Doctor accused over baby's death

A British doctor working in Zimbabwe sent a baby boy home just 75 minutes after an operation, the General Medical Council has heard.

The 19-month-old infant died just hours after the routine circumcision. He had been given high levels of morphine for pain relief.

Dr Richard Gladwell McGown has denied serious professional misconduct.

Neither of these healthy children should have died

Joanna Glynn, GMC counsel

The GMC is hearing the case in London because the doctor is on its medical register and is licensed to practice in the UK.

Dr McGown is also accused of failing to provide proper care to a nine-year-old girl who died following an appendix operation.

Routine operation

The GMC's professional conduct committee heard how the baby boy - known as Child A - was admitted to Avenues Clinic in Harare, Zimbabwe on 13 July 1988 for a circumcision because he had problems urinating.

Dr McGown, who was educated in Scotland, gave the toddler an injection of morphine into the spine to relieve the pain after the operation.

The committee heard that Dr McGown was fully aware of the risks of associated with morphine injection.

According to GMC lawyers, he wrote an article in 1989 - the year after the boy's operation - stating that "under no circumstances should a child be allowed to leave the care and support of the hospital for at least 24 hours if given a caudal morphine injection".

Counsel for the GMC Joanna Glynn said Dr McGown's decision to discharge the infant was indefensible.

"The decision to discharge him after 75 minutes was wholly indefensible. It falls below the standards of a competent medical practitioner," she said.

Dr McGown, who faced a criminal trial in Zimbabwe in relation to the deaths, acknowledged that the high dose of morphien contributed to the infant's death.

He told the GMC committee: "Had he not had this anaesthetic, he would still have been alive."

But he added: "I have had great difficulties during a criminal trial and during this hearing in trying to get across the fact that large doses are not only permitted but required when using caudal morphine."

The father of the child - who was not named - described how he was given no instructions on how to care for the baby following the operation. He said he had not been told that his son had been given morphine.

Evidence

He described how Dr McGown handed him the child following the surgery, saying: "He said: 'Here is your child. I've brought him back from the dead.' It seemed like a joke."

The father, from Harare revealed how the baby was irritable and later fell into a deep sleep.

He began vomiting yellow liquid and was taken back to the hospital where he died, six hours after his operation.

Dr McGown is also accused of giving the patient an excessive amount of morphine and failing to keep adequate anaesthetic records.

Ms Glynn told the disciplinary committee: "Neither of these healthy children should have died. Their deaths were preventable.

"They were caused by culpable failures set out in the charges."

The case continues.