Hadiza Bawa-Garba case
Dr. Hadiza Bawa-Garba, the junior doctor who treated him (under the supervision of duty consultant Dr Stephen O'Riordan) and a nurse, Isabel Amaro, were subsequently found guilty of manslaughter on the grounds of gross negligence.
[2] In 2010, the Medical Programme Board demonstrated almost a quarter of junior doctors dropped out of their NHS training in England after two years, and according to Unions, this was due to high workload.
[3][4][5] In 2016, a report issued by the Royal College of Physicians stressed "gaps in rotas, poor access to basic facilities and an ever-growing workload" for doctors in training.
The report presented "a bleak picture of the conditions junior doctors currently face and the impact this is having on the patients they care for every day" and this was at "a harmful and unsustainable level".
[6][7] The problem of rota gaps and high levels of stress and its resulting effect on staff morale was also later emphasized at the 2017 BMA annual representative meeting.
[8] On 18 February 2011, Jack Adcock, a 6-year-old boy, was referred to Leicester Royal Infirmary by his GP and admitted to a Children's Assessment Unit (CAU) at 10.20am.
[1] He was treated by Dr Hadiza Bawa-Garba, a specialist registrar (SpR) in year six of her postgraduate training (ST6) who had recently returned from maternity leave, who was responsible for Jack's care.
A point-of-care venous blood gas test revealed profound Metabolic acidosis with a lactate of 11.4 mmol/L and serum pH of 7.084.
She did not ask the on-call consultant to review Jack during an afternoon handover meeting at 4.30pm but did share abnormal laboratory results with him which he duly wrote down in his notebook.
Although she correctly omitted the patient's medicine enalapril on the drug chart, she did not make it clear to the child's mother not to give it.
Bawa-Garba attended the cardiac arrest call to the side-room believing it to be the terminally-ill child she admitted earlier with a DNAR order.
[13] On 4 November 2015, Bawa-Garba was found guilty of manslaughter by gross negligence in Nottingham Crown Court before a jury directed by Mr Justice Andrew Nicol after a 4-week trial.
Revalidation, according to BMA council GMC working party chair Brian Keighley 2012, was intended "to encourage quality in healthcare for patients through self-assessment, appraisal, continuing medical education and reflective practice."
He also stated that, "Over the past 10 years there has been confusion and tension between those who believe it is a screening tool for the incompetent, rather than a formative, educational process for the individual.
"[22] As is common for clinicians, Bawa-Garba kept reflective learning material in an e-portfolio as part of her training, including relating to the treatment of Jack Adcock.
In the case of Dr Bawa-Garba, the NHS Trust in question recognised there were systemic failures and pressures which contributed to the death of a patient.
[12] Dr Jeeves Wijesuriya, the then junior doctors' committee chair for the British Medical Association (BMA), argued that these systemic shortcomings were not adequately considered in the initial trial.
[30] At the end of January 2018, BMA council chair, Chaand Nagpaul, expressed concerns over doctors' fears and challenges in working under pressure in the NHS.
