Gross negligence manslaughter and defensive medicine

Roger-Kirby,-MRI-imaging-videoRecently there has been an alarming increase in the number of doctors and other healthcare workers being prosecuted for gross negligence manslaughter (GNM), with a great deal of personal disruption and devastation as a result. Almost all of the mistakes that resulted in these criminal prosecutions could be construed as ‘system errors’ rather than the sole responsibility of a single clinician. More often than not the case will rely on the stated opinion of medical ‘experts’, whose knowledge and independence are variable and who are totally unregulated. Moreover, the judicial process, which is adversarial and often unduly prolonged, has more often than not prevented important lessons from being learned from the underlying inadvertent mistakes.

A survey has just been launched to evaluate whether or not the rising incidence of criminal prosecutions has resulted in doctors adopting a more defensive (and therefore expensive) form of medicine. Do go online to https://www.surveymonkey.co.uk/r/MK85BHR and fill in the questionnaire.

In addition, please add your own comments below about this disturbing recent trend.

Comments (47) Add yours ↓
  1. Jonny Coxon

    I can’t imagine there are many doctors out there who would say they’re less defensive in their practice than they used to, but a legion who are more so.
    We have probably all been involved in errors of various magnitudes, and know how profoundly they can affect us, even when relatively minor. While we try to learn clinical lessons from them, one of the more inevitable learnt behaviours is a tendency to practise more defensively in the future. That is compounded partly by every one of these high profile cases about which we read, and partly by the growing culture that the “customer is always right”. So then the costs spiral: we pay for the increased investigations, we pay for the increased indemnity insurance.
    Will there come a breaking point when action is taken to sensibly take stock of this situation, when enough has become enough? I dearly hope so. No one wants to see poor clinical practice go unchecked, but context is everything.

    January 11, 2016 Reply
  2. Christian Brown

    My wife who is a lawyer said in her training her mentor always said ‘remember CYA’ after each conversation and I have never forgotten her telling me.

    ‘Cover your a*se’ may seem inappropriate in medicine as we are just there trying to help people? Sadly no. Litigation is real and for the current practicing specialists it will happen and we need to be prepared.

    Litigation may not only come from a bad clinical outcome such as highlighted in the recent press such as death but also from pain, poor cosmetic result or even failure to offer a type of investigation or treatment.

    Our only way through this as a profession is to do what we think is right based on our experience and if we are not sure use a colleague or MDT, discuss our thought process with the patient and their family and document everything.

    I recently determined a patient inoperable for robotic prostatectomy based on pelvic lipomatosis at laparoscopy, a difficult decision and one I had not made before. To support this (with a fear of complaint in my mind) I involved another consultant who agreed. I called his wife and spoke to the patient at length and organised alternative treatment and documented everything in detail.

    All this takes time and we are under increased pressure to do more but moving forward I will always try to do the right thing, if in doubt I will involve a colleague and document why, and sadly but importantly I will remember ‘CYA’ at all times.

    January 12, 2016 Reply
  3. Roger Kirby

    Good comments, Jonny and Christian. By coincidence, David Sellu, who was convicted for “Gross Negligence Manslaughter” (GNM) 2 years ago and who went to prison for a spell, has been given leave to appeal and the retrial starts this very day! I suspect his case, and the spate of other GNM cases that followed, will already have resulted in a more defensive (and therefore more expensive) form of medicine being practised in the UK today. It will be interesting to see the results of the survey, the link to which is in the introduction to this blog. Readers: do please take a few minutes to answer the 10 or so questions posed yourselves.

    January 12, 2016 Reply
  4. Mike Flannigan

    In 2002 Tony Blair commissioned a report from Sir Derek Wanless on the state of the NHS 20 years in the future. The 2003 Wanless report suggested that the cost of the NHS in 2022 is likely to be 165 billion, of which 40 billion (approx 25%) is litigation costs. It is my belief that since that time much of the change in the NHS has been designed to distance the organisation from blame and implicate the Consultants instead. My simplified view is that this must minimise the corporate financial risk and highlight the role of individual doctors in any errors resulting in a reduced settlement. Crown indemnity appears to be used to protect the Organisation but isolate the Doctors. Any possible reason to shift blame to the doctors seems to be getting used to this end.

    I left the NHS 6 years ago because of my unhappiness in my post so some of my comments may now be dated. However I remain convinced that unspoken financial concerns relating to mistakes are considered by Government as more compelling than the reported “patient safety’ concerns.

    I have yet to meet a doctor in the NHS who does not consider patient safety of prime importance. However, I believe we all require training in patient safety practices. Indeed, I believe Doctors in the NHS are more likely to focus on safety before healthcare costs than are Management or Government.

    We all know that learning from mistakes is probably the most powerful postgraduate educational experience. However, because of the nature of our work even small errors are viewed by others as reason for vilification rather than education. Apart from occasional much publicised exceptions, no doctor goes to work each day to deliberately plan to harm patients.

    In what I believe was Roger Kirby’s first conference on Patient Safety some years ago an Astronaut identified that trainees in his field spent 2 years on scenario training before being allowed into space. I believe the introduction of the WHO checklist missed an opportunity to introduce such training. 5 minutes at the start of the operating list considering one of a random list of potential problems (produced from actual past incidents) would encourage team working and a culture of freedom of speech within an operating environment which might otherwise not exist.

    Sadly, I believe the transfer of control from Clinicians to Management over the last 30 years can never be corrected.

    January 12, 2016 Reply
  5. Tom Bourne

    Thanks for this Roger – we found over 80% of doctors reported defensive practice and over 40% avoidance as a result of either being involved in complaints processes or observing other go through them….. so am sure you will find very high levels of both…
    See paper here: http://bmjopen.bmj.com/content/5/1/e006687.full

    Bourne T, Wynants L, Peters M et al. The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey.
    BMJ Open. 2015 Jan 15;5(1):e006687. doi: 10.1136/bmjopen-2014-006687.

    and also:

    Verhoef L.M, Weenink J-W, Winters S et al. The disciplined healthcare professional:
a qualitative interview study on the impact of the disciplinary process and imposed measures in the Netherlands. BMJ Open 2015;5:e009275. doi:10.1136/bmjopen-2015- 009275

    McGivern G, Fischer M. Medical regulation, spectacular transparency and the blame business. J Health Organ Manag. 2010;24(6):597-610.

    Reisch LM, Carney PA, Oster NV et al Medical Malpractice Concerns and Defensive Medicine: A Nationwide Survey of Breast Pathologists. Am J Clin Pathol. 2015 Dec;144(6):916-22.

    January 12, 2016 Reply
  6. Ben Challacombe

    Really interesting stuff- some thoughts on it all.
    All you can do is your best. Do the best job with diagnostics, the operation itself and the post-operative care. Things will occasionally go wrong but as long as the process has been robust then litigation is less likely. MDMs have given us the ability to justify our clinical decisions to our peers and outsiders on cancer cases and there are now some benign MDMs which are equally important. Integrity is doing the right thing when no-one else is watching and we would do well to bear this in mind at times when an easy option is more appealing.
    Apologise if complications occur, work within a team and support each other, know when not the operate and well as when to intervene, document clearly and don’t push your limits of knowledge and ability.
    We are all only as good as our last case!

    January 12, 2016 Reply
  7. Roger Kirby

    Another gross negligence manslaughter trial is currently in progress. Read today’s Channel 4 News report by following this link:
    http://www.channel4.com/news/caesarean-death-wholly-avoidable-court-told

    January 13, 2016 Reply
  8. Roger Kirby

    General Practitioner Dr Rajendra Nayak-Kokkarne knows first-hand the profound distress an accusation of manslaughter arising from clinical practice can cause, and how the MDU support can help.

    Read this article from the MDU Journal:

    A deadly mistake https://shar.es/1h2zFa via sharethis

    January 21, 2016 Reply
  9. Roger Kirby

    Another fatal error:
    http://www.bbc.co.uk/news/health-35403822
    We shall see if it is NHS 111 or the clinicians who get the blame for this.

    January 26, 2016 Reply
  10. Roger Kirby

    Hot news: the two anaesthetists and Tonbridge NHS Trust have just been found not guilty of manslaughter. It would be interesting to know how much money has been spent on mounting a defence and in the CPS preparation of hte charges etc. The case is obviously a dreadful tragedy, but the cause of death multifactorial. This case illustrates again that the criminal courts are not the best way to deal with clinical mishaps. There has to be a better way!

    January 28, 2016 Reply
  11. Roger Kirby

    A doctor and hospital trust have been cleared of the manslaughter of a woman who died hours after a Caesarean birth, after a landmark trial collapsed.
    Mr Justice Coulson halted the trial of Dr Errol Cornish and Maidstone and Tunbridge Wells NHS Trust, saying it would be “unsafe and unfair” to go on.
    Frances Cappuccini, 30, died after suffering a haemorrhage at Tunbridge Wells Hospital on 9 October 2012.
    It was the first prosecution of an NHS trust for corporate manslaughter.
    ‘Death a tragedy’
    Dr Cornish, 67, of Holmbury Park, Bromley, south-east London, a consultant anaesthetist, denied manslaughter by gross negligence.
    Mr Justice Coulson said: “I am firmly of the view that it would be unsafe and unfair to everyone, including Mrs Cappuccini’s family, to leave this case to the jury.
    “Her unexpected death can only properly be described as a tragedy.”
    He told the court Dr Cornish had taken actions that were “as far removed from a case of gross negligence manslaughter as it’s possible to be” and he and the trust that employed him had “no case to answer”.
    In a statement following the collapse of the trial, Maidstone and Tunbridge Wells NHS Trust said “no outcome from these proceedings could bring any consolation to the family” adding its sympathies were with them.
    “The allegation of corporate manslaughter has been consistently denied by the trust and now also comprehensively rejected by the court,” it continued.
    “The trust regrets that the Crown Prosecution Service saw fit to pursue the charge in the first place, given the additional stress this will have caused all involved.”

    January 28, 2016 Reply
  12. Roger Kirby

    PROSECUTING DOCTORS FOLLOWING UNEXPECTED PATIENT DEATHS DOES NOT IMPROVE PATIENT SAFETY

    • Results from survey on “doctors.net” of almost 1500 doctors from across medical practice

    • 85% of medics believe bringing criminal prosecutions into post-death investigations encourages a culture of secrecy and cover-up

    • 90% of doctors admit to practicing more defensive medicine techniques, in light of increased culture of fear, subjecting patients to additional, often intrinsically risky and intrusive tests, sending costs per patient soaring

    • Fewer than half considered they were delivering safer care as a result of increasingly defensive medical practice

    A survey of 1443 doctors, conducted by ‘Doctors and Manslaughter’ a campaign group working to raise awareness of the effects of the recent trend towards the criminalisation of healthcare, has uncovered alarming findings in light of the increased involvement of criminal process following unexpected hospital deaths and complications.

    Police investigations into healthcare has escalated in recent years following the conviction of respected surgeon David Sellu (now the subject of an appeal). In the past year alone, 9* healthcare professionals have either been charged, prosecuted or convicted for Gross Negligence Manslaughter. These recent prosecutions, with the prospect of jail sentences for doctors when patients die, has alarmed many in the profession who say there is no evidence that a ‘blame’ culture actually makes patients safer. There is also a growing body of opinion that the charge of gross negligence manslaughter is being used inappropriately to prosecute doctors in some specialties who, in their daily lives, work in an inherently high risk environment.

    Of the 1443 UK doctors responding to the survey, nearly 90% of doctors admitted to being more defensive (ordering more tests for patients than they might need, as a result of the fear of litigation), but less than half admitted that they felt they were delivering safer care as a result. 85% agreed, or strongly agreed, that being open about mistakes was less likely with increasing involvement of the law.

    Most health-care professionals accept deaths and complications are best discussed in a transparent, no-blame environment. This allows lessons to be learned and future care to be improved in much the same way that pilots analyse aviation incidents. The threat of criminal sanctions leads to the practice of defensive medicine in which healthcare professionals order more investigations than necessary and the patient may be exposed to harmful procedures they do not actually need. Surgeons are circumspect about operating on high risk patients in case they end up accused of manslaughter if the outcome results in death of a patient – this results in those patients with other underlying health problems potentially losing out on operations from which they have a chance of recovery.

    Defensive medicine provides no benefit, other than perhaps to the doctor, and in contrast may cause actual patient harm as well as significantly increasing costs at a time when NHS budgets are under massive pressure. The survey also shows a growing concern that the brightest doctors will not choose to enter high risk specialties such as anaesthetics, obstetrics or emergency surgery as they risk future jail sentences if they do. This could mean that a future generation of patients are made even less safe.

    January 28, 2016 Reply
  13. Roger Kirby

    The rise and rise of defensive medicine:
    http://www.theguardian.com/society/2016/jan/29/doctors-avoiding-risky-operations-due-to-prosecution-threat-survey-finds

    January 30, 2016 Reply
  14. Roger Kirby

    Great article on Medical Manlaughter in The Bulletin by Dr Jenny Vaughan. Here is the link:
    PDF: http://publishing.rcseng.ac.uk/doi/pdf/10.1308/rcsbull.2016.60
    Full text link: http://publishing.rcseng.ac.uk/doi/full/10.1308/rcsbull.2016.60

    February 1, 2016 Reply
  15. Roger Kirby

    Now two General Practitioners in South Wales accused of gross negligence manslaughter following the death of a 12 year old boy in 2012. The case is due to be held in May.
    Follow this link: http://www.bbc.co.uk/news/uk-wales-south-east-wales-35523100

    February 8, 2016 Reply
  16. Roger Kirby

    Doctors Lindsey Thomas, 42, and Joanne Rudling, 45, deny unlawfully killing Ryan Morse through gross negligence

    Two GPs have appeared before a judge at Cardiff Crown Court accused of the manslaughter of a child patient.

    The doctors, Lindsey Thomas, 42, of Copper Beach Drive, Tredegar , and Joanne Rudling, 45, of Blackberry Way, Pontprennau , Cardiff , each entered a not guilty plea to an allegation that they unlawfully killed 12-year-old Ryan Morse “on or about” December 8, 2012, by gross negligence.

    No further details of the child’s death were put before the court during Monday’s short hearing.

    The plea hearing was held before Recorder of Cardiff Judge Eleri Rees who granted both women bail until their trial takes place on May 3.

    The prosecution was represented by John Price QC and both Thomas and Rudling also had leading counsel acting for them.

    Ryan lived with his family at Brynither, Abertillery, and the doctors are understood to have been working in the Gwent town.

    The child’s mother is expected to be called as a witness during the trial, which is expected to last about three weeks.

    WalesOnline

    February 9, 2016 Reply
  17. Roger Kirby

    http://www.walesonline.co.uk/news/wales-news/two-gps-deny-killing-12-10856608

    February 9, 2016 Reply
  18. Roger Kirby

    Check out a new website focusing on the issue of gross negligence manslaughter charges against healthcare workers put together by Jenny Vaughan and Ian Franklin and others. Here is the link: http://www.manslaughterandhealthcare.org.uk/

    February 16, 2016 Reply
  19. Roger Kirby

    Another manslaughter charge against a healthcare professional: http://www.birminghammail.co.uk/news/midlands-news/iris-teale-nurse-cleared-manslaughter-8548357

    May 8, 2016 Reply
  20. Roger Kirby

    The trial of the Marie Stopes doctor (Adedeji) and midwives involved in a termination of pregnancy has just collapsed with prosecution offering no evidence.
    It is hard to understand how it go so far to produce so little, and at how much expense?

    https://www.lifesitenews.com/news/charges-dropped-against-marie-stopes-abortionist-accused-of-killing-woman-w

    May 17, 2016 Reply
  21. Roger Kirby

    A second GP is cleared of gross negligence manslaughter on the grounds of lack of evidence:
    http://www.pulsetoday.co.uk/your-practice/practice-topics/legal/court-clears-one-of-two-gps-accused-of-addisons-disease-manslaughter/20031865.article

    May 30, 2016 Reply
  22. Roger Kirby

    At last a step in the right direction!
    The UK’s chief inspector of air accidents is the leading contender to run a new organisation which aims to make the NHS in England safer.
    Keith Conradi’s appointment as head of the new Healthcare Safety Investigation Branch is due to be confirmed at a parliamentary hearing next week.
    Leading doctors have said for many years that healthcare has a lot to learn from systems which promote safety in the airline industry.
    Mr Conradi was a professional pilot.
    He took up his current role in as chief inspector of air accidents in 2010.
    Scandals at Mid Staffs and Southern Health Trusts have highlighted failings in how the NHS in England responds to patients’ complaints and deaths.
    The new healthcare investigation body (HSIB) will begin work soon, with an initial budget of £3.5m.
    It will carry out about 30 reviews a year.

    June 4, 2016 Reply
  23. Roger Kirby

    Interesting piece in the BMJ about the potential benefits of ending the blame culture in the NHS:
    http://careers.bmj.com/careers/advice/Ending_blame_culture_would_improve_NHS_care_in_three_years%2C_US_health_leader_says?utm_source=Email&utm_medium=Email&utm_campaign=BMJCareers_nonGPnewsletter&utm_content=leadership

    June 6, 2016 Reply
  24. Roger Kirby

    Oh dear! Another manslaughter charge against a healthcare professional: http://www.express.co.uk/news/uk/635921/Filipino-nurse-KILLED-75-year-old-by-giving-him-WRONG-type-of-blood-in-transfusion

    July 5, 2016 Reply
  25. Roger Kirby

    An optometrist who failed to spot abnormalities in the eyes of a boy who later died has been found guilty of gross negligence manslaughter.

    Eight-year-old Vincent “Vinnie” Barker died on 13 July 2012 – about five months after he had a routine eye test at Boots opticians in Upper Brook Street, Ipswich.

    The conduct of locum optometrist Honey Rose, 35, fell so far below the standards expected that it was “criminal”, prosecutor Jonathan Rees QC said at the beginning of the trial.

    Suffolk police said the jury at Ipswich crown court found Rose, of Newham, London, guilty of manslaughter through gross negligence.

    Jurors heard postmortem examinations showed the cause of death was hydrocephalus – a buildup of fluid on the brain which led to an increase in pressure within his skull and, ultimately, his collapse and death.

    Opening the prosecution case, Rees said: “The prosecution allege that Vinnie’s death was preventable and would have been prevented had the defendant, Ms Rose, done her job properly.”

    He added: “At the heart of the prosecution case against the defendant is the allegation that the defendant’s failure to detect the swollen optic discs and refer Vinnie on for further investigation was grossly negligent on her part.”

    Rees said it is agreed that at the time of Vinnie’s examination on 15 February 2012 there were “obvious abnormalities” in both of his eyes.

    The jury heard photographs taken by another member of staff of the back of his eyes shortly before he was examined by Rose suggested he had bilateral papilloedema – the optic disc at the back of each eye was swollen because of the raised pressure within his skull.

    Rees added: “The prosecution say that the abnormalities in his optic discs would have been obvious to any competent optometrist who had examined them.”

    He said this would have led to him being “urgently referred for further investigation” because of swollen optic discs signifying the patient may be suffering from papilloedema, “a life-threatening condition”.

    The jury was told Rose’s failure to detect the swelling of Vinnie’s optic discs was a significant contributory factor to his death.

    In a statement, Vinnie’s parents, Ian and Joanne Barker, said: “The outcome of this case does not change our life sentence; we will never be able to fully accept that our special little boy is never coming home.

    “The void left in our lives will never heal and the ripple effect to those around us is immense. As parents the distress of witnessing your child’s life from start to end in just eight short years is excruciatingly hard and nonsensical.

    “The decision of a jury or judge cannot bring Vinnie back or undo the devastation of his death. A guilty verdict would never make us winners, our loss is simply too great.

    “Our main concern has always been the accountability of those we entrust with our own health and the health of those we love. It is the responsibility of individuals and the organisation they work for to perform their duties to the expected levels of good practice without exception.

    “The actions of professionals or their failure to act to a standard at which they are required to perform should not go without consequence.”

    Suffolk police senior investigating officer Det Supt Tonya Antonis said: “If this case makes the optometry profession reflect on their practices and review their policies to prevent it happening to anyone again, or encourages other parents to take their children to get their eyes tested with the knowledge that any serious issues would be picked up, then it will be worthwhile.”

    Rose will be sentenced at Ipswich crown court on 25 August.

    July 16, 2016 Reply
  26. Roger Kirby

    Another manslaughter case against a clinician – this time a psychiatrist: https://www.theguardian.com/world/2012/dec/19/france-europe-news

    July 17, 2016 Reply
  27. Roger Kirby

    Dr David Nicholl (@djnicholl)
    Add your signature to David’s petition:
    Open letter to the Academy of Medical Royal Colleges & Dept of Justice on the use of Gross Negligence Manslaughter gopetition.com/petitions/open…

    July 22, 2016 Reply
  28. Roger Kirby

    Here is the link for the petition: https://www.gopetition.com/petitions/open-letter-to-the-academy-of-medical-royal-colleges-department-of-justice-on-the-use-of-gross-negligence-manslaughter.html

    More than 1000 signatures so far!

    July 23, 2016 Reply
  29. Roger Kirby

    Joanna Pallister Durham
    Why would anyone join the medical profession?
    I read with dismay the short article (In the Independent) on the optometrist jailed for failing to spot a life-threatening disease.
    Whilst this is an appalling tragedy and my thoughts are with the boy and his family, our ability as a nation to see humans for what they are, human and fallible, and therefore too desperately seek blame, horrifies me. Why would anyone want to put themselves in a position where your employers are threatening constant cuts, privatisation (as in this case) and personal liability? We are creating, or actually running headlong to, a less caring, more selfish society.

    August 28, 2016 Reply
  30. Roger Kirby

    An optometrist who failed to spot symptoms of a life-threatening brain condition during a routine eye test of an eight-year-old boy who later died has been sentenced to a two-year suspended prison term. Honey Rose, 35, failed to notice that Vincent Barker had swollen optic discs when she examined him at a branch of Boots in Ipswich. The abnormality is a symptom of hydrocephalus – fluid on the brain – and Vincent died in July 2012, about five months after the eye test. Rose had not looked at retinal photos taken by a colleague and failed to examine the backs of his eyes with an opthalmoscope, Ipswich Crown Court heard. Judge Jeremy Stuart-Smith, sentencing, said although it was a “single lapse”, the breach of duty was so serious that it was criminal.

    August 28, 2016 Reply
  31. Roger Kirby

    For clinicians who feel strongly about this the petition is still live and the comments are there and are no longer anonymous:

    https://www.gopetition.com/petitions/open-letter-to-the-academy-of-medical-royal-colleges-department-of-justice-on-the-use-of-gross-negligence-manslaughter.html

    August 30, 2016 Reply
  32. Roger Kirby

    Why become a Doctor?
    Please allow me to recommend this series: http://www.bbc.co.uk/programmes/b07q3k8g/episodes/player
    There’s a very topical episode 3, dealing with Gross Negligence Manslaughter (GNM), and featuring an insightful contribution from Ian Barker of the MDU. Well worth listening to!

    August 31, 2016 Reply
  33. Roger Kirby

    Channel 4 tries to get to grips with GNM ( medical) on a park bench a stones throw from Raymond Bldgs http://bcove.me/3feuxpx8

    September 2, 2016 Reply
  34. Roger Kirby

    Dr David Nicholl (@djnicholl) Letter in The Times manslaughterandhealthcare.org.uk@vaughan_jenny #justculture#manslaughter #patientsafetypic.twitter.com/gVxBpYlW2v

    September 2, 2016 Reply
  35. Roger Kirby Professor of Urology

    Bmj http://www.bmj.com/content/355/bmj.i5812#
    Read the latest information about David Sellu’s appeal against his conviction for Gross Negligence Manslaughter (GNB) .
    Judgement has been reserved – we will have to await the decision!

    October 30, 2016 Reply
  36. Roger Kirby Professor of Urology

    Judgement has been reserved after the appeal of david Sellu against his conviction for gross negligence manslaughter. We await the decision of the judges with some trepidation! A new piece of evidence was put forward by Mark Ellison QC: it transpires that James Hughes, the patient who died, had been prescribed the platelet-inhibiting anticoagulant dabigatran, which at the time had no antidote. If Hughes had been operated on during the period that Sellu was accused of being grossly negligent for not operating, the presence of dabigatran created a very high risk of catastrophic surgical haemorrhage, carrying a significant risk of death.
    The new evidence is crucial because, for a manslaughter conviction, the prosecution must prove not only that the doctor was grossly negligent but that this negligence caused or significantly contributed to the patient’s death

    November 6, 2016 Reply
  37. Roger Kirby Professor of Urology

    The very latest news on the David Sellu saga: the conviction has been quashed this morning! Congratulations to David and to Jenny Vaughan, Peter McDonald, Ian Franklin, David Nichol and all the other clinicians who have striven tirelessly on behalf of David to achieve this result. The whole medical profession will heave a sigh of relief! As will David himself and of course his wife Catherine and the rest of his family.
    http://www.bbc.co.uk/news/uk-england-37986372

    November 15, 2016 Reply
  38. Roger Kirby Professor of Urology

    More good news.
    The prosecution have (very sensibly!) decided not to apply for a retrial!
    The ordeal is finally over for David and his family.

    November 16, 2016 Reply
  39. Roger Kirby Professor of Urology

    The appeal judges said the trial judge did not give the jury adequate legal guidance on what gross negligence meant. Speaking after the conviction was quashed, Mr Sellu said there was a range of factors which contributed to Mr Hughes’s death, including problems with the whole system at the hospital. “I think for the sake of that poor man and his family justice has not really been done,” he said. “It has been retribution, but I don’t really believe that they’ve been served as well as they should have been.” Mr Hughes became ill after a routine knee replacement carried out by another surgeon. Mr Sellu later carried out surgery to repair a perforated bowel, but there had been delays in that carrying operation. Mr Hughes died two days later. The Crown Prosecution Service has decided not to seek a retrial after David Sellu’s conviction was quashed The original case against Mr Sellu, of Hillingdon, was based on the standard of his care over about 25 hours. Mr Sellu argued he knew Mr Hughes needed an urgent operation, but an anaesthetist was not available for several hours and it was not safe to move the patient to the nearby hospital. “It really was another routine day. A busy day of course, but I’d been used to working in this sort of way for many, many years,” Mr Sellu said. Mr Sellu’s medical licence was suspended when he was convicted and would only be reinstated after a General Medical Council (GMC) hearing. The Crown Prosecution Service has decided not to seek a retrial. In a statement, Mr Hughes’ family said the doctor had “served his sentence”. “Our father’s suffering was not prioritised as the emergency it so clearly was,” they said. A spokesman for Clementine Churchill Hospital said the “original prosecution was a criminal case led by the Crown Prosecution Service and the police”.

    November 19, 2016 Reply
  40. Roger Kirby Professor of Urology

    http://www.dailymail.co.uk/news/article-3953076/They-called-Dr-Death-want-restore-good-surgeon-jailed-alongside-murderers-hospital-buried-evidence-support-case-reveals-agony-finally-cleared-killing-patient.html

    November 20, 2016 Reply
  41. Roger Kirby Professor Of Urology

    A spokesperson for the Royal College of Surgeons said:

    “It is welcome news that judges have found David Sellu was wrongly convicted of gross negligence manslaughter. Many in the surgical community were greatly concerned by the case.

    “Wrongful convictions only harm the NHS’ efforts to improve patient care and culture, as well as efforts to seek justice where it is correctly deserved. The judiciary and the Government must commit to urgently reviewing any lessons learnt from this case for future criminal prosecutions”.

    November 20, 2016 Reply
  42. Roger Kirby Professor Of Urology

    A spokesperson for the Royal College of Surgeons said:

    “It is welcome news that judges have found David Sellu was wrongly convicted of gross negligence manslaughter. Many in the surgical community were greatly concerned by the case.

    “Wrongful convictions only harm the NHS’ efforts to improve patient care and culture, as well as efforts to seek justice where it is correctly deserved. The judiciary and the Government must commit to urgently reviewing any lessons learnt from this case for future criminal prosecutions”.

    November 20, 2016 Reply
  43. Roger Kirby Professor of Urology

    Professor Sir Norman Williams says prosecutors are becoming ‘energetic’ in prosecuting and convicting surgeons: http://www.dailymail.co.uk/news/article-3959052/Doctors-scared-save-lives-case-hauled-court-NHS-adviser-s-warning-surgeon-cleared.html#comments

    November 22, 2016 Reply
  44. Roger Kirby Professor of Urology

    Senior surgeon’s conviction for manslaughter is quashed
    BMJ 2016; 355 doi: http://dx.doi.org/10.1136/bmj.i6178

    November 25, 2016 Reply
  45. Roger Kirby Professor of Urology

    http://thejusticegap.com/2016/11/poor-bad-truly-atrocious-directing-jury-gross-negligence-manslaughter/

    December 5, 2016 Reply
  46. Roger Kirby Professor of Urology

    An all-day meeting at the Royal Society of Medicine on “Patient Safety, Litigation and Gross Negligence Manslaughter” with speakers including David Sellu, Sir Robert Francis QC and Professor Sir Terence Stevenson, Chairman of the GMC has been organised on Friday the 21st April. You can register online here:
    https://www.rsm.ac.uk/events/events-listing/2016-2017/sections/urology-section/urh08-patient-safety,-litigation-against-doctors-and-gross-negligence-manslaughter.aspx
    Do come along and join the discussion.

    January 14, 2017 Reply
  47. Manslaughter-consequences, causation and culpability – Site Title

    […] 11.For a medic’s perspective on this, see http://trendsinmenshealth.com/wp-content/uploads/sites/13/2014/11/3.-Medical-mistakes.pdf (accessed 9/8/2017) and http://trendsinmenshealth.com/gross-negligence-manslaughter-defensive-medicine/ […]

    August 14, 2017 Reply

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