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Nurse may be struck off over Pauline Cafferkey temperature reading Doctor who took Pauline Cafferkey's temperature faces disciplinary panel
(about 1 hour later)
A British medic who helped fight the spread of Ebola in Sierra Leone two years ago faces being struck off or suspended from nursing after allegedly misleading doctors about her colleague Pauline Cafferkey, the Scottish nurse who twice nearly died from the virus. A doctor who took Pauline Cafferkey’s temperature hours before she was diagnosed with Ebola is facing a disciplinary hearing next year, it has emerged.
Donna Wood, a senior sister with more than 30 years’ experience, is accused of failing to record Cafferkey’s elevated temperature when she arrived at Heathrow from west Africa on 28 December 2014. Hannah Ryan, who volunteered in Sierra Leone in her first year after graduating from medical school, will appear before the Medical Practitioners Tribunal Service (MPTS) over the airport screening of Cafferkey following her return to the UK in 2014.
A raised temperature can be the first sign of Ebola fever, and Cafferkey went on to develop one of the worst cases on record for people treated in the west. Ryan’s referral emerged as she was giving evidence in the case of another volunteer medic, Donna Wood, who is accused of concealing Cafferkey’s elevated temperature before she became ill.
At the Nursing and Midwifery Council (NMC) in Stratford, east London, on Monday, Wood faced three misconduct charges over the botched screening. Wood, a senior nurse with more than 30 years’ experience, was described as a “hero” by the former international development secretary Justine Greening in a government promotional campaign. But she now faces being struck off over claims she recorded Cafferkey’s temperature as normal during a “chaotic” screening at Heathrow airport on 28 December.
She allegedly recorded a temperature 1C lower than it actually was during a screening process at Heathrow, was “dishonest” because she knew this was wrong and failed to escalate the potential marker for Ebola appropriately. In September Cafferkey, who twice nearly died from the virus, was cleared of misconduct over the recording of her temperature.
Opening the hearing, the case presenter, Aja Hall, told an NMC panel that Cafferkey’s temperature had been taken by a volunteer colleague, Hannah Ryan, a doctor who had returned from Sierra Leone with Wood and Cafferkey. A raised temperature can be the first sign of Ebola, and Cafferkey went on to develop one of the worst cases on record for people treated in the west.
At the Nursing and Midwifery Council (NMC) in Stratford, east London, on Monday, Wood faced three misconduct charges. She allegedly recorded a temperature 1C lower than it was during a screening process at Heathrow, was “dishonest” because she knew this was wrong and failed to escalate the potential marker for Ebola appropriately.
Opening the hearing, the case presenter, Aja Hall, told an NMC panel that Cafferkey’s temperature had been taken by Ryan, who had returned from Sierra Leone with Wood and Cafferkey.
The first reading from her left ear was 38.2C – above the average body temperature of 37C and higher than the threshold of 37.5C that requires further assessment by a consultant in infectious diseases.The first reading from her left ear was 38.2C – above the average body temperature of 37C and higher than the threshold of 37.5C that requires further assessment by a consultant in infectious diseases.
Ryan had stated that she was in “shock” after taking Cafferkey’s temperature in her left and right ears and finding it raised, Hall said. “I told her to stay calm, we were both a bit panicky,” said Ryan.Ryan had stated that she was in “shock” after taking Cafferkey’s temperature in her left and right ears and finding it raised, Hall said. “I told her to stay calm, we were both a bit panicky,” said Ryan.
The hearing was told that an elevated temperature was considered the body’s first reaction to Ebola, which can kill within five days.The hearing was told that an elevated temperature was considered the body’s first reaction to Ebola, which can kill within five days.
“I asked Pauline if she was feeling OK? She said she was feeling fine,” Ryan told the hearing in a written witness statement. “I stood there in shock. It was like I was paralysed. I had no clear thought process. Ebola is such a horrible disease that every time you have a high temperature you worry, even when you know there’s no reason to.”“I asked Pauline if she was feeling OK? She said she was feeling fine,” Ryan told the hearing in a written witness statement. “I stood there in shock. It was like I was paralysed. I had no clear thought process. Ebola is such a horrible disease that every time you have a high temperature you worry, even when you know there’s no reason to.”
Ryan said only the three medics were present and that Wood “broke the inertia by saying something like, ‘I’m just going to write it down as 37.2 degrees’” so they could “get out of here and sort it out”.Ryan said only the three medics were present and that Wood “broke the inertia by saying something like, ‘I’m just going to write it down as 37.2 degrees’” so they could “get out of here and sort it out”.
The three medics had returned to a screening area described by various witnesses as “busy, dangerous and even chaotic by some of those present”, Hall said.The three medics had returned to a screening area described by various witnesses as “busy, dangerous and even chaotic by some of those present”, Hall said.
They had been asked to fill in a Public Health England form and wait for a PHE medic to take their temperature. Amid the chaos, they decided to record their own temperatures, the hearing heard. They had been asked to fill in a Public Health England (PHE) form and wait for a PHE medic to take their temperature. Amid the chaos, they decided to record their own temperatures, the hearing heard.
Cafferkey was subsequently allowed to leave the PHE screening area and enter the arrivals section because her form did not state that her temperature was above 38C. At some point Cafferkey had taken paracetamol, the NMC panel heard. Cafferkey was subsequently allowed to leave the creening area and enter the arrivals section because her form did not state that her temperature was above 38C. At some point Cafferkey had taken paracetamol, the NMC panel heard.
Ryan meanwhile informed Dr Sharon Irvine, another volunteer doctor returning from Sierra Leone. Irvine questioned Cafferkey about her temperature in the arrivals hall and advised her not to proceed with her onward flight to Glasgow. Ryan meanwhile informed Dr Sharon Irvine, another volunteer doctor returning from Sierra Leone. Irvine questioned Cafferkey about her temperature and urged her not to fly on to Glasgow.
Cafferkey was then returned to the screening area where her temperature was taken three further times at 15-minute intervals. Only one of those readings was above the threshold of 37.5C and she was allowed to fly home. Cafferkey returned to the screening area where her temperature was taken three more times. Only one of those readings was above the threshold of 37.5C and she was allowed to fly home.
That night Cafferkey fell seriously ill and it later emerged that she had one of the highest Ebola virus loads on record.That night Cafferkey fell seriously ill and it later emerged that she had one of the highest Ebola virus loads on record.
The NMC claims that Wood’s “fitness to practice is impaired by reason of your misconduct”. Wood’s counsel, Ben Rich, denied the charges on her behalf. The NMC claims Wood’s “fitness to practise is impaired by reason of your misconduct”. Wood’s counsel, Ben Rich, denied the charges on her behalf.
The hearing heard that Cafferkey had remarked that she had felt warm on the plane home, but later said she had said that as a joke. The group of volunteers on the plane with her, including Wood, had “ascribed it to her sleeping in a hoodie on the plane”. The hearing was told Cafferkey had felt warm on the plane but later said she had been joking. The volunteers on the plane with her, including Wood, had “ascribed it to her sleeping in a hoodie”.
The hearing heard that some weeks later, Wood had written in an email to PHE that “Pauline Cafferkey said to me she had woken on the plane … and she had said she felt very hot and she did not mention having a fever”.
In 2014, Wood, who works at Haywood hospital in Burnslem, Staffordshire, was the face of the government’s campaign to get volunteers to work in Sierra Leone to help stop the spread of the worst Ebola outbreak in history. In 2014, Wood, who works at Haywood hospital in Burnslem, Staffordshire, was the face of the government’s campaign to get volunteers to work in Sierra Leone to help stop the spread of the worst Ebola outbreak in history. Greening, said at the time: “These NHS heroes, like Donna, spending Christmas on the Ebola treatment wards are an absolutely essential part of our efforts to contain, control and defeat this terrible disease.”
The then international development secretary, Justine Greening, said at the time: “These NHS heroes, like Donna, spending Christmas on the Ebola treatment wards are an absolutely essential part of our efforts to contain, control and defeat this terrible disease.” In evidence, Ryan admitted becoming “nervous” about the group’s decision to allow an incorrect temperature to be recorded when Cafferkey was initially screened. “I was worried about Pauline, I was worried about Donna, I was worried about myself. I know what we had done wasn’t right and it may lead to difficulties,” she told the hearing.
In evidence, Ryan said that in a conversation four days after the Heathrow screening the group “had allowed an incorrect recording of Pauline’s temperature to be made when she was initially screened”. Ryan denied allegations put to her by Wood’s counsel that emails she had exchanged with Cafferkey were intended to “collude or contaminate” evidence.
She made the admission in the second of two phonecalls on 2 January 2014 with Nick Gent, a consultant in health protection for the PHE. Ryan, who works at the Royal Liverpool hospital, is under investigation by the General Medical Council and is scheduled to appear before the MPTS next March.
Ryan admitted that she was later “nervous” about the group’s decision to allow an incorrect temperature to be recorded when Cafferkey was initially screened.
“I was worried about Pauline, I was worried about Donna, I was worried about myself. I know what we had done wasn’t right and it may lead to difficulties,” she told the hearing. Wood’s misconduct hearing, which is scheduled to last until 25 November, continues.
Under cross-examination by Rich, Ryan said she could not “recall” Wood’s reaction when she took Cafferkey’s raised temperature. “I was sort of overcome with fear and panic.”
The NMC panel heard Ryan had given her first account of what had happened in Heathrow to Gent. But within minutes of the call she realised she had not given him the full account, including the recording by a member of the group of the wrong temperature.
She discussed it with her mother and father and rang him back. Wood also told her “honesty is the best policy” Ryan said, adding that she had not discussed the content of Gent’s call with her colleague.
Describing the second call to Gent, Ryan said: “I was nervous because I knew what I was saying could get myself and others into trouble. I was aware I was admitting to being part of a very serious incident.” She said she knew that it could get her and others referred to the regulator. “At that point there were still NHS workers going out to SL and going through screening and this was a whole series of set of mistakes.”
The doctor, who graduated in 2014, and works at the Royal Liverpool hospital, is under investigation by the General Medical Council and is scheduled to appear before the Medical Practitioners Tribunal Service next March.
She was accused of giving a “deeply flawed” account of what had happened at Heathrow by counsel for Wood. He pointed out that she kept changing her story about who took her own temperature and could not therefore be trusted to provide an accurate account of who made a note of Cafferkey’s statement.
He accused her of discussing the events with Cafferkey following the conversation with Gent, even though she was aware that both may come under investigation at a future point.
Ryan admitted she had exchanged emails with Cafferkey and had regretted it.
But she added: “I didn’t do it with any intention to collude or contaminate anyone’s evidence.” He said her statements were unreliable and confused. “I suggest to you your evidence that day is highly flawed.” She said she was clear on some memories of the day, but not on the events surrounding Wood and Cafferkey.
The misconduct hearing, which is scheduled to last until 25 November, continues.