Hadiza Bawa-Garba: Doctor at centre of sepsis death case should be able to return to work, Court of Appeal rules

High Court 'wrong' to strike off paediatrician after medical tribunal found it would be disproportionate in light of mitigating factors, say judges

The doctor struck off over mistakes that led to the death of six-year-old Jack Adcock in 2011 could return to work after the Court of Appeal upheld her challenge against the decision.

On Monday, Dr Hadiza Bawa-Garba won her appeal against a High Court ruling earlier in 2018 which said erasing her from the medical register was the only way to maintain confidence in the profession.

But the Court of Appeal found the earlier judgement was “wrong” and overturned its decision that Dr Bawa-Garba should be erased, reinstating a 12-month suspension. The General Medical Council (GMC) has said it will not challenge the Court of Appeal judgement further.

The case and the GMC’s role has become a flash point for the medical profession, which has raised concerns about the chronic understaffing and unsustainable pressures in the health service, and the lack of protection for those working under these conditions.

The judgement by chief justice Lord Burnett, Sir Terence Etherton, and Lady Justice Rafferty said: “The Court of Appeal unanimously allows the appeal and it holds that divisional court was wrong to interfere with the decision of the tribunal.

“The Court of Appeal sets aside the order of the divisional court that Dr Bawa-Garba should be erased from the medical register and restores the order of the tribunal that she be suspended from practise for 12 months, subject to review.”

Speaking to the BBC from Nigeria after the ruling, Dr Bawa-Garba said: “I’m very pleased with the outcome, but I want us to pay tribute and remember Jack Adcock, a wonderful little boy who started this story.

“I want to let the parents know I am sorry for my role in what has happened to Jack.

“I’ve dedicated my life to medicine, it is my purpose. I can’t see myself being anything else but a practising doctor serving the community. So of course when I got the news that I can be given the opportunity to work again, I was very pleased and I thank god for this day.”

Jack, who was born with Down’s syndrome and a heart condition, was admitted to Leicester University Hospitals NHS Trust with digestive and respiratory issues and was treated for acute gastroenteritis initially, but died from sepsis brought on by pneumonia.

Though still training to be a paediatric consultant, Dr Bawa-Garba was the senior doctor on the ward and was found guilty of manslaughter by gross negligence over the death, but the GMC’s own tribunal service ruled in 2017 she should be allowed to return to work after a suspension of 12 months.

The Medical Practitioners Tribunal Service had said erasure was “disproportionate” taking into consideration failings at the trust, including a lack of senior consultant cover, IT problems and staff shortages leaving Dr Bawa-Garba covering several wards.

However, the GMC argued it was not the tribunal service’s job to overrule the courts and that Dr Bawa-Garba’s mistakes, including failing to spot “barn door” signs of sepsis, according to expert witnesses, should lead to her deregistration.

Monday’s ruling confirms that the tribunal service was right to take account of the wider context and mitigating factors in forming its judgement.

Doctors and supporters raised hundreds of thousands to hire an independent legal team for the appeal, with many saying Dr Bawa-Garba was being scapegoated for systemic failures which were becoming increasingly common across the NHS.

Former health and social care secretary Jeremy Hunt had also spoken out against the decision to have Dr Bawa-Garba struck off, saying it would harm efforts to introduce a learning culture in the NHS and ordering a review into the gross negligence manslaughter charge in healthcare.

“We fully accept the Court of Appeal’s judgment,” GMC chief executive Charlie Massey said, saying it acted in good faith and the complex case had provided important clarity on the roles of criminal courts and tribunals.

“As the independent regulator responsible for protecting patient safety we are frequently called upon to take difficult decisions, and we do not take that role lightly.

“We are sorry for the anguish and uncertainty these proceedings have had on Jack’s family, Dr Bawa-Garba and the wider profession.”

Mr Massey added that the case had rightly showed the GMC it could do more to speak out in support of doctors working in highly pressurised environments.

Dr Chaand Nagapul, chair of the British Medical Association, said: “We welcome today’s judgement of this important case … We hope that Dr Bawa-Garba will now rightly be given space to resume her career.

“Today’s successful appeal in no way detracts from the tragic circumstances of this case and the unexpected death of a young boy, and we once again send our deepest condolences to Jack Adcock’s family.