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Ebola nurse Pauline Cafferkey cleared of misconduct Ebola nurse Pauline Cafferkey cleared of misconduct
(about 2 hours later)
Pauline Cafferkey has been cleared of professional misconduct by a panel at the Nursing and Midwifery Council in Edinburgh following an investigation into her return to the UK after contracting the Ebola virus. Pauline Cafferkey has described her delight after being cleared of professional misconduct by a panel at the Nursing and Midwifery Council (NMC) in Edinburgh following an investigation into her return to the UK after contracting the Ebola virus.
The NMC panel ruled that Cafferkey’s judgment had been so compromised by her developing illness that she could not be held responsible for putting the public in danger, concluding: “In your diminished medical state, you were swept along by events.” But the Scottish nurse, who nearly died twice after contracting Ebola while working as a volunteer in west Africa in 2014, added that she hoped lessons would be learned after the two-day hearing in Edinburgh exposed serious deficiencies in Public Health England’s (PHE) screening processes at Heathrow airport.
Describing Cafferkey as an experienced nurse, the panel concluded that she would not have acted against her training unless her judgment had been seriously impaired. Reading a statement on Cafferkey’s behalf, after the NMC’s conduct and competence panel had cleared the 40-year-old of all charges, the nurse’s legal representative Joyce Cullen said: “As the panel heard, when Pauline and her fellow volunteers arrived at Heathrow, they were faced with chaotic scenes. Public Health England were unprepared for the volume of people returning from areas affected by Ebola. There were also serious failures of communication amongst the PHE staff.”
“There was no evidence that you set out to mislead Public Health England by allowing an incorrect temperature to be recorded,” the ruling said. Cullen continued: “It is perhaps ironic that given the criticisms made of PHE’s processes, it was their complaint that led to the NMC investigation and these proceedings being initiated against Pauline. No doubt lessons have been learned.”
Clearing Cafferkey of all charges, the chair of the panel acknowledged that it had been a distressing process and wished her a full recovery and every success for the future. She added that Cafferkey would “never have knowingly put anyone in danger … The NMC disciplinary process has been very upsetting and stressful for Pauline. However, she’s delighted that the panel has made the decision that she has no case to answer and that she’s now able to continue her nursing career in Scotland.”
Cafferkey, who was infected with Ebola while working as a volunteer in west Africa in 2014, had faced possible sanctions including being struck off. Earlier on Wednesday, the panel ruled that Cafferkey’s judgment had been so compromised by both her travel fatigue and her developing illness that she could not be held responsible for potentially putting the public in danger, concluding: “In your diminished medical state you were swept along by events.”
Cafferkey’s legal representative, Joyce Cullen, read a statement on her behalf, in which she expressed her relief that the disciplinary process was at an end. Describing her as an experienced nurse who would not have acted against her training unless her judgment had been seriously impaired, panel chair Timothy Cole told Cafferkey: “There was no evidence that you set out to mislead Public Health England by allowing an incorrect temperature to be recorded.”
Cullen said: “She willingly put her life at risk to travel to Sierra Leone to work as a volunteer helping to treat people suffering from Ebola. She and hundreds of other volunteers played a vital role in saving lives and helping curb the epidemic in extremely challenging circumstances.” During the two-day hearing, the NMC submitted that following Cafferkey’s return to the UK from Sierra Leone at the end of December 2014, she allowed an incorrect temperature to be recorded by Public Health England’s screening facility at Heathrow airport and that, realising she had an elevated temperature, an initial symptom of Ebola, she left the screening area without reporting this to a member of staff.
Cafferkey went on to highlight the deficiencies in PHE’s screening processes, which were exposed during the hearing. “As the panel heard, when Pauline and her fellow volunteers arrived at Heathrow, they were faced with chaotic scenes. PHE were unprepared for the volume of people returning from areas affected by Ebola. There were also serious failures of communication among the PHE staff,” the statement said. While Cafferkey, who faced being struck off if found guilty, did not deny the facts of the case, her representative argued that an isolated incident of poor judgment brought about by extreme exhaustion and the early stages of Ebola infection should not be allowed to blight the nurse’s otherwise impeccable professional record.
“It is perhaps ironic that given the criticisms made of PHE’s processes, it was their complaint that led to the NMC investigation and these proceedings being initiated against Pauline. No doubt lessons have been learned.” On Tuesday, the panel struck out a charge that Cafferkey had acted dishonestly after hearing expert evidence suggesting her “ability to make decisions and reason properly” had been severely compromised by the time she reached the UK.
She added that Cafferkey would never have intentionally put the public at risk through her actions. “Throughout her career, Pauline has been motivated by a genuine desire to help other people, even if this meant putting her own life at risk,” Cullen said. “She would never have knowingly put anyone in danger. Pauline was lucky to survive and since her return from Sierra Leone, has continued to suffer from ill health,” Cullen said. The hearing was told that on 28 December 2014, Public Health England’s Heathrow facility had not been prepared for a large influx of passengers and the screening area was “busy, disorganised and even chaotic”.
Describing the NMC disciplinary process as “upsetting and stressful”, she said Cafferkey was delighted with the decision that she had no case to answer and was able to continue her nursing career in Scotland. An agreed statement of fact described how each person was given a port of entry Ebola health assessment form, on which their temperature and other relevant information was to be recorded by medical staff. As the delays continued and frustrations grew, one member of Cafferkey’s group suggested they take their own temperatures.
During the two-day hearing, the NMC submitted that following Cafferkey’s return to the UK from Sierra Leone at the end of December 2014, she allowed an incorrect temperature to be recorded by PHE’s screening facility at Heathrow, and, realising that she had an elevated temperature, an initial symptom of Ebola, left the screening area without reporting this to a member of staff. The hearing was told that a member of that group, referred to as Doctor 1, took Cafferkey’s temperature twice and found it to be 38.2C, then 38.3C.
But Cafferkey’s representative argued that an isolated incident of poor judgment brought about by extreme exhaustion and the early stages of Ebola infection should not be allowed to blight the nurse’s otherwise impeccable professional record. Doctor 1 stated that she read out both numbers in the presence of Cafferkey and Registrant A, another member of the group, who said she would record the nurse’s temperature as 37.2C and then they would “get out of here and sort it out”.
On Tuesday, the panel struck out a charge that Cafferkey had acted dishonestly, after hearing expert evidence suggesting that her “ability to make decisions and reason properly” had been severely compromised by the time she reached the UK. Cafferkey stated that she remembers somebody using the words “let’s get out of here” but cannot remember who said them or who entered the temperature of 37.2C on her screening form.
A submission from Dr Thomson, a medical expert, said: “I have no doubt that a combination of early Ebola virus infection and fatigue resulting from a busy night shift, followed by a lengthy journey [from Sierra Leone], would have impaired Pauline’s judgment at the time of entering the screening process at Heathrow airport.” Any temperature above 37.5C was considered to be elevated and should have been reported to a consultant for further assessment, but Cafferkey left the screening area without alerting a member of PHE staff.
The panel also heard about serious deficiencies in the way that PHE managed its Heathrow screening facility. Cafferkey’s representative, Joyce Cullen, suggested that this action was “entirely out of character” and the result of the previously established combination of illness and exhaustion, emphasising that immediately after leaving the screening area Cafferkey informed another doctor of her elevated temperature.
Cafferkey came close to death twice, the first time after being diagnosed in Scotland. She was flown to London to be treated in a special tented Ebola isolation unit at the Royal Free hospital in Hampstead. She then returned to the screening area where her temperature was taken three times by Doctor 2. Only one of those readings was above 37.5C, and that was by 0.1C. She was cleared to travel home to Glasgow, and the following day she was diagnosed with Ebola, with one of the highest viral loads ever recorded.
Last October, Cafferkey developed meningitis as a result of the Ebola virus and was transferred once again to the Royal Free, where her condition became critical for a time, before she eventually recovered. The NMC made the case that Cafferkey’s actions potentially put the public at risk and jeopardised the reputation of her profession, rendering her unfit to practice
David Cameron announced in February 2015 that NHS staff who had volunteered to work fighting Ebola in west Africa would be awarded a special medal, but Cafferkey did not accept it, because she felt the award was inappropriate in light of the continuing investigation. Commenting on the outcome, NMC chief executive, Jackie Smith, said: “As the independent panel recognised, the NMC has an overarching duty to protect the health and wellbeing of the public and need to ensure the maintenance of public confidence in the profession. The referral from Public Health England showed a highly unusual set of circumstances that clearly required a thorough and proper investigation.”
Scotland’s first minister, Nicola Sturgeon, responded to the news that Cafferkey had been cleared on Twitter. Professor Paul Cosford of Public Health England said that the organisation supported the judgement of the panel, and wished Cafferkey will with her ongoing recovery. Cosford said: “The Ebola outbreak in West Africa was unprecedented and we are hugely grateful to all the volunteers who contributed at great personal risk, including our own staff.” He did not respond to Cafferkey’s criticisms of the Heathrow facility.
Scotland’s first minister, Nicola Sturgeon, responded to the news that Cafferkey had been cleared on Twitter, saying: “Sending my very best wishes to Pauline Caffrkey. Her bravery is an inspiration to us all”.
The Scottish parliament’s former presiding officer Tricia Marwick described the case as “disgraceful”, tweeting: “Those responsible for bringing these charges need to have a hard look at themselves.”
Sending my very best wishes to Pauline Cafferkey. Her bravery is an inspiration to all of us. https://t.co/zrVIuODCQ5Sending my very best wishes to Pauline Cafferkey. Her bravery is an inspiration to all of us. https://t.co/zrVIuODCQ5
The Scottish parliament’s former presiding officer Tricia Marwick described the case as “disgraceful”.
Those responsible for bringing these charges need to take a hard look at themselves. Disgraceful. https://t.co/vgmmRIV70bThose responsible for bringing these charges need to take a hard look at themselves. Disgraceful. https://t.co/vgmmRIV70b