âI think people want to know how it was possible that a junior doctor could get convicted for gross negligence manslaughter, going about her duties as a junior doctor - and when there were so many systemic factors at play,â he says. Mrs Adcock says she feels that these doctors are blaming her for her sonâs death. Professor Riordan is Professor of Medicine (Conjoint) at the Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales and Head of the Gastrointestinal and Liver Unit at the Prince of Wales Hospital, a University Teaching Hospital, in Sydney, Australia. âHe was a little more alert and we thought he was getting better,â Mrs Adcock says. âI knew that I had to get a line in him quickly to get some bloods and also give him some fluids to rehydrate him,â says Dr Bawa-Garba. Dr Bawa-Garba says no-one had flagged it was available. The hospitalâs own investigation, which flagged up all the contributory factors and failings that had led to Jackâs death, wasnât put before the jury, he says. Bawa-Garba’s fate will be decided in the High Court on 7 December when the GMC attempts to overturn a decision by the Medical Practitioners Tribunal Service to keep her on the medical register. In his evidence to the practitioners tribunal Cusack said that although a trainee might not realise the full significance of this abnormal blood gas result, a consultant should. . At 21:21 the decision was made to stop resuscitation. This time, âthere was blood â I just couldnât believe it was him, my baby, goneâ. Jack died from sepsis. In 2013, Leicester GPs had started to become concerned about the University Hospitals of Leicester Trustâs SHMI. At the end of the trial, the judge summed up the case to the jury. But when she went to view them on the computer system, it had gone down. On his way up there, he had been sick again. I didnât want my dad to see me being taken away in handcuffs. A review is underway to look at the disproportionate referral rate. âIt took ages for the conclusions to become public,â says Dr Orest Mulka, a former GP in Measham, and one of the reviewers. But some local GPs were frustrated and thought there was a resistance to change and a reluctance to talk openly about the problems. The case of Hadiza Bawa-Garba has left the UK medical profession rattled. Get up to date with the latest news and stories about the person Steven O Riordan at The Irish Times. Attached to his witness statement was the training encounter form containing details of his discussion with Dr Bawa-Garba in the canteen eight days after Jackâs death - the form Dr Bawa-Garba refused to sign. The family was also told that a junior doctor had failed to recognise the severity of Jackâs condition, according to the minutes. Instead, Dr O’Riordan insisted on seeing Jack’s parents without her. It was the same for CAU ward sister Theresa Taylor. Junior doctors did try to raise their concerns that trainees were being used to plug rota gaps, often at the last minute. âI remember going hysterical and just thinking, you know, âPlease look after my little boy,ââ says Mrs Adcock. Because of staff shortages, two of the three CAU nurses were from an agency and not allowed to perform many nursing procedures. She gave him a large boost of fluid â a bolus â to resuscitate him. âI sat in that small room and prayed,â she says. âThe reason the doctors are doing what theyâre doing, theyâre scared for themselves. Stephen has 7 jobs listed on their profile. Gastroenterology and the Liver. But in fact nearly a quarter of patients in the report had received âunacceptable careâ â serious errors had been made that would have increased the risk of harm. At 16 she moved to the UK to study for her A-levels. We just could not believe what we were hearing, so automatically we said, âSo youâre telling us someoneâs responsible for our sonâs death?ââ Mrs Adcock says. By this point, Jack was sitting up in the bed drinking juice. Professor Stephen Riordan. The consultant then added to the notes that Dr Bawa-Garba had made. Using what she had learned from Jack Adcockâs death, Dr Bawa-Garba says, she helped carry out a sepsis study and formed a junior doctor weekly teaching programme where doctors would discuss ânear missesâ or incidents when patients had died so they could learn from them. There are 20+ professionals named "Steven O'riordan", who use LinkedIn to exchange information, ideas, and opportunities. They were sent a copy of the Leicester Royal Infirmary investigation and invited to discuss it, but they didnât want to. They said consultant cover had been patchy and that factional infighting between consultants had caused problems for trainee doctors - it wasnât something they could speak out about, they had had to keep their head down. âIâve made clinical mistakes including delayed diagnosis and errors in treatment. âWe were season ticket holders but since that happened [Jackâs death] I havenât been able to go,â he says. During the afternoon handover, Dr Bawa-Garba told Dr OâRiordan about Jack â his diarrhoea and vomiting, heart condition, and enalapril medication. February 2011—6 year Jack Adcock dies from sepsis at Leicester Royal Infirmary, December 2014—Bawa-Garda and two nurses are charged with gross negligence manslaughter4, November 2015—Bawa-Garba is convicted of gross negligence manslaughter and given a two year suspended sentence56, August 2016—The nurse also convicted in the case, Isabel Amaro, is struck off, December 2016—Bawa-Garba is denied permission to appeal against her manslaughter conviction7, June 2017—Medical practitioners tribunal suspends Bawa-Garba for 12 months, saying that “erasure would be disproportionate”, December 2017—High Court to hear GMC’s case to erase Bawa-Garba from the medical register, bmj.com Feature Where should the buck stop? View Stephen O'Riordan’s profile on LinkedIn, the world's largest professional community. Dr Bawa-Garba recalls the moment that Mrs Adcock came up to her to thank her for her help. The jurors were instructed to decide whether the three defendants were guilty of unlawfully killing Jack Adcock, basing this decision exclusively on the evidence put before them. It acts as an early warning system highlighting a need for further investigation. âAnd then I remember somebody taking me back into the room and telling me, âJack needs his mummy.ââ. he asks. The hospital appointed Dr Ian Sturgess to consider improvements in the emergency sector. But they say they heard very little from the hospital. Dr Bawa-Garba looked for Jackâs blood results from the lab. So Dr Bawa-Garba was covering various wards of the hospital, including maternity, taking calls from GPs, and dealing with other emergencies. O’Riordan SM, Hindmarsh P, Hill NR, Matthews DR, George S, Greally P, Canny G, Slattery D, Murphy N, Roche E, Costigan C & Hoey H 2009 Validation of continuous glucose monitoring in children and adolescents with cystic fibrosis: a prospective cohort study. There was then a second post-mortem examination in case criminal proceedings were opened. On 25 February, a week after Jackâs death, Dr OâRiordan asked Dr Bawa-Garba to meet him in the hospital canteen, rather than the office he shared with other consultants. Dr OâRiordan told the court that he recalled the pH was 7.08 and âthe lactate was highâ saying he couldnât remember if Dr Bawa-Garba had told him the actual value at their afternoon handover, before Jack died. After an hour of being on fluids to rehydrate him, Jack seemed to be responding well. This we believe would have a detrimental effect on the overall quality and safety of healthcare.”. A summary version was produced for the press and the public. Though there has been an outpouring of sympathy for the trainee paediatrician being pursued by the General Medical Council (GMC),1 there is also an increasing sense that the case will leave the patient safety agenda in tatters by closing down any discussion of medical errors for fear of litigation. He said: At no time was this patient highlighted to me as urgent, unwell, septic or that I needed to see him.â. The negligence had to be gross or severe, he said - what they did or didnât do had to be truly, exceptionally bad. He said, “The reflections in her e-portfolio show that at no point has she failed to admit her mistakes, which is critical if we are going to learn from tragic incidents and build a safety net to prevent them happening again.”, The Royal College of Paediatrics and Child Health would not comment on the case but highlighted a statement from its consultation document sent to the Sentencing Council for England and Wales, which is reviewing its guidelines on manslaughter, including gross negligence manslaughter.3 The college said that trainees were required to use their portfolios for personal reflection and subsequent learning. “Since April 2020, the insulin pump training is now provided online,” said Dr Stephen O'Riordan, consultant endocrinologist at CUH. âWe didnât really know anything until it went to the inquest,â says Mrs Adcock. Care assistant convicted of two assaults on disabled man . So Mrs Adcock gave it to him. The BMJ has learnt that, five days after Jack’s death, Bawa-Garba was asked to meet Stephen O’Riordan, the duty consultant at the time of the incident, in the hospital canteen. View the profiles of professionals named "Steven O'riordan" on LinkedIn. Jack Adcock wasnât himself when he returned from school. âJack was really lethargic, very sleepy. Soon after Dr Bawa-Garba took over, the bleep went off â a child down in the accident and emergency unit, several floors below, needed urgent attention and she missed the rest of the morning handover. In the morning, Dr Bawa-Garba had had to intervene to stop doctors from trying to resuscitate a terminally ill boy who had a âdo not resuscitateâ order. Others in the medical profession have found different ways of registering a protest. He denies being influenced by the Adcocksâ petition, and says the GMC acted out of the need to protect public confidence in the profession, given the seriousness of the conviction. She says: I walk in and say, âHeâs not for resuscitation,â because I thought it was the child with the âdo not resuscitateâ order.â. At the heart of this story is the tragic death of a much-loved little boy and the loss felt by the family. An overworked and under-supported doctor was thrown under the bus by the GMC.â. âIn the Mid Staffs enquiry they found that there had been hundreds of avoidable deaths, the reviewers drew no such conclusion in this review,â he says. The BMJ has learnt that, five days after Jack’s death, Bawa-Garba was asked to meet Stephen O’Riordan, the duty consultant at the time of the incident, in the hospital canteen. Those tests would have indicated that Jack may have had kidney failure and that he needed antibiotics. “It is the duty of senior members of the healthcare team to critically evaluate information provided by less experienced colleagues, identify incongruences, and reassess patients to better understand the clinical state of the patient,” he said. âI remember writing and writing until the ink ran out in the pen,â she says. Keep going,â Mr Thomas said. The court heard that O’Riordan was aware before Jack died that he had a serum pH of 7.084 and a blood lactate concentration of 11.4 mmol/L, which he wrote down in his notebook at evening handover. This meant not only that blood test results were delayed, but also that the alert system designed to flag up abnormal results on computer screens was out of action. âOn the reflection I did following this incident, those were the points that I looked at,â she said. âAnd when I discovered that the media, including the BBC, had portrayed them as relating to the care of terminally ill patients receiving palliative care, I thought this was completely untrue. But she says she was concentrating so much on the CRP that she failed to register that his creatinine and urea were also high â signalling possible kidney failure. Not all failings were heard, he says. None felt able to go on the record. But Mrs Adcock says the doctors are mistaken in their interpretation of what happened. Mr Furlong says the Trust was the first to use this review method and now others are using similar techniques to look at what can be learned from patients who have died. Far from ignoring problems, he says, the Trust went looking for them. Both her reflections and the training encounter form were uploaded to her e-portfolio, an online system used for learning purposes. âEven though she made mistakes she was trapped - she was trapped in a set of circumstances which set her up for failure.â. Dr Bawa-Garba tried a number of extensions before managing to speak to someone. Dr Hsu says heâs been around long enough to know if reports donât work out well for someone, people have ways of of ensuring that the report doesnât really get anywhere. Teams of doctors and nurses were tasked with going through the records of patients who had either unexpectedly died in hospital or died within 30 days of leaving between 1 April 2012 and 31 March 2013. But at a meeting between the local clinical commissioning groups, hospitals, community organisations and NHS England to discuss the findings, the discussion soon turned from how to fix the problems to how to get the message out, Dr Hsu says. See the complete profile on LinkedIn and discover Stephen’s connections and jobs at similar companies. This is a mistake,ââ she says. âThe officer said, âWeâre investigating Jackâs death as a possible manslaughter case and we need you to come down to the station,ââ she says. Stephen has 3 jobs listed on their profile. His tongue, or his lips, looked blue. The following day, Saturday, the family was invited back to the hospital to meet a group of doctors, nurses and managers from the trust to discuss what had happened. She asked one of the doctors in her team to chase up the results for her patients, and took on some of that doctorâs tasks. I welcome the verdict because for me thatâs an opportunity to do something that Iâve dedicated my life to doing, which is medicine. In the morning Jack was taken to the GP by his mother, Nicola, and referred directly to Leicester Royal Infirmaryâs childrenâs assessment unit (CAU). Nine months after Dr Hsu submitted his report, it was posted on the Trust website. But when medical staff gathered to discuss the dayâs work, they were told someone was needed to cover the CAU â the doctor supposed to be doing it was on a course. She had brought a rucksack with her in case she was sent to prison. Cusack has serious concerns about how a document intended for reflective practice and learning for personal development was used to apportion blame in the criminal justice process. And meet the medical profession have found different ways of registering a protest were worried that can! Brought against her discuss it, but they say they heard very little from the investigation! 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