Advising with empathy and experience

Doctor convicted of manslaughter.

A doctor has been found guilty of the manslaughter-by-gross-negligence of a six-year-old boy.

Dr Hadiza Bawa-Garba, 38, of Leicester, was accused of medical failings in the death of Jack Adcock after he was admitted to Leicester Royal Infirmary on 18 February 2011 with severe vomiting, diarrhoea and breathing difficulties. She was convicted by a 10-2 majority verdict after the jury deliberated for nearly 25 hours.

Sister Theresa Taylor, 55, of Leicester, was found not guilty of the same charge

During the trial, the jury heard how Bawa-Garba, an experienced paediatrician, had mistaken Jack for another patient she had treated that day marked “do not resuscitate” (DNR) and stopped life-saving treatment on the boy. It was only restarted when a junior doctor pointed out her mistake.

Isabel Amaro, an agency nurse, was also found guilty of gross negligence on Monday. Amaro, 47, of Manchester, accepted that she breached her duty of care but denied that any of her failings significantly contributed to the youngster’s death. Bawa-Garba and Amaro will be sentenced later.

The boy, who had Down’s syndrome, died 11 hours after being admitted to hospital following a heart attack brought on by “septic shock” due to a virulent form of pneumonia.

Andrew Thomas QC, prosecuting, said: “Under their care, Jack’s condition needlessly declined to a point where, before he had been transferred to the next ward, he was effectively beyond the point of no return. If the defendants had recognised the severity of Jack’s illness and the fact he was in shock, if they had re-assessed him and acted on the findings, the risk of death would have been very greatly reduced.”

He added that Bawa-Garba’s confusing Jack with another patient who was marked “do not resuscitate” was a remarkable error. He added that, Jack being “beyond the point of no return” and resuscitation being futile, suggested Bawa-Garba had not given the youngster sufficient care. Bawa-Garba said working without a break could have led to her mistakenly believing Jack was under a DNR order when he was not.

In the DNR incident, Jack had collapsed at 7.45pm, when prosecutors said his lips had started to turn blue and a paediatric arrest team was summoned.

Andrew Thomas added: “During this critical period an event occurred which you may think is powerful evidence of Dr Bawa-Garba’s performance that day. When she came into the bay, almost immediately she called the resuscitation off. She told the other doctors Jack had been marked down as do not resuscitate earlier in the day.”

A first-year doctor then re-read the notes and said she could not see a DNR entry.

In a key exchange, Mr Thomas asked Bawa-Garba: “Did you ask anyone what is the name of the patient you were treating?” She replied: “No.”

Mr Thomas then asked: “When you arrived, you could see the face of the little boy being resuscitated?” The doctor said: “I cannot recall whether I saw the face or not. I could see a small room, an oxygen mask, it’s an emotionally charged environment.”

Mr Thomas said: “Is it symptomatic of your behaviour that day that you rushed to a decision without checking?” She said: “It’s not that. It’s a reflection of how long I had been working without a break.”

Blood test results on Jack showed abnormally high levels of urea and creatinine, which would have suggested problems with the youngster’s kidneys and cast doubts on an initial diagnosis of gastroenteritis and moderate dehydration.

Asked if she accepted that she missed the results, Bawa-Garba said: “I have thought and reflected on this and yes, I did miss those results.”

The prosecution had said the failings of each of the defendants contributed significantly to the boy’s death. Thomas said Bawa-Garba also failed to offer clear direction to her team, or call on the assistance of a senior consultant.

He said Taylor, who was the first to see Jack, should have “realised that he was seriously ill and required treatment as a medical emergency”, while Amaro, who was registered as an adult nurse, “wrongly indicated that his case was ‘low-level concern’, despite the fact Jack needed high levels oxygen.”