On 11 February 2010, consultant colorectal surgeon David Sellu was called to see 66-year-old James Hughes, who had developed abdominal pain a few days after a successful left knee replacement. Sellu suspected a perforated bowel, and knew Hughes would require urgent operation.

Sellu’s subsequent actions, however, to order a CT scan for the following day and delaying the operation till the early hours of 13 February, landed him on a path towards his 15-month jail time. Hughes condition had deteriorated by the time of operation and he died at the BMI Clementine Churchill Hospital.

Surgeon made a difficult decision due to lack of anaesthetist

In his argument Sellu pointed out that an anaesthetist was not available for several hours and transferring Hughes to another hospital was not safe.

“I’ve analysed what happened a thousand times, and with the benefit of hindsight, there are things I might do differently. But there were reasons for the delay in operating that had absolutely nothing to do with me – for example, there was no rota for emergency anaesthetists,” he said.

On account that such an operation should have been performed earlier, Sellu was tried and convicted of gross negligence manslaughter in November 2013, and was sent to a high-security jail in Belmarsh, London to begin his two-and-a-half-year prison term.

In a statement from Hughes’ family, they said, "Our father's suffering was not prioritised as the emergency it so clearly was."

Sellu was released in February 2015 after winning an appeal against his conviction. Evidence put forward were that Hughes’ risk of death had been much higher than the 2.6% initially proposed by the prosecution, that little weight was put into the fact that Hughes had been on dabigatran, a new generation oral anticoagulant, and that there was inadequate legal guidance given to the jury by the judge.

How medical errors led to being called “Dr Death”

It is known that most medical errors in the healthcare industry are usually the result of a flawed system allowing multiple mistakes to line up, leading to a final catastrophic event.

“In the Sellu case, there were a number of errors,” said professor Roger Kirby, medical director at The Prostate Centre. “Junior doctors didn’t give the right messages, it was hard to get the CT scan, it was very hard to get an anaesthetist and the hospital didn’t have an on-call system for anaesthetists.”

Following Sellu’s conviction, the hospital has made effort to form a rota for anaesthetists.

“The whole system could improve. Just locking David up is not going to improve the system and it has devastated David’s life and made other doctors paranoid about being prosecuted themselves,” Kirby said.

After the conviction was nullified, Sellu said there was an array of causes which led to Mr Hughes's death, including problems with the entire system at the hospital.

"I think for the sake of that poor man and his family justice has not really been done," he said.

"It has been retribution, but I don't really believe that they've been served as well as they should have been."

Focus should be bigger than just assigning blame

There has been increasing numbers of prosecutions against healthcare workers, leading to fear of taking on difficult cases among doctors, while issues of hospital system failures and patient safety remain unaddressed.

“Charging individual doctors with manslaughter does not result in a thorough analysis of what happened nor permit lessons to be learned to protect patients in the future,” said Mr Ian Franklin, consultant vascular surgeon and a representative of the Friends of David Sellu Campaign.

Over 300 doctors and medical staff have signed a letter to voice their concern about the questionable quality of evidence in complex cases put forward in courtrooms, and about the Crown Prosecution Services’ (CPS) increasing investigation of doctors over patient deaths.

“It is vital that the focus is not just on the individual doctor but equally on the system they are working in,” in a statement from the Royal College of Surgeons. MIMS

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