NHS physician convicted of murder

  1. Very sad case. I feel badly for the doctors working in the NHS.

    Medscape: Medscape Access

    The original article is in a blog here,

    Just a moment...
    Last edit by azhiker96 on Feb 19 : Reason: Correction
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    About azhiker96, BSN

    Joined: Mar '06; Posts: 3,889; Likes: 6,752

    9 Comments

  3. by   Phil-on-a-bike
    When somebody takes a story about a doctor convicted of manslaughter...

    ...and presents it as the story of a doctor convicted of murder...

    ...you have to wonder at the motivation behind that misrepresentation.

    In the interests of balance: Should Hadiza Bawa-Garba have been struck off as a doctor? I believe so | Healthcare Professionals Network | The Guardian
  4. by   heron
    Who gave the enalapril?
  5. by   toomuchbaloney
    After reading about the events I guessed that a portion of the motivation for posting this story was to cast doubt on single payer health systems.
  6. by   azhiker96
    Quote from heron
    Who gave the enalapril?
    I wondered this since it was not ordered by the doctor and thus presumably not given by nursing.

    It was given by his mother.

    Dr Hadiza Bawa-Garba: What led to six-year-old Jack Adcock's death? | The Independent
  7. by   azhiker96
    Quote from Phil-on-a-bike
    When somebody takes a story about a doctor convicted of manslaughter...

    ...and presents it as the story of a doctor convicted of murder...

    ...you have to wonder at the motivation behind that misrepresentation.

    In the interests of balance: Should Hadiza Bawa-Garba have been struck off as a doctor? I believe so | Healthcare Professionals Network | The Guardian
    I tried but was not able to modify the title. Perhaps an admin can edit murder to manslaughter in the title.

    I did like your linked piece. The main gist of it seems to be we need to respect the court decision regardless of personal feelings. This quote is from your link.

    I am not sure whether the criminal court is the best place to hold a medical professional to account, and I welcome Hunt's belated review into medical manslaughter. Medical professionals who do their utmost for patients should not live in fear of legal action for honest mistakes. Bawa-Garba was let down by the system that she worked in. I, like many of my colleagues, do not believe she should have been convicted of manslaughter.
  8. by   azhiker96
    Quote from toomuchbaloney
    After reading about the events I guessed that a portion of the motivation for posting this story was to cast doubt on single payer health systems.
    I was struck at how understaffing was a major factor in the case. I work at a safety net teaching hospital. Sometimes we are stretched thin but not near what was represented in this tale.

    If the NHS is understaffed that is more of an indictment of funding rather than the system itself. Perhaps those served are not paying their fare share in taxes.
  9. by   Phil-on-a-bike
    Quote from azhiker96
    I tried but was not able to modify the title. Perhaps an admin can edit murder to manslaughter in the title.

    Fair enough - good to know it's an error rather than an 'agenda' thing, if you see what I mean.

    The comment from the Guardian article that stayed with me was that Dr Bawa-Garba had been 'found guilty in court, but found innocent in doctors' coffee rooms'. Once you've heard that, you realize how much of the commentary on this case is of that nature.

    The understaffing issue looms large over this case, but it is less relevant when you start drilling down into the specifics.

    There was a clear pathway for observing, recording and reporting the warning signs of sepsis.
    IF understaffing was the causative issue, you might expect some of those steps to have been missed. They were not. The warning signs of incipient sepsis were detected, recorded, and reported.
    (In fact, that recording and reporting formed much of the evidence against Dr Bawa-Garba.)
    Once reported, there was a clear policy of treatment escalation - which Dr Bawa-Garba conciously chose not to follow.

    Why?
    Because of her own conviction - arrived at utterly without foundation - that a DNAR order was in place for Jack Adcock.

    To my mind, the issue of understaffing is - at best - tangential to this situation.
    "I chose not to order more active treatment based on my own erroneous impression that a DNAR order existed, an impression I took no action to verify, because.... understaffing?"

    That doesn't cut it.

    It wouldn't matter if they had short staffing, full staffing, or overstaffing.
    If the lead clinician tells those staff a DNAR order is in operation and orders palliative treatment only... that's what's happening.
    Granted, more staff = more chance of somebody looking to verify the existence of the DNAR.
    But - 'we need more staff in order to monitor physicians for clinical error" is kind of a stretch.

    As for feeling sorry for doctors working in the NHS... meh.

    Any UK doctor could take themselves into private practice tomorrow.

    Because the UK has all the same healthcare systems as the the US. Private patients, healthcare insurance plans, private hospitals, etc.

    We have the NHS in addition to those things, not instead of them.

    Said doctor would be removing themselves from the security of a salaried position, and taking themselves into the competitive open market.
    They're distancing themselves from the vast majority of the patient population, because in Britain, the NHS is Big Dog at the Feed Bowl, but they are availing themselves of the wealthiest patient groups, corporate and commercial work.
    Good luck to them.

    (In reality, most UK doctors do the majority of their work in the NHS, and do various amounts of private practice as a sideline.)

    Hope there's food for thought in there!
  10. by   azhiker96
    I disagree that staffing was not an issue. I would refuse a triple assignment as it would not be safe and would put my patients and my license in jeopardy.

    [quote]Normally, a registrar each is assigned to cover the wards, the emergency department and the Children's Assessment Unit (CAU). On that day, Dr. Bawa-Garba covered all three. [\quote]

    Perhaps it takes very little effort for a doctor to cover one of those areas so it might have been reasonable to dole them all out to her. It just seems a bit excessive to me.

    Her initial working diagnosis was shock due to gastroenteritis. After she reviewed a chest X-ray she diagnosed pneumonia and prescribed abx. It was an hour after his mother gave him enalapril that he had cardiac arrest and Resucitation was started. It was paused for a minute due to the confusion about a DNR. Death was from streptococcal sepsis.

    It is worth noting that her supervisor had reviewed the labs and did not make the connection to sepsis. I have seen sepsis caught in PACU several times. This is after it was missed by the surgeon in consult and Preop and missed by anesthesia in surgery.

    Nobody wants a patient to have sepsis which leads to choosing any other possible cause for tachycardia and hypotension. This is why our EMR has sepsis triggers built into it. If a patient trips those triggers then a nurse must contact a doctor to assess the patient for sepsis. Sepsis is assumed based on presentation until proven otherwise.

    I don't know if it is common for people to take their home medications while hospitalized in the NHS. In the US, home medications are not to be given. All medications must come from the hospital. If someone brings in their home medications we ask them to send them home with a family member or we lock the meds up for the duration of their stay.
  11. by   Phil-on-a-bike
    That's a solid precis of the situation - and a lot clearer than the versions presented in much of the media coverage.

    I should point out that one registrar covering three units doesn't equate to one doctor covering three units.
    The registrar's role is largely one of oversight for more junior medical staff.
    Overnight, each unit will have a Senior House Officer/FY2 (foundation year 2) doctor on duty.
    They are nominally based on the unit, but - like the registrar - will be on-call hospital-wide for their particular clinical specialty.
    Under the SHO's are the House Officers/F1 (foundation year 1) doctors.
    They are based on their respective units.

    Again, there's a lot of 'slant' in the coverage.
    Much of what I've read is phrased to make it sound as if Dr Bawa-Garba was the only doctor available.

    Edited to add: Pt.s own meds in the NHS: Patients are encouraged to bring their own meds in when attending.
    This is to ensure accurate recording of their existing med regime, to identify any compliance issues, (BD drug with an issue date six months ago, still half-full... what's going on there?) and to avoid any delay in administration. (You're on an unusual medication? We'll get it to you as soon as pharmacy gets it to us. But if you have it with you, you can have it now.)
    Once a patient is admitted, their own meds go in their med locker. Those meds which tally with their in-patient regime can be given from the patient's own stock (remember, the general practitioner they got those meds from is also NHS - it's a seamless service) or from hospital stock.
    Last edit by Phil-on-a-bike on Feb 21 : Reason: Med details added

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