|Previous Section||Index||Home Page|
One of the things that parents come to realise is just how intimately their own happiness is bound up with that of their children. Therefore, one of the things that parents dread is the diagnosis that their child has meningitis. The disease strikes fast and can be fatal, and I remember the pain of my own son and his fear as he submitted to a lumber puncture when he had meningitis five years ago.
Wassan was 15 years of age. She was born on 26th of June 1984 at Portland Hospital in London. She has lived all her life in the UK and attended Heathfield School in Pinner. Wassan was always in good health and was a happy child.
On Friday 4th of February Wassan attended a party at her school. We collected her from the school at 10.30 p.m. and she was safely in bed by 11 p.m. She awoke on Saturday the 5th complaining of a severe headache. She was vomiting and had a high fever. I considered the situation serious enough to call our GP at the Chalkhill Medical Centre and ask him to make a house call. I was advised that Dr. David Rapp, with whom Wassan was registered, would call as soon as possible. Dr. Rapp arrived at Midday. He asked Wassan what was wrong and she told him of her headache and vomiting. She evidently had a high fever although Dr. Rapp never actually took her temperature. He examined her chest and back with a stethoscope and visually examined her throat.
As a normal father, I was concerned about my daughter's situation. I was aware of the fact that there had been a number of cases of meningitis recently and that the government was undertaking a vaccination programme at all schools. I specifically told Dr. Rapp twice, once before and once after he examined Wassan, that she had not been inoculated against meningitis.
Dr. Rapp's diagnosis was that Wassan had a slight throat inflammation and told me that "there was nothing to worry about".
Wassan's condition continued to deteriorate in the afternoon and by 7 o'clock that evening, her parents had become sufficiently worried to call the emergency number at the Chalkhill health centre. They requested another doctor to make a house call to see Wassan. Dr. Chowdhury, a locum, arrived at about midnight--five hours later. By that time, Wassan's condition was very bad. Her father says:
Dr. Chowdhury gave Wassan's parents four capsules of solpadol, with a prescription for further tablets if required. Once again, Wassan's parents deferred their doubts in favour of the doctor's professional opinion. Solpadol is a
At 7.30 the following morning, Mr. and Mrs. Khatib checked on Wassan to discover that her body was covered with a rash and that she was extremely weak. She continued to vomit and have a high fever. They decided that she must go to hospital and told her to dress, only to find that she was unable to support her own body weight. They called an ambulance, and it took Wassan to Northwick Park hospital in my constituency. The parents were left in no doubt about the seriousness of the matter by the ambulance crew, who radioed ahead to tell those at the hospital to prepare an intensive care bed. That was seven hours after Dr. Chowdhury had told Mr. and Mrs. Khatib that Wassan had a migraine.
The staff at Northwick Park acted promptly and efficiently. A specialist unit at St. Mary's hospital was requested. Wassan arrived at Northwick Park at 10 o'clock in the morning and staff spent the next few hours attempting to stabilise her condition for the transfer to St Mary's. She was finally moved to St Mary's at about 3 o'clock. She survived at St Mary's for a further two hours before her fight for life ended at about 5 o'clock.
A formal complaint was submitted to the General Medical Council about the conduct of Dr. Rapp and Dr. Chowdhury. I obtained a copy of the medical notes of both doctors at the time of their examinations of Wassan. Dr. Rapp's notes were not contemporaneous; they were printed on a computer system on the Monday morning, the day after Wassan had died. They seemed to indicate a level of 20:20 hindsight at variance with Wassan's parents' recollection of Dr. Rapp's visit. Under the heading "Comments", Dr. Rapp recorded:
What Mr. and Mrs. Khatib did not know when they wrote to me or when they registered the complaint--indeed, they do not know now--was that Dr. Chowdhury was already very well known to the General Medical Council. On 12 August 1994, Dr. Chowdhury was telephoned by a registered general nurse and asked to visit a seriously ill patient whom the nurse thought was dying. Dr. Chowdhury refused to attend the patient. On 9 September 1996, the national health service appeals authority had exhausted its complaints procedure and, owing to the seriousness of the case, submitted the complaint to the GMC.
It took a further one year and two months until, on 10 November 1997, the professional conduct committee of the GMC found Dr. Chowdhury guilty of "serious professional misconduct". At the conclusion of the proceedings, the chairman announced the committee's determination as follows:
The Committee have judged you to have been guilty of serious professional misconduct in relation to the facts admitted on your behalf and found proved against you in the charge.
In the light of your failure of care towards your patient, the Committee have considered most carefully whether they should direct the erasure of your name from the Register or the suspension of your registration.
However, the Committee have taken account of your expressions of regret, the assurances that you have learned from the event, and the evidence from your patients and colleagues about your general standard of practice. They expect you to ensure that your future practice is never open to such criticism again.
In all the circumstances the Committee have determined to conclude your case with a severe admonishment.
Sadly, the GMC's severe admonishment in November 1997 is not the sum total of complaints against Dr. Chowdhury. On 8 April 1998, less than six months later, Dr. Chowdhury began to sexually harass a patient. On 2 November 1998, that case too was brought to the GMC as a formal complaint. At this point, it might be thought that, with full knowledge of Dr. Chowdhury's disciplinary record, the GMC would act to suspend him. It did not do so. It did not even hold a preliminary proceedings committee until 9 September 1999, almost a year later. When it met, the committee still did not suspend the doctor, but referred the matter to the professional conduct committee, which did not meet for a further nine months until 2 June this year. On that occasion, it determined as follows:
Patients are entitled to have trust and confidence in the character and integrity of their doctors, particularly when doctors attend upon patients in their own homes. The Committee have found that, on a number of separate occasions, you attempted to pursue an improper emotional and sexual relationship with your patient, Mrs "A", who was at that time vulnerable and unwell. Furthermore, you did so on visits to her home in the evening when she was alone. You also persistently made unsolicited telephone calls to Mrs "A". By your conduct you gravely and repeatedly abused the trust Mrs "A" should have been entitled to place in you as a registered medical practitioner. You sought subsequently to dissuade Mrs "A" from pursuing her legitimate complaint, by seeking to involve one of your practice staff.
The Committee have also heard evidence of your previous history. That history includes an appearance before the Professional Conduct Committee in November 1997 when you were found guilty of serious professional misconduct. Although the facts found proved on that occasion were different in character to those we have now found proved, you should nevertheless have been left in no doubt by the terms of the severe admonishment issued to you on that occasion as to the possible consequences were you to appear again. The Committee note with considerable concern that, despite that severe admonishment, the events in relation to Mrs "A" happened within a matter of months of your previous appearance here.
The Committee have carefully noted the evidence and testimonials given on your behalf. But in view of your grave abuse of your patient's trust, and your previous history, they have found you guilty of serious professional misconduct in relation to the facts found proved in the charge, and have directed the Registrar to erase your name from the Register.
The Government must review the procedure and the length of time taken whereby doctors can continue to practise for years until they are eventually the subject of disciplinary procedures. There must be a proper process for suspending doctors.