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TSR Med Students' Society Part VI

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Original post by SpringNicht
I feel like the inappropriate labetalol and consultant running to Ireland after this would have come up much more.


What?? When did this happen?
Original post by BlindingLight
What?? When did this happen?


Think they meant after the incident. He got a job at Cork.

He was outside the hospital on the day that happened though.


I had never realised the nurse was adult trained. I don't understand why they didn't have a problem putting her on a childrens ward, let alone somewhere like CAU. The NMC made such a big deal about saying they couldn't ensure it wouldn't happen again... well if she wasn't made to work outside her scope of practice I'm sure she'd be fine (she was, after all, by all accounts an excellent nurse for 17 years).

I must admit things like this really worry me, particularly the case of the nurse. I'm definitely a soft touch and very prone to trying to go the extra mile to 'help out', but I think I'm going to have to learn to protect myself a lot more when I qualify again.
Original post by BlindingLight
What?? When did this happen?


Mum gave him enalapril from home that had been discontinued in hospital - a hypovolaemic, AKI-y child in septic shock. Enalapril. Enalapril!!!

Original post by hslakaal
Think they meant after the incident. He got a job at Cork.

He was outside the hospital on the day that happened though.


He was away doing teaching, but was there for the 4:30 handover. Was handed over the ABG result - he even wrote it down - and left it to his juniors, no further discussion, before pissing off.
Original post by Hype en Ecosse
Mum gave him enalapril from home that had been discontinued in hospital - a hypovolaemic, AKI-y child in septic shock. Enalapril. Enalapril!!!



He was away doing teaching, but was there for the 4:30 handover. Was handed over the ABG result - he even wrote it down - and left it to his juniors, no further discussion, before pissing off.


That's what I'd call not being there on the day. If anything, he should be suspended alongside the others imo.
Original post by Hype en Ecosse
Mum gave him enalapril from home that had been discontinued in hospital - a hypovolaemic, AKI-y child in septic shock. Enalapril. Enalapril!!!



He was away doing teaching, but was there for the 4:30 handover. Was handed over the ABG result - he even wrote it down - and left it to his juniors, no further discussion, before pissing off.


I wonder if part of the family's dogged dertermination to see her punished was actually partly due to guilt. I would imagine a parent of a child who has likely been in and out of hospital for a while would be used to letting nurses know what medications they are giving/ letting the hospital dispense.

The more you hear, the more you realise just how badly the whole system has been out to get these two women.
Original post by ForestCat
...well if she wasn't made to work outside her scope of practice I'm sure she'd be fine.


It sounds like she 'volunteered' to help out a unit in dire straights. No obligation to take the shift but they were desparate and she came to help out. Makes it even more tragic!

Original post by Hype en Ecosse
Mum gave him enalapril from home that had been discontinued in hospital - a hypovolaemic, AKI-y child in septic shock. Enalapril. Enalapril!!!


Was it definitely the mum? Could it have been a nurse?

Of all the actual errors in management that probably did make a difference that one is probably the largest, right? There's no doubt in my mind that whoever it was would be more responsible for the death than Bawa-Garba. If it was mum it would be tragic and arguably a non-medic could never have known it was a mistake, but responsible nonetheless.
Original post by nexttime
It sounds like she 'volunteered' to help out a unit in dire straights. No obligation to take the shift but they were desparate and she came to help out. Makes it even more tragic!



Was it definitely the mum? Could it have been a nurse?

Of all the actual errors in management that probably did make a difference that one is probably the largest, right? There's no doubt in my mind that whoever it was would be more responsible for the death than Bawa-Garba. If it was mum it would be tragic and arguably a non-medic could never have known it was a mistake, but responsible nonetheless.


It was definitely the mum, as per previous court proceedings.

http://www.bailii.org/ew/cases/EWCA/Crim/2016/1841.html

Paragraph 15 (I keep trying to quote it here, but it completely f's the post formatting).
Original post by Hype en Ecosse
It was definitely the mum, as per previous court proceedings.

http://www.bailii.org/ew/cases/EWCA/Crim/2016/1841.html

Paragraph 15 (I keep trying to quote it here, but it completely f's the post formatting).


Yep you're right. And they acknowledge in court that it probably contributed to his death. She is certainly more responsible than Bawa-Garba. How tragic.
Original post by BlindingLight
What?? When did this happen?


Sorry, knew it was a weird antihypertensive but got the wrong one. Enalapril was in fact what was given despite Bawa Garba not prescribing it. Stephen O'Riordan, the consultant who wrote down the lactate of 11, pH of 7.084, and said that his junior needed to emphasise it being bad before he'd see the patient, left the country and went to practice in Cork after the incident.
(edited 6 years ago)
Painful to read.
Anyone use/recommend the Osmosis online service and app for studying and revision?

Really like their YouTube videos, so was wondering if anyone thought it was worth the money? Pretty happy with my ANKI stuff, but if this is a strong alternative then I’d be tempted!
Important to bear in mind that we are all incredibly biased with respect to Bawa-Garba given we are doctors.

Rather uneasy about reading people almost trying to "blame the mum" on this page.

Important to remember people posting in this thread may well feel differently had it been their child that had died.
Original post by Anonymous
Important to bear in mind that we are all incredibly biased with respect to Bawa-Garba given we are doctors.

Rather uneasy about reading people almost trying to "blame the mum" on this page.

Important to remember people posting in this thread may well feel differently had it been their child that had died.


Your comment is pretty unfair imo. It's not blaming the Mum, it's just pointing out that Dr Bawa Garba was put in an impossible situation and has been forced to take blame when it wasn't her fault. Maybe she should have refused to cover the rota gaps and leave all of those kids without a doctor. Except that would have also gotten her struck off. And don't even get me started on the poor nurse who was struck off too. We're simply pointing out that the GMC have treated Dr Bawa Garba horribly as if she was the only one to blame. She wasn't trying to kill a child, she was trying to keep the wards running while doing the jobs of multiple people and wasn't helped by system failures that frankly terrifying.

With severe staff shortages, stuff like this may become more common and what's the point in working in dangerously understaffed hospitals where one mistake can get us struck off when we can switch careers into pharma, business, finance, whatever or escape to Aus/NZ as soon as we can?
Original post by paniking_and_not_revising
Your comment is pretty unfair imo. It's not blaming the Mum, it's just pointing out that Dr Bawa Garba was put in an impossible situation and has been forced to take blame when it wasn't her fault. Maybe she should have refused to cover the rota gaps and leave all of those kids without a doctor. Except that would have also gotten her struck off. And don't even get me started on the poor nurse who was struck off too. We're simply pointing out that the GMC have treated Dr Bawa Garba horribly as if she was the only one to blame. She wasn't trying to kill a child, she was trying to keep the wards running while doing the jobs of multiple people and wasn't helped by system failures that frankly terrifying.

With severe staff shortages, stuff like this may become more common and what's the point in working in dangerously understaffed hospitals where one mistake can get us struck off when we can switch careers into pharma, business, finance, whatever or escape to Aus/NZ as soon as we can?


I agree with that.

I just think it's important that we remember that we are not unbiased observers.
Original post by Anonymous
Rather uneasy about reading people almost trying to "blame the mum" on this page.


I don't think anyone is saying it was deliberate. But had Bawa-Garba been the one to give it it would probably been her most significant mistake in this entire case, especially given the close link timing wise of the deterioration. It may be tasteless to point out who in fact was at fault there - hence why its literally not mentioned anywhere else i assume - but it's the truth and ignoring it doesn't help either. The case does take on a different tone when the prosecutors are more culpable than the defendant, the only difference being medical knowledge.

Edit: and of course, re-emphasis on how tragic it all is.

Important to remember people posting in this thread may well feel differently had it been their child that had died.


Of course and I have previously pointed out that stopping resuscitation without obsessively checking and not acting (? this seems unclear) on such a high lactate are in fact significant mistakes.

It's the total lack of consideration of staffing factors in both the court's decision and press coverage - press coverage that the GMC openly admits was its main motivation in pursuing this - that is most notable here. Its just bizarre how its consistently left out.
(edited 6 years ago)
Original post by Anonymous
I agree with that.

I just think it's important that we remember that we are not unbiased observers.


Surely being a med student/doctor/HCP means we have a deeper understanding of the issues raised in this case? This case is going to have implications we'll be dealing with one day. The hospital managers haven't faced criminal disciplinary action for failing to run a safe hospital but they get to hide behind their desks and point their fingers at front-line staff.

I don't think we're really biased though. Go read the Daily Mail comments. That's bias.
Original post by Anonymous
I agree with that.

I just think it's important that we remember that we are not unbiased observers.


Not completely unbiased no. But I think that is because we are more aware (and experienced in) of the complexities of the situation. Until a few months ago the most I knew was that it was mistakenly assumed he had a DNR, because that is what is presented by the media. Its only through sites like this and 54000doctors.org that I have learned more about the case. And you don't have to read much into the case to see just how easily it could be you. So if its a bit biased to want to protect your safety and that of your collegues in an ever increasingly dangerous workplace, then I think most of us would be ok with that label.

But if you've never worked in healthcare, it must be very easy to just see the headlines and assume its as simple as one doctor screwing up. I imagine if more people really understood what happened that day, I imagine she would have a lot more support from the public than she currently does.

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