I did not keep cancer patient in the dark, doctor tells GMC hearing


A doctor at the centre of sports doping allegations has said he did not keep a cancer patient in the dark that her condition was terminal.

The woman knew there was no cure and Mark Bonar was simply fulfilling her wishes to "hold on to as many days as she could in this world", a disciplinary tribunal heard.

The London-based doctor administered "unconventional" nutritional treatment to Patient A at a time when it was dangerous to do so and unlikely to improve her health, the General Medical Council (GMC) claims.

The GMC also claims he failed to inform Patient A, an American woman in her 40s, that the spread of cancer meant there was no hope of a cure.

Dr Bonar, 38, insists he was merely following a treatment plan said to have improved her quality of life and that she had already been informed by numerous medics that she was dying.

Earlier this month, Dr Bonar was reported to have claimed to have treated more than 150 sports people, including Premier League footballers, with banned substances including EPO, human growth hormones and steroids.

He dismissed the Sunday Times allegations as "false and very misleading".

Since last year he has faced unrelated matters in relation to his care of a cancer patient at a five-star Mayfair hotel apartment between December 2013 and January 2014.

A Medical Practitioners Tribunal Service panel sitting in Manchester could strike him off the medical register if they find any misconduct has impaired his fitness to practise. His licence is currently suspended.

Patient A, surrounded by her sister and her "sister's entourage", received total parenteral nutrition (TPN) - a form of intravenous feeding lasting eight hours per day - at the apartment after she was previously administered it in Germany by another doctor.

Two nurses on the treatment team became concerned about her quality of care, the panel heard, and admitted Patient A to hospital as an emergency on January 16. She died two months later.

Summing up his client's case, Gary Summers, representing Dr Bonar, told the panel the nurses' version of events was disputed and they had "tried on several key issues to pull the wool over your eyes".

He said Patient A had been told by a number of medical professionals during 2013 that her condition was terminal.

Mr Summers said: "He discussed with Patient A her prognosis. Patient A certainly knew that. She knew that from several professionals who, forgive me, were far higher up the medical chain than Dr Bonar. It was simply not an issue."

The NHS-registered GP was said to be have been forced into "a temporary arrangement" of treatment by December 2013 at the apartment after the womans' family had run up huge medical bills and been blacklisted by most private practices in London.

He said her wishes were to continue receiving TPN after previous treatment in Germany for two a half months which "transformed her quality of life" from flying out in a wheelchair to walking after her return to the UK.

Mr Summers said: "Patient A was desperate to hold on to as many days as she could in this world.

"What was Dr Bonar to do ... throw up his hands and indicate that he was refusing to do anything for this patient or was he to look at the circumstances, checking the position in relation to TPN and try to fulfil the patient's wishes?

"That was his patient's wishes. It is simple as that."

Dr Bonar followed the treatment plan of the German doctor which had been "tried and tested" and had Patient A's best interests at heart, it was said.

He denies administering TPN when it was not clinically indicated, dangerous and unlikely to improve Patient A's health.

Another doctor who treated Patient A at the apartment, Siegfried Trefzer, denies similar misconduct allegations.

Both deny failing to take overall responsibility for the woman's care or to ensure there was a clinician with overall responsibility.

Charles Garside QC, for the GMC, has said Dr Bonar's treatment made Patient A's discomfort "worse rather than better" as she was treated ineffectively in "chaotic conditons".

He said the two nurses had no reason to lie to the tribunal.