At
the beginning of November 2015, two people were convicted of
manslaughter. They were Isabel Amaro and Hadiza Bawa-Garba, and they
were convicted of the manslaughter of Jack Adcock. But Isabel Amaro
is a nurse and Hadiza Bawa-Garba is a doctor, and Jack Adcock was a
six year old boy in their care.
Jack was admitted to
Leicester Royal Infirmary, on Friday the 18 February 2011, with
diarrhoea and vomiting, and breathing difficulties. Jack had Down’s
Syndrome. He died eleven hours later after a cardiac arrest, due to
Sepsis, secondary to pneumonia. This was a very ill child.
Both Isabel Amaro and
Hadiza Bawa-Garba missed his deteriorating condition. He had abnormal
blood results, high levels of urea and creatinine in his blood, and
he was showing signs of septic shock. When he had a cardiac arrest
his lips had turned blue. Dr Bawa-Garba had not contacted her
consultant about his condition and when he arrested she stopped the
crash team, mistaking Jack for another patient who was not for
resuscitation.
This was serious
misconduct and negligence by both these women, but was it
manslaughter? Did these two women deliberately neglect Jack’s care
to the extent that he died? There is no evidence of this.
We don’t know the full
details of what happened when Jack Adcock died. How busy was the
ward? (In her evidence Dr Bawa-Garba said that she’d not had time
for a break) How many other patients where Isabel Amaro and Hadiza
Bawa-Garba also looking after? How many of them were also very ill?
How many other staff were on duty that day? Was the ward short
staffed? (Isabel Amaro was an agency nurse so the ward was down at
least one member of permanent staff)
Many
of us nurses have been on duty when it has been busy and our unity or
team has been short staffed. For many NHS nurses this is now a common
working condition. This is the time when things can go wrong, drugs
errors can occur, lapses in care can happen. Staff are pressured,
stressed and short of time, with more and more demands being made on
them. They are only human. As resources are squeezed and pressures
increase more and more nurses and doctors will be working under these
conditions. This is now the reality in Jeremy Hunt's NHS.
Negligence and misconduct
should never be tolerated but is a manslaughter charge the right
response? But our courts do not deal in the complicated factors that
busy and under staffed units are being put through, and are they
always the right place to deal with lapses in healthcare practice?
They deal in the rights and wrongs of one person's actions, they
rarely deal with complicated institutional failings (Because what
else are the stresses being put on NHS staff today?)
When working on a busy
and short staffed hospital ward do nurses now have to take care so
that we don’t end up charged with manslaughter?
Drew Payne