In November one of our blogs explored the consequences following the conviction of a Paediatrician and nurse responsible for Jack Adcock’s care when he died from septic shock at Leicester Royal Infirmary in 2011. Jack was denied life saving treatment after being mistaken for a patient with a “Do Not Resuscitate Order”. By the time the medics involved in his care recognised the error, it was too late to save Jack. The Nottingham Crown Court has now sentenced Dr Hadiza Bawa-Garba and nurse Isabel Amaro for their errors, whilst across the border in Wales, Cardiff Crown Court sentenced three nurses following their failure to carry out blood glucose tests and then faking results in patient’s medical records.
Turning first to Dr Bawa-Garba and Ms Amaro, they have been given a suspended two year prison sentence, which means that whilst they will not be imprisoned immediately, they will have to serve their time if they are found guilty of other offences in the future. The charge for manslaughter can vary greatly depending on the circumstances of each case, but a conviction of manslaughter does often lead to time in prison. Many may consider the suspended sentence handed down to be lenient in the circumstances, but one has to question whether or not this decision has been reached on public interest grounds.
As discussed in our last blog, there has been deep concern within the legal and medical communities at the conviction of Dr Bawa-Garba and Ms Amaro. Until now, criminal convictions have been reserved for medics wishing to cause deliberate harm to patients and not those who make an unintentional error which sadly leads to death. It has long been thought that the threat of imprisonment and a criminal record for errors at work could discourage doctors and nurses from remaining in, and entering the profession; particularly at a time when NHS medics are busier and under more pressure than ever. It is not clear why the CPS and the Court’s have decided to take this case further, as there are examples of such errors across the country, but the sentence handed down yesterday may be a message that the law is not yet ready to use its full weight in cases where medics have made avoidable but unintentional errors.
The Judge explained the use of suspended sentences by the fact that Dr Bawa-Garba is the sole carer for her autistic son, and therefore seems to have sympathy for the effect that a prison sentence would have on her child. He also cites Ms Amaro’s psychiatric problems as the reason for suspending her sentence. He did however add that the pair’s careers in medicine “would come to and end”.
The Judge in Wales took a very different view, however, when considering the sentencing of Lauro Bertulano, Rebecca Jones and Natalie Jones; the nurses at the Princess of Wales hospital in Bridgend faking blood test results on a specialist stroke ward; all pleading guilty to wilful neglect. Natalie Jones was sentenced with a community order; however Rebecca Jones and Lauro Bertulano were given custodial sentences of 8 and 4 months respectively.
In handing down his decision, Judge Tom Crowther QC said
I pause to remind myself that you all would have seen worried relatives coming and going, sitting with their mothers, fathers or spouses as they lay ill, some approaching the end of their lives, and to wonder with bemusement how you could have continued to betray your patients and those families as you did”. He added, “This was not a failure to do your job, it was a failure of compassion and humanity.
Many may view this sentencing as being too lenient, given that the nurses involved had deliberate acted in a way that they knew could harm a patient’s health. This was not an isolated example of a momentary loss of judgment but deliberate acts on a routine basis. From a lawyers perspective it is difficult to see how the nurses in Wales could be held less culpable, save for lack of any evidence that their actions directly led to the death of a patient, than Dr Bawa-Gaba and Ms Amaro.
It remains to be seen whether either approach is considered to be the beginning of routine convictions of medics causing death through negligent practice, and whether the Courts will be lenient or begin to take a harder line as more and more cases come before them. The only thing we can be sure of is that nothing is certain in this new arena of conviction following clinical malpractice and we can only wait and see what else the Courts have in store.