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Back to blame: the Bawa-Garba case and the patient safety agenda

BMJ 2017; 359 doi: (Published 29 November 2017) Cite this as: BMJ 2017;359:j5534
  1. Deborah Cohen
  1. The BMJ

How can the NHS ever learn lessons from medical errors if doctors’ personal reflections backfire in court, asks Deborah Cohen

The case of Hadiza Bawa-Garba has left the UK medical profession rattled. 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.

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. 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

Blame culture

Senior and trainee doctors have told The BMJ that the handling of the case by those directly involved, the judiciary, and the GMC risks reviving a culture of blame in healthcare. “The criminalisation of medical error when events are considered singularly rather than as a part of a highly complex system is going to seriously impede learning,” said Jonathan Cusack, the Leicester Royal Infirmary neonatologist who was Bawa-Garba’s educational supervisor after the incident. He gave evidence in support of her in her criminal trial and at the medical practitioners tribunal.

David Grant, a consultant in paediatric intensive care at University Hospitals Bristol NHS Foundation Trust with a special interest in simulation and human factors, told The BMJ that the case risked setting a precedent that “will undermine all attempts to create a culture of openness and learning aimed at improving patient safety through proactive healthcare systems improvement.”

He said, “Without such a system and culture in place, organisations and healthcare …

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