Two UK junior doctors are to stand trial for manslaughter over the death of a 31 year old patient who developed staphylococcal toxic shock syndrome following a routine knee operation.
Rajeev Srivastava and Amit Mizra, both senior house officers at the time, have been charged with causing the death of Sean Phillips, who died in June 2000 following surgery at Southampton General Hospital. A trial date has been set for March 2003 at Winchester crown court in Hampshire.
The case follows the acquittal last month of consultant urologist John Roberts and locum registrar Mahesh Goel, who were charged with manslaughter after Dr Goel removed a patient's healthy kidney by mistake instead of the diseased one. They were acquitted on the direction of the judge after a prosecution pathologist said he could not be sure of the cause of death.
Medical manslaughter cases are a development of the 1990s, following a policy decision by the Crown Prosecution Service to pursue prosecutions for gross negligence or recklessness at work.
A paper published two years ago in the BMJ by consultant physician Dr Robin Ferner of the City Hospital NHS Trust, Birmingham, showed that whereas only four doctors were charged with manslaughter during the 1970s and '80s, 17 were charged during the 1990s (2000;321:1212). In the two and a half years since the completion of that research, another six doctors have been tried for manslaughter.
Although the Crown Prosecution Service's decision to pursue prosecutions for negligence at work has affected mainly doctors, the service did prosecute a plumber for causing death by electrocution while working on a kitchen.
The success rate for medical manslaughter prosecutions is much lower than for manslaughter generally. The reason is simply that for a manslaughter charge to stick, it must be proved that the defendant caused the death. The cause of death is much harder to state with certainty in medical cases than in more ordinary manslaughters, such as a death after a fight got out of hand.
Of the 21 doctors charged between 1970 and 1999, 10 were convicted, but three of them had their conviction quashed on appeal. Of the six doctors charged with manslaughter between the beginning of 2000 and mid-2002, only one, an anaesthetist, was found guilty. At least three of the remaining five were acquitted on the direction of the judge, after the prosecution case collapsed. In another, the judge had nudged the jury towards its decision by summing up for an acquittal.
By comparison, Home Office figures for manslaughter cases generally in 2001 show that of 278 defendants who stood trial, 238 were convicted and only 40 acquitted. 