Doctor pleads guilty to gross negligence manslaughter following death of patient

Earlier this week, Manchester Crown Court heard how father-of-four Christopher Hales was the victim of a "catastrophic" error made by Shahid Khan, a cardio-thoracic surgeon with a previously "unblemished" record, Manchester Evening News reports.

Mr Khan, 63, has avoided jail after he pleaded guilty to gross negligence manslaughter. He recieved a suspended sentence and was placed under a ten month curfew as an "alternative to immediate custody" due to a number of factors, including concerns regarding his own health. 

"Catastrophic mistake"

The judge, Mrs Justice Yip QC, told the surgeon of nearly 30 years that he had made a “catastrophic mistake” by administering a toxic dose of anaesthetics which killed Christopher “for reasons which are still not entirely clear”, adding that Mr Khan's professional conduct "fell so far below the standard to be expected of any doctor as to be criminal".

Christopher developed smoking-related lung problems during his life which became more serious in 2017. He was initially admitted to North Manchester General (NMG) with a collapsed right lung in January of that year. However, the problem resolved itself and he was discharged with a referral to the specialist chest and lung centre, Wythenshawe, Greater Manchester. A few months later in April, Christopher was again admitted to NMG after his left lung collapsed. He was discharged once more, but his pain continued and so he was readmitted to NMG for a third time on 2nd May 2017, before being transferred to Wythenshaw on 12th May.

On 15th May Christopher's consultant informed him of a number of potential treatments for his condition, and he opted for 'bedside talc pleurodesis', with his wife Carmen coming into the hospital to be by his side. Mr Khan was tasked with carrying out the procedure as he was the on-call registrar that day. He administered two agents at their max dose - one fast acting and one that had a longer effect. He received one lot of drugs in a bag marked for epidural use rather than in ampoules, as he had anticipated, and the court heard how he has now admitted mixing the other drug into this. As a result of this, and the fact that they were of differing concentrations, Mr Khan 'lost control' of the amount of the anaesthetics he was administering.

Christopher collapsed and went into cardiac arrest - unfortunately attempts to resuscitate him were unsuccessful. The exact amounts of drugs he recieved is still unclear, with the cause of death recorded as neurological and cardiovascular toxicity of local anaesthetic agents. An independent expert concluded in their report that Mr Khan's standard of care fell "seriously below" that expected of a "reasonably competent practitioner."

What is talc pleurodesis?

According to the Royal Birkshire NHS Foundation Trust's website talc pleurodesis is "a procedure in which sterile talc mixed with saline is inserted via a tube in order to cause an inflammatory reaction in the lining of the lung. The aim is to prevent fluid building up in the lining of the lung. It is successful in approximately 70%-80% (7-8 in every 10) of patients."

Never event

Justice Yip told Khan: "You were an experienced surgeon entrusted with carrying out a routine procedure on (Mr Hales). For reasons which are still not entirely clear, you made a catastrophic mistake and administered a toxic dose of anaesthetics which killed him. 

"That is what is sometimes described as a 'never event.' It should not have happened. There is no excuse for it. By your plea, you admit Mr Hales’ death resulted from your gross negligence. Put simply, your conduct that afternoon fell so far below the standard to be expected of any doctor as to be criminal.

"This case involves a real tragedy for all concerned but centrally for Mr Hales’ family. Mr Hales was clearly a committed family man, taken far too soon. The trauma experienced by Mrs Hales who was at her husband’s side when things went tragically wrong is hard to imagine."

Mr Khan was handed a 20 month prison sentence, suspended for two years, and was also made subject to a 10 month curfew between the hours of 8pm and 8am. Justice Yip added that the curfew would "restrict your freedom and will serve as a reminder to you and others as to the seriousness with which your offending is viewed." He was also ordered to pay prosecution costs of £32,319.

Joint Group Medical Director at Manchester University NHS Foundation Trust (which runs Wythenshawe Hospital) Ms Toli Onon, said: “We wish again to offer our sincerest condolences to Mr Hales’ family and we are deeply sorry for their loss. Following the patient’s death in 2017, the Trust launched a thorough internal investigation to examine the circumstances leading up to and following this tragic incident. The Trust has completed a detailed action plan and a number of lessons have been learnt and improvements implemented. The Trust investigation has been shared with the patient's family and their solicitor. 

“Mr Khan was suspended immediately and is no longer employed at Manchester University NHS Foundation Trust. The Trust liaised closely with Greater Manchester Police throughout their investigation and the subsequent legal proceedings. We would like to reiterate our sincere apology previously provided to Mr Hales’ family. Our heartfelt sympathies go out to them.”

Statement from Potter Rees Dolan

Sophie Birch is a Clinical Negligence solicitor here at Potter Rees Dolan and is handling the Hales family's civil claim against the Trust. Sophie comments:

"Gross negligence manslaughter is a serious charge and reflects the gravity of the failings in care which led to Christopher’s death. It is important that there are both criminal and civil processes in place to investigate such circumstances, although the outcomes never really come close to making things significantly better for the bereaved family; at best they can shine a light on the details of the events leading up to the death, and offer the opportunity for learning which provides some comfort."

Sophie is a Solicitor within the Clinical Negligence team here at Potter Rees Dolan. If you would like to speak with Sophie regarding medical negligence claims or fatal accidents, please call 0800 027 2557. Alternatively, you can contact Sophie directly here.