Background
Dr Chitlapalli Sathyanath, a general practitioner, examined Patient A during a September 2022 consultation. The Medical Practitioners Tribunal found that he placed his hand inside her underwear, slowly brushed her pubic-bone region, and examined both sides of her groin. He had neither offered a chaperone nor properly explained or obtained consent for the intimate examination.
The Tribunal found serious professional misconduct but concluded that the examination was clinically indicated, that the contact with the pubic region was inadvertent rather than sexually motivated, and that Dr Sathyanath’s fitness to practise was not currently impaired. It issued a formal warning. The General Medical Council appealed under section 40A of the Medical Act 1983, challenging the findings on clinical indication and sexual motivation and, alternatively, the no-impairment determination.
The Court’s Holding
Mr Justice Morris allowed the GMC’s appeal. The Tribunal was wrong to find that the specific conduct of placing a hand inside Patient A’s underwear and slowly brushing her pubic region was clinically indicated. The Court substituted a finding that allegation 3(a)—lack of clinical indication—was proved in relation to that conduct.
The Tribunal’s rejection of sexual motivation was also wrong because it depended materially on the erroneous clinical-indication finding, treated inadvertence as Dr Sathyanath’s explanation even though he had denied the brushing occurred, and omitted material evidence bearing on motivation. The Court did not itself find sexual motivation proved. It quashed the no-impairment decision and remitted the case to a differently constituted tribunal to reconsider sexual motivation, misconduct, and impairment. The GMC’s separate impairment ground did not arise; the judge said it would otherwise have failed.
Key Takeaways
- A clinically justified groin examination does not make every act performed during that examination clinically indicated.
- A tribunal’s finding on sexual motivation may be set aside when it rests on a material factual error, inconsistent reasoning, or failure to consider relevant evidence.
- The High Court may substitute a finding on one allegation while remitting disputed questions of sexual motivation, misconduct, and impairment to a fresh tribunal.
Why It Matters
The judgment emphasizes that medical disciplinary tribunals must assess the precise conduct alleged, rather than treating the general clinical justification for an examination as justification for each act occurring during it. Findings about inadvertence must also correspond to the practitioner’s evidence and the primary facts actually found.
The decision further illustrates the appellate distinction between inferential findings, such as sexual motivation, and the specialist evaluative judgment involved in determining impairment. Although the Court intervened on the former, it did not substitute its own determination of sexual motivation or current impairment.