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Bawa-Garba: timeline of a case that has rocked medicine

What happened and when

18 February 2011

A six year old boy is admitted to the Children’s Assessment Unit (CAU) at Leicester Royal Infirmary following a referral from his GP. Jack Adcock, who had Down's Syndrome and a known heart condition, had been suffering from diarrhoea, vomiting and had difficulty breathing.

Dr Hadiza Bawa-Garba was a specialist registrar in year six of her postgraduate training (ST6) with an 'impeccable' record. She had recently returned from maternity leave and this was her first shift in an acute setting. She was the most senior doctor covering the CAU, the emergency department and the ward CAU that day. She saw Jack at about 10.30am.

Jack was receiving supplementary oxygen and Dr Bawa-Garba prescribed a fluid bolus and arranged for blood tests and a chest x-ray. At 10.44am the first blood gas test was available and showed a worryingly high lactate reading. The x-ray became available from around 12.30pm and showed evidence of a chest infection.

Dr Bawa-Garba was heavily involved in treating other children between 12-3pm, including a baby that needed a lumbar puncture. At 3pm Dr Bawa-Garba reviewed Jack's X-ray (she was not informed before then that it was available) and prescribed a dose of antibiotics immediately, which Jack received an hour later from the nurses.

A failure in the hospital's electronic computer system that day meant that although she had ordered blood tests at about 10.45am, Dr Bawa-Garba did not receive them until about 4.15pm. It also meant her senior house office was unavailable.

During a handover meeting with a consultant which took place about 4.30pm, Dr Bawa-Garba raised the high level of CRP in Jack's blood test results and a diagnosis of pneumonia, but she did not ask the consultant to review the patient. She said Jack had been much improved and was bouncing about. At 6.30 pm, she spoke to the consultant a second time, but again did not raise any concerns.

When she wrote up the initial notes, she did not specify that Jack’s enalapril (for his heart condition) should be discontinued. Jack was subsequently given his evening dose of enalapril by his mother after he was transferred to the ward around 7pm.

At 8pm a ‘crash call’ went out and Dr Bawa-Garba was one of the doctors who responded to it. On entering the room she mistakenly confused Jack with another patient and called off the resuscitation. Her mistake was identified within 30 seconds to two minutes and resuscitation continued.

This hiatus did not contribute to Jack’s death, as his condition was already too far advanced. At 9.20pm, Jack died.

2 November 2015

Portuguese agency nurse, 47-year-old Isabel Amaro, of Manchester is given a two-year suspended jail sentence for manslaughter on the grounds of gross negligence.

4 November 2015

At Nottingham Crown Court Dr Bawa-Garba is convicted of manslaughter on the grounds of gross negligence.

14 December 2015

Dr Bawa-Garba is given a 24 month suspended sentence.

8 December 2016

Dr Bawa-Garba's appeal against her sentence is quashed at the Court of Appeal.

13 June 2017

The Medical Practitioners Tribunal service says Dr Bawa-Garba should be suspended for 12 months and rejects an application from the GMC to strike her off the register. It says: ‘In the circumstances of this case, balancing the mitigating and aggravating factors, the tribunal concluded that erasure would be disproportionate.’

8 December 2017

GMC takes the MPTS to the High Court and argues its own tribunal was 'wrong' to allow Dr Bawa-Garba to continue to practise.

25 January 2018

The GMC successfully appeals at the High Court bid to have the MPTS decision overruled, leading to Dr Bawa-Garba being struck off the medical register. Lord Justice Ouseley says: 'The Tribunal did not respect the verdict of the jury as it should have. In fact, it reached its own and less severe view of the degree of Dr Bawa-Garba’s personal culpability.’ Health secretary Jeremy Hunt says that he is 'deeply concerned' about its implications.

26 January 2018

Prominent GPs tell Pulse that the ruling raises serious questions about how doctor's reflections are used and recorded, and that new guidance is now needed urgently.

30 January 2018

An influential international doctors group accuses the GMC of treating black and minority ethnic doctors ‘differently and harshly’, following the High Court case.

In light of the Dr Bawa-Garba case, the GMC announces a review of how gross negligence manslaughter is applied to medical practice, which was initially led by Dame Clare Marx and later taken over by Leslie Hamilton after Dame Clare was appointed the next GMC chair. Meanwhile, an influential international doctors group accuses the GMC of treating black and minority ethnic doctors ‘differently and harshly’, following the High Court case.

31 January 2018

Dr Bawa-Garba’s defence body releases a statement saying e-portfolio reflections were not used against her in court, despite ‘wide misreporting’ that they were. But Pulse uncovers that her reflections were used in court, from a document submitted as evidence by the on-call consultant on the day.

6 February 2018

Former health secretary Jeremy Hunt announces a review into the application of gross negligence manslaughter charges in medicine in light of the Dr Bawa-Garba case.

7 February 2018

Following a crowd funding campaign, which raised over £335,000, Dr Bawa-Garba decides to appeal the ruling, and considers appealing the manslaughter conviction from 2015.

12 February 2018

The GMC refutes claims that there was discrimination in its decision to launch a High Court bid. In response to an open letter from the British Association of Physicians of Indian Origin (BAPIO), the GMC said the accusations were ‘troubling and without merit’.

19 February 2018

The GMC is criticised by their regulator, the Professional Standards Authority (PSA), for striking off Dr Bawa-Garba from the medical register. The PSA said the bid was ‘without merit’, according to an unpublished review of the case.

13 March 2018

GMC chair Professor Terence Stephenson says he is ‘extremely sorry’for the distress caused to the medical profession by the Dr Bawa-Garba case.

19 March 2018

University Hospitals of Leicester NHS Trust releases its serious incident report in to the death of Jack Adcock, which was completed six months after his death. The report says that there was no ‘single root cause’ behind the six-year-old's death.

29 March 2018

Dr Bawa-Garba is granted permission to appeal the High Court’s decision to allow the GMC to strike of the junior doctor. Meanwhile, the BMA applies and is later permitted to advise the Court of Appeal in the case.

23 April 2018

The GMC announces the launch of its review into why black and minority ethnic doctors are more likely to face complaints from employers than their white colleagues, which is to be co-led by researcher Roger Kline and Dr Doyin Atewologun.

11 June 2018

Department of Health and Social Care’s ‘rapid review’ into medical gross negligence manslaughter concludes that the GMC should longer be able to appeal decisions made by its own tribunal regarding fitness-to-practise decisions.

27 June 2018

The BMA supports a vote of no confidence in the GMC in light of the Bawa-Garba case at its Annual Representative Meeting.

3 July 2018

Despite the conclusions of the DHSC's 'rapid review' in gross negligence manslaughter, the GMC tells Pulse it is not intending to halt appeals against its own fitness-to-practise tribunal until the law is changed.

25-26 July 2018

Dr Bawa-Garba’s appeal of the High Court decision that saw her struck off the medical register is heard in the High Court over one and a half days. Dr Bawa-Garba said after the hearing that she is ‘whole-heartedly sorry’ for her mistakes, while Jack’s mother Nicola Adcock says she ‘will cause a public uproar’ if Dr Bawa-Garba is reinstated.

13 August 2018

The Court of Appeal judges rule in favour of Dr Bawa-Garba, restoring the MPTS decision that she should be suspended from the medical register rather than erased. The judges said the matter has been passed to the MPTS 'for review of Dr Bawa-Garba's suspension'. 

20 December 2018

The Medical Practitioner Tribunal Service (MPTS) decides to extend the suspension of Dr Hadiza Bawa-Garba by a further six months, saying the measure is 'appropriate' to 'protect the public'.

13 March 2019

The MPTS announces a two-day review hearing for Dr Bawa-Garba set for 8 and 9 April 2019. The hearing will decide whether her fitness to practise remains impaired and whether she is deemed fit to return to work. 

8 April 2019

The MPTS rules that Dr Bawa-Garba' the fitness to practise remains impaired, due to her lack of face-to-face patient contact while she was under suspension, agreeing that the risk of her putting another patient at an unwarranted risk of harm is low.

9 April 2019

The MPTS decides that Dr Bawa-Garba will be able to return to practice from July 2019 - under certain conditions - but she does not intend to return to work until February 2020, when her maternity leave finishes. The MPTS argues that the public interest has been served already by her cumulative suspension and that any higher sanction would be 'disproportionate and punitive'.

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Readers' comments (57)

  • Vinci Ho

    Putting aside the sentimentality as a result of this verdict, I would want to discern the facts from this matter like this:
    (1) The original indictment was manslaughter . And I would be surprised the label was anything other than involuntary manslaughter (in contrast to voluntary) because this was criminal (gross) negligence with no intention of committing murder(mens rea) . She had served for her sentence for manslaughter but the question left was whether she could carry on practising medicine or not?
    (2) The legal challenge from GMC was the Medical Practitioner Tribunal Service’s recommendation of 12-month suspension was incorrect and she should be removed from the GMC list to protect the public . According to Lord Justice Ouseley, her personal culpability carried so much bearing in causing death of the patient that she would be a harm to the public if allowed to carry on practising .
    (3) Here is the appetite for an appeal to Supreme Court: Does this personal culpability in this involuntary manslaughter (with no intention to murder) equate to the immediate conclusion that she would be a harm to the society if she was to be allowed to practise medicine after some other sanction(s) ? The 12-suspension was incorrect . What about 24 , 36 , 48 months etc suspension instead? Are the current criteria to judge whether she would be a harm to society practising more medicine ,being properly challenged in court? If John Worboys , the black cap rapist convicted of 19 serious sex crimes, was allowed to be released after 9 years and now being confirmed as no threat to the public , the sanction(s) on this doctor’s career cannot be a permanent one.
    (4) Would be essential to know if there are previous case references to refer to in the legal literature. But , otherwise , this case will set a new example and reference for future cases , which is exactly what MPS was concerned of.

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  • Council of Despair

    This whole situation is very sad. It's very sad for the family and for Dr Bawa-Garba and her family. I hope they are all getting the support that they need but a few points;

    1. The public have been given the impression that we have to provide perfect care - this is impossible. Doctor's have good and bad days and our job is risk based so mistakes occur all the time.

    2. A concientious Doctor will be devestated when errors occur and I'm sure all the clinicians involved are upset over this tragedy. However, because out job is risk based and there is alaways the probability of error if you aim to get rid of doctors without giving them an oppurtunity to learn then you are going to run out of doctors as all of us have or will commit errors in time. It creates a 'lottery' career. You know at some point you are going to make a mistake that will cost you your job so why bother?

    3. this will push all of us to a non-risk taking mode.

    4. this will result in the loss of goodwill - goodwill needs to be two way.

    5. doing things for 'public confidence' doesn't actually make sense. decisions should be based on reason, logic and law.

    I openly, when asked my opinion do not advise medicine as a career in the UK - abroad yes but not here.

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  • Vinci, appreciate your efforts but armchair legalism will achieve nothing. Lawyers stick to their procedures and legal fallacies and the original judgment was one of the latter. A jury made a decision (after fifteen hours apparently). That the jury was denied common sense relevant information and did not have the education and experience to evaluate complex medical situations, seems to be considered irrelevant by the legal profession (inc two high court judges). This is simply not being judged by ones peers. It's a travesty, even if it can be claimed that everything was procedurally correct.

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  • Council of Despair

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

    http://www.bmj.com/content/359/bmj.j5534

    GMC own goal me thinks - they will get away with it as no doctor will go against the GMC as someone has already said - Judge, Jury, executioner, and re-executioner.

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  • You're misrepresenting the case somewhat in saying that she omitted to document suspension of enalapril, the implication being that it was left on the kardex and this was why "Jack was subsequently given his evening dose of enalapril around 7pm" - enalapril wasn't on his kardex (ie. was intentionally omitted) and this dose wasn't given by medical/nursing staff but rather by family. Might be worth clarifying in the timeline for the sake of fairness.

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  • Done

  • If the above is correct I am struggling to see where is the gross negligence. Yes there was a muddle/mix up at the end but little more than that.

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  • School leavers considering Medicine as a career need to understand - the NHS may put you in a role where it is impossible to practice safe medicine; if lucky, nothing bad will happen, if unlucky you could go to jail and lose your livelihood.

    The BMA could cease mimicking a jelly-fish and ensure this lesson is widely disseminated.

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  • I don't think the above 'timeline' accurately reflects the systematic failures that were present on the day - the fact that the dr in question was effectively covering for 2 of her colleagues with no consultant cover & in addition was covering 6 wards over 4 floors, taking GP calls, surgical referrals etc., on her first day back from maternity leave, with no induction & a crashed computer system. She then gets blamed for mixing-up patients because the pt with the DNAR order was originally in the bed that Jack was in when he arrested but had been moved without her knowledge. Read the link (signed by 4 consultants)about what happened : http://54000doctors.org/blogs/an-account-by-concerned-uk-paediatric-consultants-of-the-tragic-events-surrounding-the-gmc-action-against-dr-bawa-garba.html

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  • AlanAlmond

    It isn’t safe to work as a Dr in the UK any more.
    A stupid country with f£&jed up medical regulatory system.

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  • can we express no confidence in the GMC?

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  • Vinci Ho

    Fundamentally, it is flawed for medical regulatory bodies , both CQC and GMC, being funded by those being regulated . Reading about the reaction of the child’s family , one can easily work the way backwards to understand that GMC was over-stretching its effort to (a) defend its super-protector complex (b) avoid a reputation of harbouring its subscribers in the eyes of the public.

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  • Wonder why she did not appeal the initial verdict.. Did the medical defence organisation use their discretionary powers to refuse support for an appeal ??

    Please read the case of Michalak versus GMC.. May swing the pendulum back towards individual doctors who can challenge unfair decisions by the GMC using the employment tribunal process..

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  • Is the comment stating that the family gave the enalapril not medical staff true ? I haven't read that anywhere else. Alternative timelines that I've read attribute the catastrophic deterioration in the poor child's condition (after initially improving on i.v. Fluids, oxygen and then antibiotics ) to the administration of this drug. . I have wondered how it was administered if it had not actually been prescribed by the admitting doctor. . However if it is not true perhaps it should be removed ?

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  • I'm a GPST1 on GP rotation, the F" I work with is thinking of leaving medicine entirely. Now I can see why.

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  • Practice defensively always and forever.
    Look after number ONE because no one will look after you.

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  • This comment has been moderated

  • @10:52: It comes from the court documents. A lot of verification from many sources on Twitter who've read various accounts. The paediatric consultants version on 54000 doctors doesn't attribute the administration to anyone in a rather loaded way (as they understandably don't want to be seen to victim blame). The criticism of Bawa-Garba is that she didn't tell the family not to do so, not that she prescribed it or forgot to omit it. Emphasises the unrealistic expectation for her to be in all places dealing with all things at once - hospital docs don't often have to consider what might get given by family/friends as to most, the kardex is gospel. Likewise, no way nursing staff would risk giving unprescribed meds.

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  • Edoardo Cervoni

    I do agree with Vinci Ho considerations. I am also most surprised that a doctor, that is any doctor, without significant health problems (acute, subacute, or chronic), may arrive to commit errors of a gravity to be sanctioned with erasure. I would have thought that, between medical school and supervised post-graduate medical training, there should be plenty of occasions to pick-up and correct "inadequacies". And doing so, would be in best interest of everyone. I cannot really comment on the case of Dr Bawa-Garba. Many have. But, surely, saying that someone could "never be a doctor again", must mean something more about psychological or mental health frame set - and deeming this as impossible to change - that with training.
    Unfortunately, many of the considerations being made by the colleagues in response of this piece of news are also correct, in my humble opinion. However, I still believe that reflecting on errors is a good thing if we do so with the determination of getting better.

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  • @12.12
    Thank you for clarifying that.
    I understand the sensitivity towards the bereaved family.
    However it is not standard practice to have to expressly tell family members not to give previously prescribed medication to inpatients ( or at least not in my day as a junior , when the medication chart was sancrosanct and I would be phoned by staff to say it was ok to give paracetamol as pain relief ) .

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  • Just Your Average Joe

    @'Testing | Locum GP26 Jan 2018 10:29pm

    Wonder why she did not appeal the initial verdict.. Did the medical defence organisation use their discretionary powers to refuse support for an appeal ??

    The original decision did not give her the right to appeal.

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  • Yep, I agree completely, sorry if wasn’t clear. (FYI it’s point 15 on this court document: http://www.bailii.org/ew/cases/EWCA/Crim/2016/1841.html )

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  • @Glasgow-Trainee . Thank you for the link. Having read the whole document including point 33 my faith in the judicial process has been shaken.

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  • Simply outraged at this whole case against this Dr. If she ever reads this I suppose I just want her to know she has my full support. Disappointed to put it mildly in the GMC and the course of action they have taken.

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  • Quite simply the MPTS decides ' in the circumstances' that suspension is the fairest sanction.
    However, the jury had taken a ' more severe view', and the judges feel that the jury view is more important in this matter than the MPTS view.
    From my perspective, I could have easily made a similar error as Dr. Garba in those circumstances ie covering 3 other colleagues, computers down etc. No matter how good I may be at medicine, no matter how caring I am, circumstances such as severe lack of staff, facilities, computer results can contribute to my error, for which I will be severely punished.
    So, let it be known widely, we doctors can be convicted of manslaughter and struck off for circumstance deficit. Should anyone do Medicine, if we are to be punished for circumstance?

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  • It seems she worked at least 6 years in this country. Does she has any other negligence on her record in past or following this case to label her negligent for rest of her life?

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  • I have to agree that the statement in the timeline ‘When she wrote up the initial notes, she did not say that Jack’s enalapril (for his heart condition) should be discontinued’ is inaccurate. Omitting enalapril from the Kardex is a clear indicator that it should be discontinued. Yes an argument can be made that this should also have been documented in the medical notes, but given that the enalapril was given by a relative who would not have access to the notes it is hard to see how this would have altered the outcome? It seems the jury concluded that Dr Bawa-Garba’s decision to stop enalapril should have been communicated to the family, but given her numerous responsibilities that day and the pressure she was under I think many of us would have done the same thing. We assume kardexes are respected and I find it hard to understand how she can be held culpable for an unprescribed medication being given without her knowledge. Shakes my faith in the fairness of our justice system! The article above should be amended to reflect the true circumstances around the administration of enalapril as it is misleading.

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  • We have added in more information regarding this

  • Council of Despair

    i'm really confused - what error did she actually make?

    i think many of us would have made similar decisions in the same circumstances so in that case should we all be struck off?

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  • A very sad case but looking beyond from a doctors perspective I can't believe that a year 6 paediatric trainee registrar in the System not a new or a locum doctor commits a mistake in what might not be a barn door case of sepsis in a child who already had health issues and being made a scapegoat, case reopened despite the doctors and even the health secretary opposing it, the GMC should be there to support and protect doctors not punish them for any mistakes...how can one convict a doctor working in good faith umdr man slaughter...shameful state of affairs I am afraid and makes the health professionals more and more vulnerable and unprotected and most of all unsupported.

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  • Having now read more widely about this case I have made a donation to Crowd Justice and hope enough money is raised to not only enable Dr Bawa - Garba to overturn the latest ruling but also to engage a top legal team to look at the way the evidence was presented in her manlaughter trial . She was originally refused an appeal but it is hard to see how the jury reached their conclusion unless the evidence was presented in an oversimplified manner that ended up misleading them. The timeline presented in this article is a good example of how presentation of facts can be misleading.

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  • All doctors urgently need to redefine what they regard as ‘a safe workload’.
    We all know that the NHS will ground to a halt when we do this, as it means we will not accept workloads that cause us stress.
    So be it.
    We have received the message, load and very clear.
    And I would like to get something straight here- are we actually witnessing all this over the fact that a doctor is being held to blame over a dose of enalapril administered by someone else, a relative, when it wasn’t for administration on the kardex?
    And what about the portgugese agency nurse Isabel Amaro

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  • There’s multiple other criticisms in a massive chain of factors, but what’s ruffling feathers specifically about the enalapril part of the story is the absolute certainty on the part of the judge that it isn’t a novus actus interveniens. I hate the victim blaming side of bringing it up, but it’s daft to a) blame the doctor for not considering the possibility that an in prescribed med would get given when she’s too stretched to communicate it as being withheld but has correctly intentionally omitted it from the kardex which would be a safe practice in most hospitals and b) dismiss its role in causing a septic kid with renal failure to crash. Isobel Amaro has been punished significantly but just didn’t get the public shaming that Dr B-G has received but shouldn’t be dragged through the mud any further as it benefits no one. The whole point in the backlash from doctors is the isolation of an individual as scapegoat for systemic problems and we should avoid committing the same sin as the GMC.

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  • I feel desperately sorry for the family but the law is meant to be fair to everyone. I have read that the blood gases and overall condition of the child were improving prior to the administering of the drug. The doctor did not prescribe it. That should have been sufficient to ensure it was not given . I agree there is nothing to be gained by trying to pin the blame on one particular action when there seem to have been many factors in the build up to the tragic conclusion but someone has been convicted of manslaughter and denied the right to appeal because the likely final causative event ( in my humble opinion ) in a run of system failures was dismissed as irrelevant. It beggars belief.

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  • Vinci Ho

    No doubt , the culture of the world is changing . The expectations on the ‘guardians’ of the world are radically altered. With the evolution of IT technology, social media and hence, globalisation, the reflection of competing notion of virtues any authority(government) should honour or reward , is subjected to even more open and liberal challenges . One can argue the word ‘transparency’ has got a new meaning . Clearly , our prosecution and judiciary system is under huge pressure to ‘get it right’ time to time. As a strong believer of the old doctrine of independent judicial system , I chose not to comment until this verdict was reached.

    One thing I am not sure is how general public understands the difference between murder and manslaughter, with motive(s) and without intention in homicide. Ian Patterson was struck off the GMC list because he harmed(no necessarily killed)so many patients with motives and clearly would be unsafe to let him practise medicine again in future.
    Gross negligence is an involuntary manslaughter(correct me if I am wrong ) carrying no intention to kill.
    It is difficult to revisit the original indictment in 2016 as her appeal to higher court was already rejected.
    But the action of GMC was extraordinary and questionable:
    (1) If the ‘rules’ stated GMC sanction was immediate erasure whether the indictment was murder , voluntary manslaughter or involuntary manslaughter, why was the doctor not erased immediately after the indictment?
    (2) The answer was perhaps because the power of doing that lied in Medical Practitioner Tribunal Service . And if you remember recent report in here about another case :

    http://www.pulsetoday.co.uk/your-practice/regulation/ground-breaking-court-ruling-paves-way-for-doctors-to-take-gmc-to-tribunal/20035666.article

    There appears to be a ‘power’ struggle between GMC and tribunal services.
    As I wrote before , GMC has an old fashioned superhero-protector complex to fulfil that it clearly wants to ‘centralise’ all power in itself. This will serve the appetite of this ‘ Right OR Wrong ; Left OR Right; nothing in between’ climate of the world.
    (3) The conclusion of this present verdict is as long as one being found guilty when a patient died , one will be struck off GMC list PERMANENTLY , no matter what .
    (4) Whether the reflection process in appraisals(hence , revalidation)needs modification is only scratching the surface . Like many first generation appraisers(quit 5 years ago) , I lost the belief in the original telos of a genuinely reflective exercise which was replaced by a tick-boxing one anyway. If this case means anything, it simply adds more flaws into an exercise which has already lost people’s faith.
    (5) The system failure involved in this case , also well demonstrated the poor availability and distribution of resources(you should all know my definition of resources by now)in NHS. The fallacy of austerity and efficiency saving (not a lot people want to mention that openly these days) in NHS had a good translation in this case. All authorities ,including the government, ‘understandably’ wanted to distance themselves away .
    As it was written in Analects, ‘’When the higher authority had lost its way , people deserted losing their faith . After discerning all the details from the matter, we should only show sympathy rather than schadenfreude for those who committed a crime under such circumstances and climate.’’
    (上失其道 ,民散久矣。如得其情,則哀矜而勿喜。)Well , the higher authority here is ,of course , GMC .
    I am all for a legal challenge to Supreme Court if that is feasible and decided.

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  • This case is a perfect example at how the facts are twisted and even the jury which consists of ordinary citizens could be easily misled when the aim is to indict someone for the failing of the system and putting the blame solely on the individual. Are the blood test and x ray results solely the responsibility of the paediatric registrar on duty covering wards A&E taking referrals and God knows what. Is the medication which is not prescribed on the chart and given by someone else when everyone who has ever worked in hospital knows this as a fact,that it should never be given unless prescribed by anyone nurses parents carers all included..how can the blame be put on the doctor..similarly blame the doctor if someone in the hospital overdoses himself or herself with paracetamol saying it was never written in notes not take more than 8/day.
    We the doctor community should stand up and support the efforts against shaming the physicians and nurses and the profession for the few mistakes which are done in the line of duty in most adverse circumstances. We all know how tough is it on call whether for pads, gynaecology surgery or medicine with so few staff especially on weekends and also the governnent law and patients after you as well..what kind of environment are we creating. Gross negligence no one condones and should be punished but according to circumstances and situation. If one does a survey of most doctors even many of those who are asking for her throat might find themselves in same situation and simular events or near misses would have happened to most of them if they have worked long enough in a position of making decisions.

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  • Had she been a white doctor the GMC themselves would have been as lenient as possible. I speak as an ex-appointee to GMC's FTP panel where we were all given training to go easy on white doctors and try as far as possible to erase non-white doctors.I believe judges and other tribunals receive the same training. This is state sponsored racism not institutionalised racism as it is played down to be. The racists are not naïve children they are wilful.

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  • Council of Despair

    basically game over - I don't think the powers in charge realise the impact of this case on the rank and file. we've been on the edge for a while and just about coping hoping that things might get better but this case shows that it's over now. Officially there is no point being a doctor in the UK. There are too many negatives and it's sad that we are now responsible for the government, management, and public failures. In a way collpase of the NHS may be a good thing as it will force those in charge and the public to face up to the realities. Bring on total collapse!

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  • So now we are all individually responsible however messed up the system may be?!! Wonderful. "Well done" GMC !! Shame on you for pretending to represent doctors.

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  • Working as a doctor has always involved taking “calculated risks” as we only see a patient at a short moment in their illness. On top of this we all work in a broken system which is understaffed.

    This case will change my practice, I will be referring and admitting more patients.

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  • There but for the grace of God go I.

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  • Tragic ... for all
    Every time I read about this case I become enraged at the sledgehammer used against this professional.

    First headlines Nigerian female doctor....er what

    Nigeria and the rest of Africa along with other internationals make up over 35% of NHS staffing.

    Nigeria has excellent Medical schools

    Women outnumber men at medical schools in many countries

    Hadiza studied for her BSc at Southhampton

    Hadiza is a British trained medical doctor .... Leicester medical school

    St6 Reg with nonexistan SHO cover for 3 wards

    The Consultant saw the blood gas results

    76 systemic lapses withheld from the jury by the cps ( oh yes remediated by the time of her trial).....disgraceful

    Just back from maternity leave...did she have an adequate phased return to work...hmmmm an umblemished record ..methinks they thought she could be relied to dump on as much work as possible

    When i worked on the wards the lab or radiology would call through critcal results.... so the computers crashed why is this her fault?

    I want to hug her and I wonder at the strength she has exhibited. This woman is an example to us.

    Finally tonight .... I read that this poor childs Mom gave him his enalapril... a child in hospital??? Given meds by his mum.

    I cant comment i dont / wont work in pediatrics...

    A critically ill child in a hospital setting? given cvs meds by his mom in a professional setting. Enalapril on top of septic shock...who authorised this action...????

    No further comment

    I said if her erasure was upheld... I would leave medicine or the country...Actively Looking to do so

    This case is a complete disgrace and she needs to get advice to sue the lot if them hunt gmc leicester trust.....etc

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  • Oh yes...cps as well

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  • We have seen recently that trials collapse because of withheld evidence. Withholding evidence appears commonplace in the UK. The doctor may have to take this case to international courts, where the administration of Enapranil may be seen as the fundamental reason for the collapse of poor Jack by doctors. How can even very learned members of the legal profession discuss the consequences of giving Enapranil as irrelevant?

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  • Perhaps we can best support her in a practical way by crowdfunding her legal appeal, as these issues need to be properly addressed. Otherwise the practice of medicine is untenable in a failing system.

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  • Council of Despair

    I would encourage every doctor to read the public (in the press) comments about the case. I'm afraid the public views doctors protesting about this as protectionist and trying to hide 'incompetance'.

    This case is a turning point as ;

    1. we can be made liable for systemic failures not of our making i.e. political and managerial issues
    2. we 'have' to be honest even though that honesty may conviict us
    3. we have to be subject to multiple jeopardy
    4. any perceived error will not be tolerated whatever the circumstances
    5. even if you don't make an error in order to please the public you will be punished.

    I can't see how medicine will be appealing to existing doctors let alone prospective medical students now?

    I do think this is the end of medicine in the UK.

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  • The only good news about this case is that its the first thing Ive seen in approximately, forever, that is uniting our profession and we all concur about the absurdity of it all, and the fact we are being judged by those who clearly don't understand the conditions which we work in on a daily basis. If our respective leaders cannot capitalise on this one moment of unity, to achieve something substantial to redress the current imbalance, then our profession is dead.

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  • I think it would be a reasonable aim to have the majority of UK doctors contribute to the crowdfunding campaign to make a final stand on this issue, and our voices heard.... and use it to highlight the dangers in the NHS. This 'maverick' campaign which seems to have been started independently, and not by our inglorious leaders, is likely a better hope of bringing a rational debate to the table than waiting for the gong chasers to do anything......

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  • I read all and found the whole case is very upsetting for all doctors.
    It seems that doctors have to be very defensive when they are practising.
    If the same thing happen to any doctor who is sole bread earner for his/ her family, he/ she should always be ready to be ready for earning from doing another job or business.
    In other words, all doctors should seriously think of acquiring non-doctor skills as well for the rainy days because doctor profession is very uncertain in UK.
    I feel and wish I never was a doctor !

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  • Surely the boy's mother should take a little bit of responsibility, a harsh comment I know.

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  • CENSORSHIP?

    LETS HELP NURSE ISABEL ADARO ASWELL
    Dr Hadiza Bawa-Garba, Junior doctor
    Nurse Isabel Amaro,

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  • I cannot understand why this doctor was ever charged with negligence in the first place.
    In the first place she correctly suspected dehydration and possibly pneumonia and ordered appropriate investigations. She initiated therapy by giving a bolus of I/v/ fluid.
    She DID treat the pneumonia with I/v/ antibiotic. The fact there was a delay in this is explained by IT delays, not being told the xray was available and having other patients to deal with.
    She DID inform the consultant. The fact that she did not ask him to see the patient was because as far as I can make out,she felt the boy was getting better. i.e. she used her clinical judgement.
    In my opinion, although the management in this case might not have been totally perfect, this is the worst miscarriage of justice affecting a doctor I have ever heard of.

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