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Back to blame: the Bawa-Garba case and the patient safety agenda

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5534 (Published 29 November 2017) Cite this as: BMJ 2017;359:j5534

Re: Back to blame: the Bawa-Garba case and the patient safety agenda

I fully understand that Jack’s family feel owed an apology from those involved in Jack’s care. However any censure on the part of professionals regarding the absence of an apology from Dr Bawa-Garba, a trainee registrar, specifically and separately from a Trust apology, either fails to acknowledge due process and Trust’s systems or is even, possibly, misleading

Bereavement follow up and counselling support should be led by those most senior. Full disclosure should be respectfully made, with duty of candour and proper apology. A trainee would not apologise separately from this without guidance from the department and permission from the Trust, who would need to check with the legal advisors to the hospital and patient experience and liaison service. All documentation would be checked. An apology from a trainee may lead to further questions. This in itself may be discouraged by the Trust. Indeed the fact that there were so many systems errors could lead the Trust to be even more defensive in this particular case. Certainly guidance to the trainee provided in hospital canteen as stated in the BMJ article would not be the way to go about ensuring appropriate communication with the family

Once a defence organisation is involved, the legal team may recommend that the Trainee does not communicate with the family for fear of exacerbating a situation, seeming to canvass or admitting responsibility where it may not be so

Thus Dr Bawa-Garba’s hands will have tied in terms of her ability to communicate her remorse and yet as with so many things, in this case, such as the lack of records of observations by hard pressed staff and the illegal administration of a drug she suspended, this has been held against her by those who should know the process and system better

Competing interests: No competing interests

07 December 2017
Hilary Klonin
Doctor
NHS
Hull Royal Infirmary