Medical Manslaughter: The Effect of Lay Findings of (Criminal) Gross Negligence on Professional Tribunals
| Author | Elizabeth Stuart-Cole |
| Published date | 01 June 2018 |
| Date | 01 June 2018 |
| DOI | http://doi.org/10.1177/0022018318780036 |
| Subject Matter | Case Notes |
Case Note
Medical Manslaughter:
The Effect of Lay Findings
of (Criminal) Gross Negligence
on Professional Tribunals
General Medical Council vDr Bawa-Garba [2018] EWHC 76
Keywords
homicide, manslaughter, gross negligence, GMC, doctor, fitness to practice
On Friday 18 February 2011, Jack Adcock, a 6-year-oldchild with Down’s syndrome,was admitted to the
Children’sAssessment Unit at LeicesterRoyal Infirmary. On admission,he was unresponsive and limp.He
was treated by Dr Bawa-Garba, initially for gastroenteritis, then following a chest X-rayfor pneumonia. It
was laterestablished thatAdcock had septic shockthat resulted in organ failure.Despite effortsto resuscitate
him (initially hampered by Dr Bawa-Garba’s mistaken belief that he was not for resuscitation, Do Not
Resuscitate (DNR)), he died. The case adduced by the Crown was that Dr Bawa-Garba (and two others)
contributedto, or caused Adcock’sd eath, by serious neglect which f ell so far below the standard of ca re
expected by a competent professional that it amounted to gross negligence manslaughter (GNM). It was
argued that Dr Bawa-Garba’s breach of duty was evidenced by her failure to accurately reassess or refer
Adcock to the consultant on call in the light of clinical findings and the continuing deterioration in his
condition. Although the error relating to Adcock’s resuscitation status was accepted as not causative, the
Crown relied on this mistake to criticise Dr Bawa-Garba’s clinical conduct. It was agreed by all parties
that ‘multiple systemic failures’ (at [21]) beyond the control of Dr Bawa-Garba occurred on the unit the
day of the death. It was further agreed that Dr Bawa-Garba had an unblemished record and that there had
been no prior concerns regarding her clinical competency. Furthermore, Adcock’s death occurred
during Dr Bawa-Garba’s first shift on the acute unit since her return from maternity leave (at [19]).
Dr Bawa-Garba was convicted of GNM on 4 November 2015 at Nottingham Crown Court and was
sentenced to two years’ imprisonment, suspended for two years. On 13 June 2017, the Medical Practi-
tioners Tribunal Service (MPTS) concluded that Dr Bawa-Garba’s fitness to practice was impaired, and
she was suspended from practice for one year. A subsequent application from the General Medical
Council (GMC) to the MPTS to strike Dr Bawa-Garba off the medical register was rejected: ‘In the
circumstances of this case, balancing the mitigating and aggravating factors, the tribunal concluded that
erasure would be disproportionate’ (at [23]).
The GMC appealed the Tribunal’s decision to the High Court. Mr Hare QC (at [26]) submitted that
the Tribunal had allowed evidence of systemic failings to undermine Dr Bawa-Garba’s personal culp-
ability and that removal from the medical register was warranted.
Held, allowing the appeal, the court substituted suspension from practice with the sanction of
erasure (at [37]). It was determined that no punitive measure short of erasure could maintain public
confidence in the profession and perpetuate its proper professional standards and conduct (at [38] ).
Full weight was given to the jury’s verdict that Dr Bawa-Garba’s failures that day were not simply
honest errors or mere negligence but were truly, exceptionally bad (at [38]). Dr Bawa-Garba has since
been granted permission to appeal the judgment of the Divisional Court (25 January 2018).
The Journal of Criminal Law
2018, Vol. 82(3) 197–200
ªThe Author(s) 2018
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DOI: 10.1177/0022018318780036
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