The English case regarding Dr Hadiza Bawa-Garba has been followed with great interest by Australian medics and lawyers. A recent decision to reinstate Dr Bawa-Garba to the list of UK medical practitioners seems to have finally put an end to the matter, which has been ongoing for a number of years.
The case concerns Dr Bawa-Garba’s care and treatment of Jack Adcock in February 2011.
At the time, Dr Bawa-Garba was a junior doctor training to be a paediatrician. She was two years from finishing her training. She had recently returned to practice as a Registrar at the Leicester Royal Infirmary Hospital (“the Hospital”) after 14 months of maternity leave. Jack was six years old. He had Downs Syndrome along with a known cardiac condition.
On 18 February 2011, Jack presented to the Hospital in the morning with a history of vomiting, diarrhoea, shallow breathing, dehydration and slightly blue lips. On arrival, he was unresponsive and limp.
On that day, Dr Bawa-Garba was the most senior doctor on duty. She was in charge of multiple wards due to poor staffing. The consultant, Dr Bawa-Garba’s supervisor, was not onsite due to a double-booking in his calendar. He was due to attend the Hospital in the afternoon for rounds.
Jack was assessed by Dr Bawa-Garba. She ordered blood tests and initially diagnosed gastro-enteritis. He was treated with fluids. Jack underwent a chest x-ray which showed he was suffering from pneuomonia. The x-ray results were not reviewed in a timely manner. Jack was treated with antibiotics, which were administered one hour after Dr Bawa-Garba prescribed them. Jack’s condition fluctuated throughout the day, although he appeared stable when the consultant arrived at the Hospital and, for this reason, the consultant did not review Jack. Sadly, Jack went into septic shock in the evening and suffered from organ failure. Resuscitation was commenced and Dr Bawa-Garba was called. She mistakenly identified Jack as a child in the “do not resuscitate” category and stopped resuscitation efforts. A nurse alerted her to her mistake and resuscitation was re-commenced. Jack sadly passed away at 9.20pm that evening.
Dr Bawa-Garba (along with two other members of staff) was charged with the criminal offence of manslaughter by gross negligence. The case against her was that her actions contributed to, or caused, Jack’s death by serious neglect which fell so far below the standard of care expected of competent professionals that it amounted to manslaughter by gross negligence.
She was tried and ultimately convicted by a jury of the charge. The Court found that “[t]hese were not just simple breaches of duty, but really serious breaches amounting to gross negligence.” She was sentenced to a two year suspended sentence.
Following Dr Bawa-Garba’s conviction, the independent Medical Practitioners Tribunal Service (MPTS) ruled that she was a competent doctor who had made mistakes in the context of serious systemic failures. A one year suspension on her ability to practise was ordered. The General Medical Council (GMC) was successful in an appeal to have Dr Bawa-Garba struck off the register of medical practitioners in the UK. Dr Bawa-Garba obtained alternate legal representation to appeal that decision. On 13 August 2018, Dr Bawa-Garba’s appeal was successful and she was reinstated to the register.
In Australia, it is difficult to imagine that Dr Bawa-Garba would have been charged with, much less found guilty of, manslaughter due to gross negligence. There were systemic issues that appear to have contributed to Jack’s death such that it is difficult to attribute his death solely to Dr Bawa-Garba’s actions. Nurse Amaro, who was also involved in Jack’s care, was also found guilty of manslaughter. The Court was particularly critical of her record keeping, failure to monitor his vital signs and failure to bring his deteriorating condition to the attention of more senior staff members. In addition, the fact that Dr Bawa-Garba was the most senior doctor on duty that day, having returned from maternity leave and in charge of multiple wards are all concerning systemic failures which were out of her control.
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This case serves as a reminder that good doctors can and do make mistakes. Sometimes the consequences of those mistakes are devastating, as in this case.
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