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Doctor convicted of manslaughter is suspended from register for a year

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2928 (Published 15 June 2017) Cite this as: BMJ 2017;357:j2928
  1. Clare Dyer
  1. The BMJ

A hospital doctor who was convicted of manslaughter by gross negligence in the treatment of a 6 year old boy who died from sepsis and heart attack has been suspended for 12 months by a medical practitioners’ tribunal.

Hadiza Bawa-Garba was a senior specialist registrar in paediatrics at Leicester Royal Infirmary in February 2011 when Jack Adcock, who had Down’s Syndrome, was admitted with diarrhoea, vomiting, and difficult breathing.

Bawa-Garba initially diagnosed gastroenteritis and ordered a fluid bolus, chest radiography, and blood tests. But she did not review the x ray pictures or the blood test results for hours after they became available and failed to appreciate the import of the blood results when she finally did see them.

She failed to make a note that his routine medication for high blood pressure should be discontinued, leading him to receive his normal dose, and failed to ask a consultant to review him. As the boy’s condition deteriorated sharply that evening, a crash call went out, which she answered. On finding others trying to revive him she told them to stop, saying that he had a “do not resuscitate” order. In fact, she had confused him with another child. Her mistake was noticed within two minutes by a junior doctor and was not believed to have contributed to Jack’s death, which was inevitable by that point.

An investigation by University Hospitals of Leicester NHS Trust found numerous errors by Bawa-Garba and nursing staff but also blamed systemic failures. She was interviewed by police in 2011 but was told in 2012 that no charges would be pressed. She then continued working at the trust with no further incidents until her conviction in 2015.1

Both she and a nurse were convicted of manslaughter and received sentences of two years’ imprisonment suspended for two years.23 An attempt to appeal against her conviction failed last December.4

At her fitness to practise hearing before a medical practitioners’ tribunal in Manchester, lawyers for the General Medical Council argued that she should be struck off. The wholesale collapse in the standard of care she offered that day had come out of the blue, said Stuart Denney QC, and might therefore recur at any time. But he conceded that she had done everything possible since the incident to remediate her clinical failings.

In opting for suspension instead, the tribunal’s chair, Miran Uddin, said that the tribunal took account of “multiple systemic failures” that had been identified in the trust’s investigation, Bawa-Garba’s unblemished record before and since, and evidence from colleagues and consultants who called her an excellent doctor.

“The tribunal therefore determined that whilst your actions fell far short of the standards expected and were a causative factor in the early death of Patient A, they took place in the context of wider failings,” said Uddin. “Erasure would be disproportionate.”

Uddin added, “The purpose of fitness to practise proceedings is not to punish a doctor for past wrongdoing but to maintain proper standards in the profession and to protect the public. The tribunal must look forward, not back.

“Although your actions resulted in the early death of Patient A, you do not present a continuing risk to patients,” said Uddin. “The tribunal did not consider that your failings are irremediable; indeed it has already found that you have remedied them.”

The tribunal will review Bawa-Garba’s case before her suspension expires in June 2018, at which point she is likely to be allowed to return to practising.

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