to the best of his abilities on the fateful day. The only period of tension arose when the interviewers suggested a period of retraining might be in order. As Kieran was about to launch into his word- perfectwell-practised discourse on the inadequacies of the current scheme and how he had been testing when the interview panel were still in nappies, he fortuitously glanced in the direction of his VDS mentor, whose facial across at the consultant

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opposite and her expression alone was sufficient to dilute the strength of his reaction to a mild settle him down to simply harrumph whatever, you think. Kieran rang the Society the following week to confirm that the DARD had closed the case as long as he agreed to take part in a DVO- supervised test. He explained he was happy to comply as it would give him the perfect opportunity to have his say with the DVO! He had the good grace to express his gratitude for the guidance he'd received,thank the consultant for her time and patience, acknowledging that without whichher guidance he mightmay well have suffered a long period of suspension and financial hardship. It was She explained that the Societys attendance at all regulatory interviews was important, as no vet should attend without representation, whichand their role was particularlyalways appreciated by members particularly those who sometimes struggle to bite their tongue. tongue! Optic Nerve Mary, a Dubliner by birth, was happily ensconced happily in her idealdream job attending to the local dairy farming community in County Wicklow. The only fly in the ointment was the requirement to cover Saturday morning clinics, when the local population was , swelled byvia the influx of second- home owners fleeing Dublin to enjoy the rural delights of the countryside.. Whereas the indigenous population took a pragmatic approach to view towards companion pet animals, she found the temporary city in-comers toco uld be far more demanding. One Saturday, Mary found herself facing a middle-aged couple with their cat Allana. It came as a great surprise to Mary her that anybody should consider holidayingcaravanning with their cat in the first place, but to interrupt your vacationholiday to seek attention for the small injury Allana had suffered, presumably at the claws of a proper Wicklow cat, beggared belief. Although the ownerscouple showed considerable enthusiasm for Marys decision to prescribe antibiotics, they were quick to point out that Allana was allergic to penicillin. Mary would be the first to admit that feline medicine was not really her strong point, but surveying the pharmacy shelves, her eyes alighted upon an enrofloroxacin product. Based on her mistaken belief that all feline antibiotics requiredhad the same dose rate, she prescribed the 50mg tablets twice daily. It was neverwasnt going to be that simpleeasy, of course, as the couple scanned the packet of tablets minutelyreligiously and questioned the picture of a dog on the packet. Mary dismissed their concerns , because, as despite having missed certain sections of the pharmacology course, due to her greater love for Camogie, she knew the medication was licensed for cats.

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Several weeks later, Mary received a letter written in large, bold capitals. Fearing the worst,e, she grabbed a cup of coffee and sat down to read the itcorrespondence carefully. Allana had apparently developed neurological problems following her second dose of medication and hertheir usual vet had declared her permanently blind. Wishing to do everything for Allana, which after all means Dear Child in Gaelic, the ownersy had taken her to an eye specialist at a Veterinary Hospital, where retinal damage associated with an enroflofloroxacin overdose was confirmed. Mary now learnt that this was a rare, but recognised side- effect of the drug in cats and kicked herself for her decision to use antibiotics , simply to appease the owners. After all, she believed the wound would have probably have healed with benign neglect. It was the last paragraph of the letter that causedled her to shiver. The owners had spent a staggering 25,000 k converting their Dublin townhouse into accommodation safe for a blind cat and now employed a full- time carer during the day. In addition, they hoped to take Allana to America, for an experimental stem cell procedure which could possibly restore her sight, evidently expecting Mary to cover all their expenses. As these amounted to over 35k 35,000, they were clearly not intending to fly RyanA Air! Marys employer, equally shaken by the letters contents, pointed her in the direction of the telephone and she dialled the Societys number. She relaxed slightly when the consultant explained that such dispensing errors had been the subject matter of several claims, although he had to admit the sum sought was disturbing, especially as liability would have to be conceded. Over the next two years, the Society negotiated with the owners who became entrenched in their position seeking over 75k 75,000, eventually so eventually all was set for a grand day out in a Dublin cCourt. With the Societys considerable support, both practical and psychological, Mary also dealt with the additional stress of a VCI complaint regarding her approach to prescribing veterinary medicines. As the Precious claim was conspicuously disproportionate to the cats value, the Society hoped a JJudge would consider it entirely speculative, but the potential liability for both sides legal fees was risking breaching Marys indemnity limit of 100k 100,000, thereby exposing the practice, as underinsured and the partners, who had not expected to be so underinsured, to having to put their hands in their own pockets. As a last throw of the dice, the claims consultant rang the owners who readily accepted they had somewhat lost sight of reality, as but they just wanted Mary punished as Allana was their little baby. They were actually every bit as worried about the risks of paying the ever rising legal costs in case it was them who lost the game of bluff. The Society negotiated a final settlement of just over 25,000k without the partners ever having to worry about their houses needing to be putmight have to go on the market. With

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some relief, they pointed out that, on noting the VCI's intention that was intending to ensure carrying appropriate professional indemnity iInsurance cover shwould bewas made compulsory, they had pre-empted the decision by taking out VDS cover the previous year. Looking at the 25,00025k pay-out for a simple prescribing error, they realised it was common -sense to have cover in any caseanyway, as if small animal claims hit this level, what mightmust their dairy farmers be after! The consultant explained VDS was receiving ever- increasing numbers of speculative claims from all directions in every legal jurisdiction, which risked breaching the traditional indemnity limits chosen by small animal practices. For this reason alone, in 2014, the minimum indemnity limit would increase to 125,practitioners. For this reason alone in 2014 the minimum policy limit will increase to 125000k, though without any increase in premium for our Irish members. Mary admitted she had not realised how much stress and potential financial loss such a simple error could bring to her employers door, and the only good thing to come out of the whole affair was her obligation to cover the Saturday morning clinic had been removed by the partners, leaving her only to worry only about the dosing cattlebyres in future. Careless Talk Costs Lives Brian and Patrick had been the best of friends for as long as they could recall, after first bonding at school playing Gaelic football together. Patrick after a short period of adventure s hed perhaps been best advised not to recount to his mother, had returned to his native Kerry to take up a position at the local practice. Brian on the other hand had never left the county, preferring instead to take up the reins onof the family farm. That diddoes not mean he was, unambitious, however, as he was keen to improve the farm's enterprises fortunes by signing up for any health scheme that might give him an advantage in the areamarket. On discovering Patrick had returned to his roots, he insisted he would have nobody else on the farm. Brian persuaded Patrick to join the local football club and it was like old times once again, the only difference being they shared a pint of the black stuff when the final whistle blew, rather than the lukewarm orange juice of their school days. During their evenings in the clubhouse before the natural effects of alcohol removed any sense of reality from their conversation, Patrick would answer Brians queries and effectively rubber- stamp ed his Herd Health Plan, albeit verbally. The following twelve months, whilst the social life and football werewas good, Brian hit bad times on the farm with a steady fall in his production targets despite significant and widespread investment in itsfarm infrastructure. The chats in the clubhouse were getting later and more maudlin as Brian poured out his woes, includingand pointed out the increase in his veterinary account since Patrick had become involved.. The reason for his current difficulties was, in fact, an IBR problem, and as the stress of the financial burden

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tightened its screw on Brian, old friendships were quickly forgotten, and he started to blame Patricks lack of clear advice , as the source of all his present woes. The senior partner was eventually called in to manage the situation and Patrick was no longer the welcome visitor he had once been on the farm. A local solicitor, ironically also a regular at the same local Gaelic football club and a former classmate of the duo, was instructed by the Brian to recover his financial losses due to the significant decrease in production blamed on , due to Patricks alleged failure to regularly update the Herd Health Plan in writing. Brian accused Patrick of specifically of failing to recommend more stringent IBR control measures, and was looking for over 500,000k in compensation. Fair to say, Patrick stopped being a regular at the clubhouse from the moment the solicitors letter hit his doormat. The Society was Patricks first port of call in this particular friendless storm. The consultant was sympathetic, but when he looked at the original plan which regrettably looked as iflike it could have been written on the back of a soggy bear mat, he thought they might be on a sticky wicket. In addition, Patricks, perhaps understandably, loose descriptions of his latenight updates in the football club bar did not inspire fill the consultant with any confidence that a judge might consider his approach to be adequate or professional, especially as his comments never made it ithe small leap onto the practices farm records. Claims associated with Herd Health Plans or equivalent arewere an increasing focus of attention for the Societys farm animal claims consultants often proving to be some of the most complex and expensive cases handled by the VDS. Supermarkets, the government, and trade associations in Ireland are all keen to demonstrate the healthy provenance of Irish food production, but are even keener to ensure that if the plans go pear-shaped, the veterinary surgeon, as nominated professional in charge, is the fall guy. Nevertheless, Patrick was reassured that this was the very reason for having professional indemnity insurance cover in place. In addition, as his employer had sensibly chosen a 1million limit, and although he may have lost a couple of friends, he certainly should not have to spend any sleepless nights worrying about losing his own assets. The Society instructed an agronomist Farm Management Consultant to address the eyewatering quantum of the claim and eventually settled the matter for 175,000 damages plus an equivalent amount in legal costs. It was a reminder of the hazards of producing health plans especially on an ad hoc basis rather than via regular, written, updates. These claims can reach bewildering sums usually for consequential production losses, and indemnity limits are soon breached risking thereby risking members assets. The risk of a big claim is increasing, hence the Society'sour evolved policy for 2014. It offers ing higher indemnity limits for all, based on an individuals

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specific risk, but with no significant premium increase for those previously appropriately insured. For example, the new entry level for farm vets of 1million should ensure that theyfarm vets can all enjoy a peaceful night's sleep. peacefully at night.

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Question Our clients ask us to come over to the UK occasionally to vet horses at auction sales on their behalf . at auction sales. We assume being registered with the VCI will see us right but would like some reassurance that we are rightcorrect, our assumption is indeed fact or do we need also to be a mMembers of the Royal College of Veterinary Surgeons? Answer All Irish Graduates listed in the Southern Ireland section of the RCVS Register can legally work in the UK but only after notifying the College of their intention to visit for a temporary period and completing an Item of Service declaration. There is of course no such thing as a free lunch and the College charges a small administration fee. Alternatively, to work for longer periods, or even permanently, in the UK it is necessary to be fully registered on the UK practising list. Rest assured that, in both situations, policy cover with the Society is valid for working anywhere in the UK, and it is not necessary to inform the officeus that youabout are travelling over the water to work. It is, of course, necessary to inform or be registered with the RCVS, as outlined above, in order to avoid , although we will expect members to be appropriately registered with the College, so you are not working illegally. In addition, it is always prudent to ensure thatyour indemnity limits are is appropriate to the value of the horses being examined. It is quite acceptable and it is of course possible to request short term uplifts in indemnity limits, ifas necessary.

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