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One group of doctors tore up their GMC registration certificates in front of its headquarters in London and others took themselves off the register completely. But when medical staff gathered to discuss the day’s work, they were told someone was needed to cover the CAU – the doctor supposed to be doing it was on a course. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. The consultant then added to the notes that Dr Bawa-Garba had made. “Losing a child is the most horrendous thing ever. Dr Bawa-Garba was given a two-year suspended sentence. “You could fire everybody, punish everybody and put in an entirely new workforce, you will have the same injuries and the same errors occur again unless you’ve actually changed the systems of work,” he adds. But the coroner, Mrs Catherine Mason, dismissed this idea. “I was just saying, ‘Come on sweetheart go to sleep,’ and I was rubbing his face. The hospital appointed Dr Ian Sturgess to consider improvements in the emergency sector. “I just kept thinking, ‘How did that happen? She wanted to know about the interrupted resuscitation and so they talked about that too. The GMC acting in such a punitive way and focusing on retribution was only going to serve to make this situation worse, he added. Dr Liz O'Riordan with a rescued hedgehog The centre is run by an amazing couple in their 70s who look after more than 100 orphaned and poorly hedgehogs. Dr Stephen Riordan is a Gastroenterologist. Keep going,” Mr Thomas said. 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. “I wish I could take those words away. Several staff from the hospital were witnesses for the prosecution and barristers representing the other defendants each cross-examined Dr Bawa-Garba. He was due his second dose of the day. Though it criticised aspects of Bawa-Garba’s involvement, it also found fault with “many aspects of the care that child JA received, and many of these were system failings.”, Andrew Furlong, medical director at University Hospitals of Leicester NHS Trust, which runs Leicester Royal Infirmary, told The BMJ that the trust had “implemented a number of improvements to our systems and processes which have reduced the risk of such events occurring again.”, He added, “This was a tragic event, and in 2015 a jury reached its decision having had all the evidence presented to it.”. View Stephen O'Riordan’s profile on LinkedIn, the world's largest professional community. “I remember going hysterical and just thinking, you know, ‘Please look after my little boy,’” says Mrs Adcock. She then asked for an X-ray to check Jack’s chest. Following the Mid Staffs scandal – where hundreds of patients were exposed to “appalling” levels of care at Stafford Hospital – a new measure to help hospitals spot problems was introduced. That isn’t the case. Later that month, he says he received a list of 50 changes – mostly relating to the colour and presentation of the report and the size of the charts. I welcome the verdict because for me that’s an opportunity to do something that I’ve dedicated my life to doing, which is medicine. I ran out of the room, saying, ‘Can someone come and look at Jack?’”. “It just didn’t sink in.” She remembers them saying he had had pneumonia and an internal bleed. At first, she thought she had misheard what she was being told. 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 Jack’s death - the form Dr Bawa-Garba refused to sign. His tongue, or his lips, looked blue. However, she didn’t agree with all Dr O’Riordan said and didn’t sign the form. It was only then, the Adcocks say, they heard the “true facts” and “listened to the detail” about the errors that Dr Bawa-Garba had made. “We couldn’t speak to anyone – we weren’t really told anything.”. The three pleaded not guilty to the charge of manslaughter by gross negligence at the start of what was to be a four-week trial. “We were season ticket holders but since that happened [Jack’s death] I haven’t been able to go,” he says. I didn’t want my dad to see me being taken away in handcuffs. 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 had no tubes, he had nothing,” she says. Panorama has spoken to doctors who worked in the paediatric department shortly before Jack’s death. 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. “They were worried that people will lose faith in the health services,” he says. I suspect that many would have died anyway but in some cases my errors are likely to have contributed to poor outcomes and some patient deaths,” he says. Care assistant convicted of two assaults on disabled man . “Also, the result I got showed that the pH had gone from seven to 7.24. The case attracted a lot of media coverage. 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. “It took three months to get my little boy back, to be able to lay him to rest,” Mrs Adcock says. Stephen has 1 job listed on their profile. Dr Bawa-Garba had been on call for more than 12 hours when an emergency call went out for a patient who had suffered a cardiac arrest on ward 28 and doctors and nurses rushed to help. . After her first degree at Southampton University, she studied medicine at Leicester and set her sights on becoming a paediatrician. Dr Bawa-Garba says she had assumed he would go to see Jack - based on the description she had given and the fact he had asked for further tests - but he didn’t. He says that when there’s been a serious tragedy families are understandably angry. 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. Facebook gives people the power to share and makes the world more open and connected. AbbVie, +2 more University College Cork, +2 more Stephen O'Riordan Barclays Finance Change Management London. She gave him a large boost of fluid – a bolus – to resuscitate him. “I remember sitting there and listening to their account of my actions and I felt like a criminal,” says Dr Bawa-Garba. Because Jack’s death was unexpected, the hospital conducted an investigation to identify what had gone wrong with the little boy’s care. Sentencing Council. Phone: 021 4941323. Indeed, one official review concluded that BAME groups are also disproportionately prosecuted for gross negligence manslaughter - although it only looked at a small number of cases. 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. Before her 13 months’ maternity leave, she had been working in community paediatrics, treating children with chronic illnesses and behavioural problems. “I love the NHS. Seven weeks later, Dr Bawa-Garba was told that no charges were going to be brought against her. A number of other aspects of the case have also given rise to controversy. The GPs went on to say that in their view the hospital was “potentially on a par with Mid Staffordshire Hospital”. A crowdfunding campaign also got under way to enable Dr Bawa-Garba get another legal opinion. And on Monday she was reinstated to the medical register by the Court of Appeal. But, as she sat down, he told her she had been charged with manslaughter. “It contained what I felt I could’ve done better plus some of the things that Dr O’Riordan also felt that I could’ve done better.”. Because of staff shortages, two of the three CAU nurses were from an agency and not allowed to perform many nursing procedures. The boy’s hands and feet were cold and had a blue-grey tinge. She knew the hospital was meeting the Adcocks and asked if she could attend. However, he did not perform a senior review of the boy because, he said, he was not specifically asked to by Bawa-Garba. I’ll never forget – he closed his eyes and I thought something’s not quite right. Ward sister Theresa Taylor had been found not guilty. 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. On his way up there, he had been sick again. Dr Peter Wilmshurst, a Midlands-based cardiologist, wrote to the GMC to ask them to investigate him. They didn’t agree on how much it had affected him, though. Suite: 1.7. “I remember writing and writing until the ink ran out in the pen,” she says. He wrote that Dr Bawa-Garba had “not stressed” to him that Jack’s lactate level was 11. “Doctors work in teams and the consultant is in charge of that team. After Dr Bawa-Garba was struck off, The British Association of Physicians of Indian Origin, an organisation that aims to promote diversity and equality, has expressed concerns that healthcare workers from BAME groups are disproportionately referred to their respective regulators. “As you can imagine at that point, we felt physically sick – the anger raged. After two weeks, it was Dr Bawa-Garba’s turn to give evidence. Dr Bawa Garba applied for leave to appeal against her conviction, but this was denied in November 2016. . There was nothing in the report by Dr David O’Neill, the pathologist, or from toxicology, that suggested it played a role, she said. “We’d got Toy Story on but he was still knocking his oxygen mask off,” Mrs Adcock says. By this time, Jack had been moved to ward 28 under the care of a different team. “I’ve made clinical mistakes including delayed diagnosis and errors in treatment. So Dr Bawa-Garba was covering various wards of the hospital, including maternity, taking calls from GPs, and dealing with other emergencies. “Families can … Cusack, who was asked by trainees and the hospital trust to lead a debriefing for staff affected by Jack’s death, said that trainee doctors working in Leicester were concerned and angry about the conclusions of the trust’s investigation and the subsequent legal process. Her working diagnosis was gastroenteritis and dehydration. Jack had died of sepsis. “I’m a very private person, but I had my face in the newspaper.”. Recognising her need for further training, the hospital took Dr Bawa-Gaba off the on-call rota and put her on to the paediatric intensive care unit under the supervision of a consultant. What was fed into the trial, however, was a reflective document from Bawa-Garba’s e-portfolio, which she filled in seven days after the incident. She told the team to continue the resuscitation. Dr Bawa-Garba was struck off in January 2018, meaning that she could no longer practise medicine in the UK. “We have to help them understand what happened, to be open about what happened, to apologise for what happened,” he says. During the six-hour interview, all she could think about was her two-week-old daughter who would need breastfeeding. The following day, she says, she was admonished by Dr O’Riordan for making that call and told not to have any more contact with the family because an investigation was to be launched. In the morning, Dr Bawa-Garba had had to intervene to stop doctors from trying to resuscitate a terminally ill boy who had a “do not resuscitate” order. The cells below were a constant reminder of what might happen to her. Mrs Adcock says she feels that these doctors are blaming her for her son’s death. Some doctors have expressed concern that its role in Jack’s cardiac arrest has been underplayed. She then went to chase up Jack’s blood results, which still hadn’t come through – the doctor she had assigned to do it hadn’t managed to get them. he asks. Professor Stephen Riordan. Dr Bawa-Garba would travel from her home in Leicester up to Nottingham. “On the reflection I did following this incident, those were the points that I looked at,” she said. Dr O’Riordan declined Panorama’s invitation to comment on Dr Bawa-Gaba’s account of the meeting. Consultant Dr Stephen O’Riordan arrived at the hospital. Dr O’Neill said whether or not enalapril played a role was beyond his expertise. Stephen O'Riordan is a partner in A&L Goodbody's Commercial Property Department. On 4 November 2015, the jury found Dr Bawa-Garba guilty. A spokesperson for the Medical Defence Union responded on his behalf, saying that O’Riordan “cannot comment on the issues raised . But that all changed the day she covered for a colleague at the CAU. After Jack’s post-mortem examination, two days later, the family was told that he had died of a streptococcal infection and had developed sepsis and they could make plans for his funeral. But the fluid he was losing from having diarrhoea had not been documented by his nurse. She told medical staff he had been up all night with diarrhoea and sickness. “That's two. Both were subsequently struck off their respective professional registers, although Bawa-Garba had that decision overturned at appeal. Congress Theme – 2020 Vision: Navigating adversity with coaching psychology and positive psychology Welcoming video to the Congress with Dr Siobhain O’Riordan & Prof Stephen Palmer This Four-Day Virtual Congress offers four Masterclasses on Day 1, 2 and 3 and on Day 4, Keynote and Invited Speakers, Skills-based Sessions and Poster Presentations. Get up to date with the latest news and stories about the person Steven O Riordan at The Irish Times. Diabetes Care 32 1020–1022. Dr Cusack says the use of her reflections made by the prosecution has made doctors fearful about admitting their errors. We do not capture any email address. Dr Bawa-Garba says she was then told by another doctor that the patient was not the same boy as earlier – but was Jack Adcock. 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. The decision has certainly been unpopular among the medical profession. “It took ages for the conclusions to become public,” says Dr Orest Mulka, a former GP in Measham, and one of the reviewers. “I 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,” he says. On 5 October 2015, Dr Bawa-Garba found herself in the dock in Nottingham Crown Court, along with two other defendants - nurses Theresa Taylor and Isabel Amaro. And Dr Bawa-Garba volunteered to step in. Irish News; Barry Roche; January 17, 2016, 20:33; A 51 … She said she had started him on antibiotics for a chest infection, and asked his advice about the fluids Jack was being given. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. “The lessons that I’ve learnt will live with me forever. “However, we would be concerned if the duty of candour and educational reflection was wrongly influenced by court cases and convictions of medical professionals for gross negligence manslaughter. I am sorry for not recognising sepsis and I am sorry for my role in what happened to Jack.”. She went along thinking it would be a similar process to the hospital investigation. She also carried the bleep – which alerts the doctor that a patient needs seeing urgently on the wards or in the Accident and Emergency unit, across four floors of the busy Leicester Royal Infirmary – and was required to respond to calls from midwives, other doctors or parents. But five months after Jack’s death, Dr O’Riordan left the Leicester Royal Infirmary and moved to Ireland. Using what she had learned from Jack Adcock’s death, Dr Bawa-Garba says, she helped carry out a sepsis study and formed a junior doctor weekly teaching programme where doctors would discuss “near misses” or incidents when patients had died so they could learn from them. They were sent a copy of the Leicester Royal Infirmary investigation and invited to discuss it, but they didn’t want to. But some local GPs were frustrated and thought there was a resistance to change and a reluctance to talk openly about the problems. Stephen O Riordan 6 results. Facebook gives people the power to share and … Dr O’Riordan told the court that he recalled the pH was 7.08 and “the lactate was high” saying he couldn’t remember if Dr Bawa-Garba had told him the actual value at their afternoon handover, before Jack died. Join Facebook to connect with Steven Oriordan and others you may know. She was told to list everything that she could have done differently, she says. In 2013, Leicester GPs had started to become concerned about the University Hospitals of Leicester Trust’s SHMI. Based on what I read I was expecting around 10% of patients to have received unacceptable care,” he says. “I remember being absolutely terrified, thinking, ‘I haven’t done anything, why are the police here?’” Mrs Adcock says. Some sick patients died. The Summary Hospital-Level Mortality Indicator (SHMI) uses adjusted data from individual trusts to flag up a higher-than-expected number of deaths. She was convicted of gross negligence manslaughter in 2015 after the death of 6 year old Jack Adcock from sepsis at Leicester Royal Infirmary.2. The family was also told that a junior doctor had failed to recognise the severity of Jack’s condition, according to the minutes. It's a full-time job. For Dr Hsu, the outcry from around the country suggested that what he had seen at Leicester was widespread across the NHS. “Best practice shows that when you’re trying to identify learning, the way to do that is in an open culture, where people can give evidence without fear of sanction or blame,” Mr Furlong says. It’s a description Mr Furlong rejects. Mrs Adcock says she was told the nurse wouldn’t be able to give the medication to Jack, as it had not been prescribed, but his mother could. As soon as the meeting finished, Dr Bawa-Garba says she was sent home by Dr O’Riordan. But she says she was concentrating so much on the CRP that she failed to register that his creatinine and urea were also high – signalling possible kidney failure. Charlie Massey, chief executive of the GMC, says that after receiving legal advice the GMC applied to the High Court to overturn the decision made by its own tribunal. Junior doctors did try to raise their concerns that trainees were being used to plug rota gaps, often at the last minute. Mr Andrew Thomas QC, for the prosecution, told Dr Bawa-Garba that no-one was suggesting that she deliberately set out to harm Jack Adcock. Jul 2017. It acts as an early warning system highlighting a need for further investigation. Stephen O Riordan is on Facebook. The nurse was doing his observations - including his temperature, heart rate and blood pressure - but did not record them regularly. Jack Adcock wasn’t himself when he returned from school. My picture was there and the passenger sitting opposite me kept looking at the paper and looking at me and looking up,” she says. He gave evidence in support of her in her criminal trial and at the medical practitioners tribunal. 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. She recalls the nurse telling her she’d checked with another doctor on duty. 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. How can the NHS ever learn lessons from medical errors if doctors’ personal reflections backfire in court, asks Deborah Cohen. So Mrs Adcock approached the GMC to see if she could appeal. “I've been in the UK for more than half my life,” she says. The hospital had carried out its own investigation and Dr Bawa-Garba continued to work there. She went home at 23:00 – some 15 hours after she had started her 12-hour shift – and updated Jack’s notes with what had happened at the resuscitation. As the police were investigating Jack Adcock’s death, other failings in patient care across Leicestershire were emerging. “I had parents from my daughter’s school asking if I was OK because they were getting leaflets in their letterboxes saying that they should sign a petition to say that I should be struck off,” she says. Then, the following February, he received another raft of changes. Mr Furlong says that improvements have been made and that the review has now been repeated, with results due for publication in September. When Dr Hsu came to tally the results, he did not believe what he saw. “The best way to protect patients is by supporting doctors. He later started vomiting and had diarrhoea, which continued through the night. But I wanted to pay tribute and remember Jack Adcock, a wonderful little boy who started this story,” Dr Bawa-Garba said. “I have no evidence of that at all,” she said. Both her reflections and the training encounter form were uploaded to her e-portfolio, an online system used for learning purposes. That December he was asked to see officials from NHS England. So I made plans that if I was to go to prison he would have to go out and live with my mother in Nigeria.”. 6. If they had done everything they could, the Adcocks say, they would have been devastated but could have said “Thank you,” and walked away. She says she told him Jack’s lactate level was 11, and mentioned some of the other blood test results. The judge told the jury they could only convict the health professionals in front of them if they were negligent and that their negligence significantly contributed to Jack’s death or its timing. The recommendations were wide-ranging but included: - Robust processes for helping staff return to work after periods of protracted leave or maternity leave, - A dedicated presence of consultants on the children’s assessment unit, - New guidelines on the use of agency nurses, - Better visual prompts for staff about abnormal blood results. The 41-year-old mother of three says the impact on her and her family has been huge. As the consultant, he had ultimate responsibility for the patients admitted on the CAU that day. Dr Bawa-Garba passed her bleep on to another doctor and went home, her head spinning with thoughts about what would happen to her family if she were to be convicted of manslaughter and sent to prison. “Doctors became particularly concerned when they heard about all of the systems failings at the hospital and felt these weren’t heard fully in court,” says Dr Cusack, Dr Bawa-Garba’s educational supervisor, who attended parts of the trial. They need to look at the number of errors that doctor made on the day for the judge to say ‘truly exceptionally bad’,” she says. “It was shocking. Dr Stephen O'Riordan Consultant in Paediatric Endocrinology, University College Cork, Ireland Ireland 323 connections At the end of the trial, the judge summed up the case to the jury. She returned to court in December for sentencing. At the coroner’s inquest in August 2014, Dr O’Riordan’s barrister suggested that enalapril had been a significant factor. His has been recreated in the room she vacated. Use this information for marketing purposes ( SHMI ) uses adjusted data from individual trusts to flag up post! 'M not usually a weepy person, ” says Mrs Adcock says the impact on dr stephen o' riordan. It, ” says Victor, Jack’s inquest started at Leicester Town Hall not confirm or refute.! Unexpected death of 6 year old Jack Adcock, a suburb of Leicester NHS Trust was not dr stephen o' riordan worst neither! 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