Incompetent and negligent killer doctor OK for NHS

What the hell does it take for someone to be found too incompetent to work for the NHS?

A doctor convicted of killing a patient through gross negligence has been told that he can return to work in the NHS. Amit Misra, 37, fled to India after being found guilty of the manslaughter of Sean Phillips, a 31-year-old sales executive, who died from a common infection while recovering from routine knee surgery. A court was told that the trainee surgeon had failed to diagnose the infection and was “too proud” to ask senior doctors for help until it was too late. He was suspended from working for a year and avoided a jail term after his barrister pleaded that his career was in ruins.

Yet despite failing to prove himself in a series of medical assessment tests, the General Medical Council has ruled that Dr Misra should now be allowed to return to Britain to work, seven years after Mr Phillips’s death. Under the law all cautions and convictions given to doctors have to be examined by the governing body, but in many cases the GMC allows those convicted of serious crimes or unprofessional conduct to work again.

The case comes two years after the Shipman inquiry called for a radical overhaul of the GMC, which was accused of “looking after its own” and failing to protect patients. A fitness-to-practise panel of the GMC announced a series of conditions that Dr Misra will have to adhere to over the next three years.

But the family of Mr Phillips said yesterday that there was no way that the doctor should be allowed to work in Britain again. The father of one from Southampton had been expected to leave hospital the day after the operation on June 23, 2000. Four days later he was dead, after developing toxic shock syndrome from staphylococcus aureus, a common but virulent bacterial infection. Southampton University Hospitals Trust was fined 100,000 pounds over failures in his care. Dr Misra and a fellow doctor, Rajeev Srivastava, 40, were convicted of manslaughter due to gross negligence at Winchester Crown Court in April 2003 after it was found that they had failed to monitor the patient’s abnormal temperature and pulse. Despite checking on the patient at least four times, Dr Misra, a senior house officer with nine years’ experience, made only one note of the problems in Mr Phillips’s records, the court was told.

In an interview last year, Mr Phillips’s former partner, Annabel Grant, 33, who lives in Southampton with the couple’s son, Mitchell, 9, said that the doctors had never apologised. Ms Grant said: “I feel I deserve an apology from both doctors. Sean was everything I could have wished for – a soulmate, best friend and a fun-loving, caring partner. Losing him has torn my life apart but what makes the pain still harder to accept is knowing that his death was so unnecessary.”

Dr Srivastava, 40, of Invergowrie, Dundee, is understood to be working as a trainee registrar at Ninewells Hospital in the city, but has no contact with patients. Dr Misra sparked outrage when he began working at the Freeman Hospital in Newcastle upon Tyne just nine months after his conviction. He was banned from working in Britain for a year in November 2005. The doctors were given 18-month suspended sentences but not struck off.

Last year Dr Misra was ordered to undergo a performance assessment, but a team of senior doctors declared that many elements of his practice were still “unacceptable”. Speaking at a hearing to adjudge Dr Misra’s fitness to practise this week, Brian Gomes da Costa, its chairman, said: “It notes that knowledge gaps were identified in three out of the four areas of Dr Misra’s assessed professional performance. “The Panel has noted the gross negligence in postoperative care that led to Dr Misra’s conviction for manslaughter, but it has also heard of efforts that Dr Misra has made with his mentors in India to rectify the deficiencies in his clinical skills. “The overall conclusion of this assessment is that Dr Misra’s core clinical skills are at a minimum but acceptable level.”

The conditions on the doctor’s registration include informing the GMC as soon as he is back in the country, taking a course in basic surgical skills, working with a senior doctor and applying only for trainee posts. Dr Misra must also inform all future employers of the findings against him, is not allowed to do any private work and is not allowed to do any out-of-hours work or on-call duties.

The GMC is set to review the case in 18 months. A spokeswoman for the GMC said: “Our primary concern is not protecting doctors but patient safety. There are indicative sanctions that we refer to when doctors have a criminal conviction and in this case these have been taken into account.”

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Arrogant Australian public hospital again: Cancer patient refused transport, walks 30km (20 miles)

It's pretty disgraceful that only publicity humbles the hospital bureaucracies. This is not the first incident of this kind

A MAN recovering from cancer and his wife had to walk home almost 30km along dirt roads after being discharged from Maryborough Hospital in Queensland at 12.30am and refused transport. Glenn Horne and his wife Helen, both aged in their 50s, trudged for more than seven hours in sandals and thongs in the dark before finally being picked up by a neighbour about 4km from their Harris Rd property, south of Maryborough, early on Monday.

While the hospital has since telephoned and apologised for their ordeal, blaming it on "a breakdown in the communication process", the Hornes said the incident was symptomatic of administrative problems still plaguing Queensland Health. Mrs Horne said she had phoned for an ambulance on Sunday for her husband, who was in agony with an infection after enduring two operations for bowel cancer less than two months ago. They arrived at the hospital about 9pm with only $20. Mr Horne said he had expected to be kept in overnight but instead was given medication and discharged at 12.30am on a rainy night. "They said we couldn't stay even though the casualty room was virtually empty," Mrs Horne said. "When I said we lived 30-40 minutes' drive away, they just said 'well, that'll be an expensive taxi ride'."

Not wanting to bother friend and neighbour Desiree Taylor at that hour of the night and with no buses available and no money for a taxi, the Hornes said they decided they would have to walk home. "It was a moonlit night, thank heavens, but it was still very spooky," said Mrs Horne, who said they had neither water nor food. "We were exhausted, pretty worn out, when Desiree's son Kieran saw us (4km from home) and then she picked us up. We finally got home at quarter-past-eight in the morning."

Mr Horne said they had not wanted to make a fuss about their ordeal but he and his wife also wanted others who might find themselves in a similar situation to realise they had rights to transport and accommodation support options. Mr Horne said their situation had not been helped by his inability to work because of illness and the fact his car had broken down.

Tiaro Mayor Linda Harris said the incident needed to be highlighted so hospital staff could be counselled to better handle such issues. Fraser Coast Health Service district manager Kerry Winsor said that although procedures were in place to handle such situations, the support options were not brought to the patient's attention in this case and "we have apologised".

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