Monday, 13 August 2018

Justice crumbs - The real dark side of Dr Bawa-Garba's case by Dr Helen Bright

                                        Photo: BBC, Click on the photo to read their article

Dr Bawa-Garba has won her appeal in English Court of Appeal (Civil) against the decision made by the High Court following application by The General Medical Council (GMC) that she should be erased from the GMC's medical register following the death of  a sweet, little boy age 6 who suffered from Down's Syndrome and died (according to reports and judgements) very quickly from sepsis due to her alleged negligence on 18th February 2018. Dr Bawa-Garba was convicted by Crown Court of criminal negligent manslaughter.


The case is of interest to much wider public because all judgements before Court of Appeal (Civil) are faulty, in my opinion, and paid no attention to the fact that there was failure to test for viruses post-mortem which can cause rapid death in even healthy strong man very quickly.

It has been known since 2009 that Influenza virus causes 335 fold (that is 335 x 100 = 33, 500%) increase in Down syndrome deaths compared to normal population. If the judges were told this then their instructions to jury would be very different.

British did not vaccinate vulnerable children until 2013. No expert told jury in Crown Court or Court of Appeal (Criminal)  judges about that, as far as I was allowed to know (coroner refused to disclose post-mortem report or expert evidence), or the fact that Influenza virus was discovered in 1933 and that the first vaccine was made shortly after. So where was it for Downs syndrome children in 2011 when patient died? By 2011 more sophisticated vaccines would have been made already.

Apart from influenza other viruses can cause fast death, even ordinary cold, in immuno-compromised people by precipitating secondary bacterial infection leading to sepsis. Again, judgements do not mention investigations for that aspect in post-mortem. There is mention that Jack Adcock was prone to colds, but there is no testing at all mentioned for any viruses. Only Strep. Group A as cause of sepsis is mentioned in judgements but this is usually harmless bacteria in many people until something else happens as well to trigger sepsis. Many people are asymptomatic carriers.


There is no mention that England had vaccine in 1920's against Streptoccocus bacteria causing maternal childbirth deaths from Puerperal Fever (belongs to the same group as Streptococcus Group A). Vaccine was used in East London, by St. Bartholomew's Hospital midwifes.

I could not find medical history chronology of how human negativity destroys because vaccine was attacked in British Medical Journal with claim that prevention did not matter as much as treatment.  There were protesting and astonished voices from a couple of doctors that BMJ, actually, published.


The coroner in this case refused to cooperate with me as did GMC by refusing to send me redacted copy of the expert evidence. I am entitled to this as per relevant law. Justice is public and has to be seen to be done. Additionally, experts have to be truthful. They have to tell court about the limits of their opinion.

Because of the cover ups in my opinion, it has not been possible to see what this case was really about: Bad practice on a larger, much larger scale leading to many deaths unnecessarily.

What we have seen from media reports is just two women (mother and doctor) pitted against each other, medical doctors protesting about NHS conditions while the big picture is that those who were paid to do their work have not done it for decades.

Good investigation is the key to successful litigation. So law books say.


When there is shortage of public money in NHS there is need for openness. If parents are told honestly that there are vaccines they could have obtained them elsewhere.

 My guess is that Jack Adcock parents just did not know better.


Jack Adcock parents had enormous amount of grief, I imagine. Did anyone ever tell them they can ask for new techniques to be used to find out what virus/agents were present at the time of death. Sometimes it is a mutant virus that has never been detected before. There should be retained tissues that can be analysed.

Little Jack Adcock was a vulnerable person for many, many reasons to do with his Down Syndrome which causes many immune problems as well as difficulty breathing due to the anatomical features of the face in Down Syndrome (small midface, with little nostrils and mouth too small for normal size tongue). Mouth breathing misses on the immune defences in the nose as air goes directly to pharynx. Thus bacteria can move more quickly to lungs to cause pneumonia.


I looked at the temperature records in February 2011.  Most of the time it was a couple of degrees above zero Centigrade. It was a cold February in 2011. The air would be dry. It is known dry air decreases functioning of the immune system further. Wearing scarf over mouth helps to moisten air.

 There are about 60,000 deaths annually in UK related to air pollution (particulate matter).  Leicester has poor quality air in third place after London, and another city, especially in winter.

If one looked for all different factors in Jack Adcock's death one would not find it in judgements. So, how can judge or jury do the right thing if expert evidence is not there or did they ignore it?


British Empire traditionally does not care about ethnic minorities doing things harmful to themselves such as wearing clothes that lead to lack of trust and confidence in wearer even if it is linked to English people's deaths.

Those who have money can avoid Dr Bawa-Garba when mistrust, or lack of confidence occurs without a word to her or anyone, but most people would feel stuck with her in NHS and take risks such as perhaps, Jack Adcock's mother did when she gave the boy his usual pill (Enalapril) even though Dr Bawa-Garba quite rightly stopped it. This drug dramatically reduces blood pressure and can cause heart attack in the setting of dehydration and sepsis.

It is legitimate to notice differences between us and others whatever their looks without it assuming significance of prejudice or hostility in legal terms.

What is wrong in law (wilful blindness) is that UK government commissioned and knew of the research since 1998, at least, which showed clergy is more likely to be attacked physically than any other profession. They just ignored it. Doctors carry twice as high risk of violence compared to the average risk. When one adds religious dress the risk of attacks increases.

I imagine in many situations, including the courts, and amongst staff Dr Bawa-Garba has not enjoyed trust. It is likely nobody cared to tell her for fear of causing offence.

Certainly, her hospital policy was unlawful as it ignored mentally ill and their needs when it comes to the wearing of religious uniforms. Trust is of fundamental importance in medicine.

In circumstances such as medical setting (and in emergency situation even more so) there is no time for patients' or carers' exploration of their doubts about the doctor, self-searching questions, historical study of other people's clothing, political and psychological implications research, or any lengthy battles through administrative state institutions. Yet, trust and confidence is of fundamental importance in medical profession. Both General Medical Council and  UK governments just continued to live in denial attacking those who raised the issue of religious dress as a substitute for real justice, disregarding the deaths and injuries at home as well as evidence from abroad (such as murders of nuns in USA and elsewhere). Similarly, there have been attacks on those wearing hijab and other forms of ethnic clothing some claim to be Muslim, religious requirement, while others protest such claims including Islamic scholars.


In 1970's a substance called Pro-Calcitonin was discovered. It is a natural precursor of a hormone in humans and by 1990's it was recognised that it could be better at diagnosing sepsis than tests in use.

In UK, even today, it is not used although result would be available in 20 minutes and it is superior to the current tests used for sepsis and monitoring of treatment. Dr Bawa-Garba did not have this available to her. Years after the event, and in her geographic area of Leicester, England, Europe, the opinion for years was that it was as good as CRP (C reactive protein Test) which she did use. Well, it is not.

Thousands of people die in UK from sepsis because UK is as it is, a negative place where there is no social justice or culture that aims for quality.


The standard of proof in criminal setting is beyond reasonable doubt. Crown Prosecution Service in Leicester had doubts about going ahead against Dr Bawa-Garba to Crown Court. Criminal trial took place with much delay and it may have had effect on how Dr Bawa-Garba was judged by medical experts because medical diagnosis of sepsis was changing (international criteria).

Something happened and eventually, CPS went ahead with prosecution despite their initial reluctance.

I do not know the court medical experts in Dr Bawa-Garba's case and I do not know Dr Bawa-Garba. I do have experience of GMC and I sincerely doubt that they have any intention whatsoever to deal with how they have for many years allowed their own religious tribunals to cause so much damage.

In Dr Bawa-Garba's case, Medical Practitioners Tribunal (part of GMC) that suspended her medical registration, was in my opinion, religiously biased. In rush, they appeared ready to just accept findings from the criminal courts without looking at the whole case critically. Some people may say, well, this is what you can expect from the religious, lack of critical thinking. The translations of disciplinary panel members names are Leader of Faith (Islam), Garden of the one who judges on religious matters. The third member is Elizabeth Daughters a member of Women's organisation that accepts feminists who are Muslims. Many feminists would say it is impossible to be a feminist and a Muslim in the same time. However, these feminists have their own interpretation of Islam. It does matter that tribunal is perceived as being fair and unbiased.

In USA it would be perfectly acceptable for lawyers to question jury members regarding their religious belief extent in the selection process. At GMC nothing like that is ever checked with respect to Medical Practitioners' Tribunal panellists. Extremism and harm slide into disciplinary committee from time to time causing injury to doctors and deaths to patients.

I had an NHS exorcist doctor judge me, then a doctor, a sister of a Catholic nun who failed to declare she was also a preacher, a political lobbyist for religious rights and others in a case where their religious attitudes mattered a lot. One (preacher) was involved in cover ups not just of faulty policy but faulty actions by experts sitting in the Royal College executive that advises government on what would be desirable to help mentally ill.

Some religious views of those with mental illness and learning disability is that they are possessed by demons. Doctor exorcist who judged me certainly described such view as his in his book: Hard Questions and Answers.

Most religions, being patriarchal do not favour women. Dr Bawa-Garba was to be made happy to eat her justice crumbs (suspension from medical register). There was no concern for the suffering of the parents who could have been helped by full understanding of what really happened. Did anyone give them the list of all the medical, social, political and environmental factors that lead to death of their much loved son? I think that is unlikely. Modus Operandi of the system is: be secretive, they will never know better.


It took years before blood lactate levels in paediatrics were actually published since their description in adults as markers of sepsis, and it was months after Jack Adcock died that a paper was published in India.

Even in 2017 it has been maintained that serum lactate cannot be relied on in paediatric practice.

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