During your Medical School interview
, understanding hot topics
will help strengthen your answers to ethics questions
and more. This guide explains everything you need to know about the Bawa-Garba case – including some example interview questions
you could be asked.
Outline Of The Bawa-Garba Case
On 18th January 2011, six-year-old Jack Adcock had been feeling unwell – he was having difficulty breathing, as well as vomiting and diarrhoea. Jack had Down’s Syndrome and a known heart condition, and required long-term medication.
He was admitted to the Children’s Assessment Unit (CAU) at Leicester Royal Infirmary following his GP’s referral. Jack’s condition deteriorated that day and he passed away.
He was seen and assessed by Junior Doctor Hadiza Bawa-Garba, a paediatric registrar in year six of her speciality training (ST6). Generally, being an ST6 junior Doctor means being one or two years from sitting the final examinations to reach the level of a consultant.
Dr Bawa-Garba was taken to High Court and on 4th November 2015 was found guilty of manslaughter on the grounds of gross negligence.
Timeline Of Events
To thoroughly understand the Bawa-Garba case, it’s helpful to be aware of the mistakes that occurred. These were:
- When Jack was admitted, Dr Bawa-Garba ordered a chest X-ray that showed an infection. The X-ray results were available from 12:30, but didn’t get seen until 3pm. Dr Bawa-Garba then prescribed antibiotics, which were administered at 4pm. It’s important to understand that prescribing antibiotics earlier could potentially have led to a different outcome, but the ward was understaffed and Dr Bawa-Garba was extremely busy. Furthermore, she had not been made aware that the X-ray was available at 12:30.
- A blood test revealed high levels of C-Reactive Protein (CRP), which occurs due to infection and inflammation. This was reported over five hours late, due to failings in the hospital computer system.
- When Jack was assessed by Dr Bawa-Garba, she stopped the medication for his heart condition. However, she did not document this in his notes, and subsequently, this medication was administered to Jack at 7pm by his mother. Jack’s mother was unaware that he was not to be following his usual course of treatment for his heart condition.
- Jack suffered a cardiac arrest at 8pm. Dr Bawa-Garba was one of the Doctors who attended the call and arrived when resuscitation was already taking place. Dr Bawa-Garba mistook Jack for another patient, whose notes were marked as DNAR (do not attempt resuscitation), and therefore Dr Bawa-Garba called off resuscitation. Resuscitation was re-continued shortly after the mistake was identified. Jack died at 9:20pm.
Failings Within The Hospital System
It should be noted that prior to the events of 18th February, Dr Bawa-Garba had an exemplary record. She had also just come back from maternity leave. Whilst mistakes were made by Dr Bawa-Garba, there were also issues within the hospital’s system which contributed to the negligence in care provided. Notably, these were:
- Dr Bawa-Garba was carrying out the work of two Doctors and the hospital was extremely understaffed.
- Senior consultants were not on-site and therefore Dr Bawa-Garba had no one to report to. There were not enough senior nurses on the ward, either.
- The failings of the hospital computer system prolonged blood testing results. There was also no system in place to notify Dr Bawa-Garba that the X-ray was ready for analysis.
- Nurses did not notify Dr Bawa-Garba that Jack was deteriorating.
- The administration of medication for Jack’s heart condition was not carried out by Dr Bawa-Garba.
These are important factors to consider whilst weighing up whether Dr Bawa-Garba should take sole accountability for the case. Arguably, whilst mistakes were made on her part, if the hospital had been staffed correctly and with the right administrative and technical systems in place, the situation could have been prevented.
The Legal Battle
After the sentencing in November 2014, Dr Bawa-Garba appealed her sentence. The following occurred: