AN A&E doctor investigated for "slapping" a male patient during treatment has been cleared of wrongdoing.

A tribunal found that Dr Ziyad Al-Janabi's actions were "not aggressive and did not cause the patient harm", and that his primary aim had been to calm a situation in which the man was "lashing out and putting himself and others at risk".

In its determination on the case, the Medical Practitioners Tribunal Service (MPTS) concluded that Dr Al-Janabi's fitness to practise is not impaired and it was also not necessary to issue him with a warning.

The incident occurred during a "busy Saturday night" shift on May 23 2020 while Dr Al-Janabi was working as an emergency medicine specialist at University Hospital Ayr.

At the time he was based in the 'Red Resus' area, where very unwell patients with suspected Covid were being admitted for treatment.

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Patient A arrived by ambulance at A&E semi-conscious following an apparent drug and alcohol overdose, but subsequently became "agitated and combative, trying to shuffle off the bottom end of the trolley in order to get off it", according to the tribunal's findings.

Staff - including nurses and a junior doctor - were said to have called for Dr Al-Janabi's help after being unable to restrain the patient, who is described as a "large man".

However, concerns were raised by colleagues about Dr Al-Janabi's conduct after he shook and slapped the man in the face while repositioning him back on the trolley, before saying "that felt good".

The case was ultimately referred to the General Medical Council for investigation, before being brought to the MPTS for determination.

The tribunal concluded that Dr Al-Janabi - who qualified in medicine at Glasgow University in 2002 - had "moved swiftly to take control of a difficult situation", adding: "Dr Al-Janabi lifted Patient A back on to the trolley, held Patient A’s head in his hands while shaking it up and down and shouting at him to get his attention; that shaking had been neither vigorous nor harmful.

"On failing to get Patient A’s attention by other means, Dr Al-Janabi had then slapped the patient on the cheek, a little harder than he might have done had he been administering a tap in a calm clinical setting.

"On realising that his actions had startled those present, Dr Al-Janabi had said words to the effect of ‘that felt good’ in an ill-judged attempt to lighten the atmosphere."

The tribunal said it was "satisfied that Dr Al-Janabi’s first concern had been Patient A’s safety and the safety of staff in the room", given that "large amounts of sedation had failed to stabilise [Patient A]".

There was no evidence that the patient had suffered any harm as a result, it said.

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The tribunal also cleared Dr Al-Janabi of an allegation of shouting "inappropriately" at the man, and noted that the incident had not impaired his working relationships at the hospital.

It said: "[The tribunal] accepted that Dr Al-Janabi’s actions startled three of the four colleagues who were present, but there was no evidence before it that he had otherwise failed to maintain good relationships with colleagues.

"To the contrary, those witnesses who have continued to work with Dr Al-Janabi have done so without incident and have been happy to work alongside him again."

Dr Al-Janabi admitted that his "that felt good" comment after slapping the man had been "crass and ill-judged", but said it had been an attempt "to lift the tension of the situation after a lot of extreme physical exertion had taken place just seconds before".

The tribunal concluded that the statement had "compounded, rather than alleviated the atmosphere in the room", but did not amount to misconduct.

It said: "The Tribunal does not consider that a crass statement made to colleagues following a difficult patient intervention such as this fell below the standard to be expected of a doctor in all the circumstances.

"At the point the comment was made, Patient A was unresponsive and unaware of his surroundings.

"The Tribunal, while accepting that a patient in this state can have their dignity infringed, did not consider this to be the case here."

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The tribunal added that while "shaking a patient and slapping them on the face to get a response was a departure from accepted practice", this was "not sufficiently serious a departure as to reach the threshold for a finding of misconduct".

It added: "The shaking was neither vigorous nor harmful, and was done only for the purpose of getting Patient A’s attention and calming him. The slap was not aggressive and did not cause the patient harm."