GMC to push for erasure of paediatrician convicted of manslaughterBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5223 (Published 09 November 2017) Cite this as: BMJ 2017;359:j5223
The General Medical Council is to press ahead with an appeal in the High Court against what it considers a too lenient regulatory sanction on a paediatrician convicted of gross negligence manslaughter, despite a letter signed by more than 100 doctors urging the GMC to reconsider.
Last June a medical practitioners tribunal found that Hadiza Bawa-Garba’s failings were a causative factor in the death of 6 year old Jack Adcock from sepsis. But the tribunal decided not to accede to the GMC’s call to strike her off the UK medical register.
Instead, the tribunal opted for a 12 month suspension from the register, citing “multiple systemic failures,” her unblemished record before and since, and evidence from colleagues and consultants that she was an excellent doctor. The tribunal found that Bawa-Garba did not present a continuing risk to patients and had already remediated her failings. In the circumstances, it said, erasure would be disproportionate.1
But the GMC decided to exercise its right to appeal against the tribunal’s decision, which came into force in December 2015. Now more than 100 doctors, most of them paediatricians, have signed a letter to the GMC’s chair, Terence Stephenson, calling on the GMC not to go ahead with the appeal, scheduled for 7 December.2
The letter refers to evidence to the tribunal of “failings on the part of the nurses and consultants, medical and nursing staff shortages, IT system failures which led to abnormal laboratory test results not being highlighted, the deficiencies in handover, accessibility of the data at the bedside and the absence of a mechanism for an automatic consultant review.” The letter also coincides with a petition on Change.org headed “Striking off trainees is wrong when the system is bust,” which has garnered more than 9000 signatures.3
A GMC spokesperson told The BMJ, “We never take the decision to appeal lightly and we only do so if, after careful consideration of all of the relevant circumstances, we conclude that a medical practitioners tribunal’s decision was insufficient to protect the public.
“We believe the decision to appeal in this case was appropriate, having taken note of all the relevant matters. This included careful consideration of the circumstances of the doctor’s conviction for gross negligent manslaughter which was highlighted in both the sentencing remarks of Mr Justice Nicol and the tribunal’s determination.”
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 difficulty breathing. An investigation by University Hospitals of Leicester NHS Trust found numerous errors by Bawa-Garba and nursing staff but also blamed systemic failures.
She and a nurse were convicted of gross negligence manslaughter in November 2015 and received sentences of two years’ imprisonment, suspended for two years.4
Jonathan Cusack, a consultant neonatologist who was Bawa-Garba’s educational supervisor, told the Royal College of Paediatrics and Child Health in a written briefing on her case, “On the day of the incident, there were staff shortages. She was covering multiple wards, expected to lead the paediatric resuscitation team and managing a higher workload than would be usual.” He explained that the consultant on duty was at a conference and another consultant was providing cover but in addition to her other duties.
“The children’s hospital had no adequate ‘senior alert system’ to trigger an automatic review of a child meeting predesigned criteria. This is now in place following this incident,” he added. “A decrease in the availability of the consultant and a lack of a senior alert system effectively removed a safety net designed to pick up a child who had unrecognised sepsis.”