British surgeon faces compensation claims for patient deaths

BMJ 1998; 317 doi: (Published 12 December 1998) Cite this as: BMJ 1998;317:1615
  1. Clare Dyer, legal correspondent
  1. BMJ

    A British surgeon whose conviction in New Zealand for the manslaughter of a patient was overturned by the Privy Council in London now faces compensation claims from families of patients who died during surgery.

    Keith Ramstead was convicted of the manslaughter of Nancie Muncie, 72, but acquitted of similar charges over the deaths of two other patients. Last month, the Privy Council quashed his conviction because of a “material irregularity” in the 1996 trial. The deaths happened between 1991 and 1993 while Mr Ramstead, 46, a cardiothoracic surgeon from St Helens, Merseyside, was employed at Christchurch Hospital. An inquiry carried out by the Royal Australasian College of Surgeons in 1993 found that seven cases that resulted in deaths had been “incompetently managed.”

    Mr Ramstead, who returned to Britain in 1993 and is now working at a Merseyside hospital, was the first doctor to be charged with multiple manslaughter in New Zealand. He initially resisted extradition moves but returned to stand trial after the New Zealand authorities agreed to drop charges connected with a fourth patient's death. After three days of deliberations the jurors at the trial sent the judge a note saying that they had reached verdicts of not guilty on two counts but guilty on one. They added a rider in a second note: “Even though we have come to decisions, we would respectfully ask that the following be considered. In all cases due care, skill, and knowledge were breached but we were unable to establish these failures as an essential cause.”

    The judge called the jury foreman into his chambers and asked him if the verdicts had been unanimous. The foreman said that they had. The jury returned to court and the verdicts were announced. Only after the trial did the judge disclose to counsel what had happened. After hearing legal argument, the judge decided he could interpret the note as meaning “an essential cause [in all cases].” In each case, the jury had to have been satisfied that the failures had caused the death in order to convict of manslaughter. The defendant challenged the decision but the Court of Appeal dismissed the appeal, holding that the judge should have disclosed the existence of the note immediately and should not have called the foreman into his chambers, but that the irregularity had caused no prejudice. But the Privy Council--the British law lords--quashed the conviction by a majority of three to two, ruling that there was doubt about causation, and that Mr Ramstead had been denied a fair trial.

    View Abstract