Doctor ‘should be struck-off’ for Jack Adcock manslaughter

A doctor who was let off with a 12 month suspension after her blunders resulted in the death of a six-year-old boy should be struck off ‘to protect the public’, the High Court heard. 

Dr Hadiza Bawa-Garba was convicted, along with agency nurse Isabel Amaro, of the manslaughter of Jack Adcock at Nottingham Crown Court in November last year.

Jack, who had Down’s syndrome and a heart condition, died at Leicester Royal Infirmary in February 2011 following a septic shock, hours after being admitted with sickness and vomiting.

Dr Bawa-Garba, 35, made the ‘remarkable error’ of mistakenly placing Jack under a ‘do not resuscitate’ order after confusing him with a two-year-old who had been discharged. 

But she was allowed to remain on the medical register after an independent Medical Practitioners Tribunal Service panel ruled that she should not be struck off and instead suspended her for a year.

Jack Adcock died after Dr Hadiza Bawa-Garba confused his case with a two-year-old who had a 'do not resuscitate order'

Dr Hadiza Bawa-Garba, left, was convicted of the manslaughter by gross negligence of Jack Adcock, six, right, and the General Medical Council wants her suspension upgraded to being struck off to ‘protect the public’

Jack's parents Nicola and Victor Adcock, pictured outside the High Court today, previously said the doctor has 'not been held accountable' after she confused Jack's case with a child who had a 'do not resuscitate' order

Jack’s parents Nicola and Victor Adcock, pictured outside the High Court today, previously said the doctor has ‘not been held accountable’ after she confused Jack’s case with a child who had a ‘do not resuscitate’ order

The General Medical Council wants the decision to be quashed and replaced with erasure because suspension ‘is not sufficient to protect the public’.

But their actions have already sparked outrage by many professionals who claim doctors would be scared to admit mistakes.

Some 800 medics and other professionals have signed a letter supporting Dr Bawa-Garba and more than 10,000 have signed a petition backing her.

They say that it would set a dangerous precedent if she were to be struck off from the register, arguing that the doctor previously had an unblemished career.

Mr Justice Ouseley said before the appeal hearing began he fully understood that ‘obviously this is tragic case all around and we fully understand that’.

Ivan Hare, QC, representing the GMC, said the case makes for ‘grave reading’ and there is ‘great deal of interest in these matters.’

He said the MPTS ‘got it wrong’, adding: ‘The exercise of judgement by the MPTS is simply incorrect.’

Mr Hare told the court: ‘In the briefest of outlines at the relevant time Dr Bawa-Gerba was working as a registrar, she had just returned from maternity leave.

‘The patient was a six-year-old boy who was born with a number of health conditions.’

Jack, who had Down’s Syndrome and a known heart condition, was described as a popular student who attended a mainstream school and was a ‘happy and energetic child.’

‘He had been unwell the night before, when Jack arrived he had been unresponsive and limp – despite efforts to resuscitate him Jack died at 9.20pm,’ said Mr Hare.

‘We say this is a fundamentally and very straight forward case, we are not inviting the court to pour over the transcripts.

‘It is simply a case where we say the Medical Practitioners Tribnal Service went behind the findings of the crown court – they regard her culpability as substantially reduced.’

Dr Bawa-Garba failed in her appeal against conviction at the Court of Appeal earlier this year.

Mr Hare said: ‘The judge had correctly directed the jury that the prosecution had shown that the defendants treatment was exceptionally bad.’

Referring to the judge who sentenced the doctor, Mr Hare said: ‘For what it is worth – and I do not say that with any disrespect – Mr Justice Nicol in his sentencing remarks was clear that the inevitable outcome in her conviction would be the end of her career.’

Sean Larkin, QC, representing Bawa-Garba, said the MPTS are ‘well used to dealing with cases that end in fatalities’.

Mrs Adcock is at the hearing today, pictured, and said the doctor has 'never said sorry' for her son's death

Mrs Adcock is at the hearing today, pictured, and said the doctor has ‘never said sorry’ for her son’s death

But he said that every case is different and should be treated as such.

He said manslaughter is ‘one of the wider offences that is capable of being committed.’

‘And the GMC accept in there submissions and sanctions each case is different,’ he said.

He questioned if there were errors made because Bawa-Garba was she was ‘simply being lazy or not bothered’.

‘Mr Justice Nicol has said that this was not the case,’ he added.

‘What we have in this case is a good and safe doctor who was good and safe up until this incident and was good and safe for the many years after the incident.

‘One has to ask why this good and safe doctor made these errors on this day, and we submit that the systemic failures are relevant.

‘We submit that this did not go behind the jury’s finding.’

Mr Larkin said: ‘We submit that the tribunal properly followed what they were required to do.

‘There is no definition of what upholding public confidence means – we submit that public confidence does not mean public opinion.

‘Public opinion may change, different regulators may have different approaches.

‘Decisions may be made that are controversial, decisions may be made that people do not like – that does not mean that the confidence in the system is undermined.’

He added: ‘Of course there are cases in which one can say the behaviour of a doctor is so egregious that it must result in an erasure.’

‘This case has attracted some publicity and there was this letter to the Times on Tuesday and a comment from the patient’s mother that she had not received an apology.’

Mr Justice Ouseley interrupted and said that that would be dealt with at a later stage in the hearing.

Mr Larkin said: ‘I am simply explaining that an apology has been made – I have no doubt too little to late but it has been made.’ 

Dr Barwa-Garba attended the first day of the hearing today with her husband and hugged a member of the public gallery as she took her seat in front of Jack’s parents in the packed courtroom. 

Earlier this week more than 700 doctors protested against attempts to strike off Dr Bawa-Garba, The Times reported.

In a letter to the newspaper, healthcare professionals said the General Medical Council’s pursuit of Dr Bawa-Garba ignores the role short-staffing played in the tragedy.

Jack, pictured, had Down's Syndrome and a heart condition and was admitted to hospital in February 2011 with sickness and shortness of breathing

Jack, pictured,  suffered a septic shock but treatment was stopped for two minutes after Dr Barwa-Garba confused his case with the other child's

Jack, left and right, had Down’s Syndrome and a heart condition and was admitted to hospital in February 2011 with sickness and shortness of breathing. He then suffered a septic shock but treatment was stopped for two minutes after Dr Barwa-Garba confused his case with the other child’s

They also claim that the case could lead to a ‘climate of defensiveness’ where doctors would be scared to admit to mistakes. 

Jack’s mother Nicola previously said she was ‘disgusted that doctors are all sticking together’ and defending Bawa-Garba, who was given a two-year suspended sentence.

She’s never been held accountable for what she did,’ added Mrs Adcock. ‘She hasn’t gone to prison, she hasn’t been struck off.

‘Never once did she ever say sorry to us, she showed no remorse, nothing.’

Speaking on the eve of the case, Mrs Adcock added: ‘Hundreds have signed this letter. I don’t care if I have to stand up against thousands of them.

‘They will not intimidate me, they won’t patronise me or make me feel I shouldn’t be there.

‘I will do whatever is necessary for my son, and to stop parents having to go through the sort of thing my family has gone through.’

The GMC argued that the healthcare profession in the UK will be damaged if a doctor convicted of manslaughter is allowed to continue working.

Charlie Massey, Chief Executive of the General Medical Council, told MailOnline: ‘We have a clear responsibility to maintain the public’s confidence in the medical profession.

‘That is why we must act in cases where a truly exceptional degree of negligence – the very high threshold set in the criminal law for gross negligence manslaughter – has been established, as was the case with Dr Bawa-Garba.’

Jack, who lived with his parents and younger sister Ruby in Glen Parva, Leicester, was said to be a ‘lively and energetic’ boy who attended a mainstream primary school.

But on February 18, 2011, Jack showed symptoms of diarrhoea, sickness and breathlessness and was admitted to hospital’s children’s assessment unit.

Although he had sepsis and urgently needed antibiotics, Dr Bawa-Garba – originally from Nigeria – wrongly diagnosed him as having gastroenteritis and failed to look at an X-ray for over three hours which showed he had signs of the highly dangerous infection.

Nurse Isabel Amaro, pictured, was previously struck off after receiving a two-year suspended sentence for gross negligence manslaughter around Jack's death after providing 'truly, exceptionally bad care'

Nurse Isabel Amaro, pictured, was previously struck off after receiving a two-year suspended sentence for gross negligence manslaughter around Jack’s death after providing ‘truly, exceptionally bad care’

She also did not review ‘seriously abnormal’ blood tests results which showed the youngster was suffering organ failure and later allowed him to be mistakenly given medication usually used to treat high blood pressure.

That evening Jack suffered septic shock and a ‘crash call’ went out to medics to revive him only for Bawa-Garba to call off CPR because she mistakenly believed there were instructions not to resuscitate him.

Efforts to help Jack were halted for up to two minutes until the junior colleague picked up the mistake but by then it was too late.

Mother-of-two Dr Bawa-Garba was convicted at Nottingham Crown Court of manslaughter by gross negligence in December 2015 but was given a 24-month jail term suspended for two years after she said she was sole carer for her five-year-old son who is disabled.

She said her husband, who lives in Dubai and works in aviation, would not be able to care for her autistic son and has no right to work or claim benefits in the UK.

Portuguese agency nurse, 47-year-old Isabel Amaro, of Manchester was also given a two-year jail terms suspended for two years for gross negligence manslaughter.

The court heard the pair had provided Jack with ‘truly, exceptionally bad care’ in the hours before his death. 

Amaro, 47, was previously struck off by the Nursing and Midwifery Council for failing to give Jack proper care over a seven-hour period. 

The Court of Appeal hearing, in front of Lord Justice Gross and Mr Justice Ouseley, continues. 



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