Foreign doctor who killed patient on his first shift is struck off

Nigerian-born Dr Daniel Ubani flew into the UK from Germany and injected David Gray, 70, with 100mg of a pain relief drug - 10 times the recommended dosage.

Mr Gray, who was suffering from kidney stones, died at his home in Manea, Cambridgeshire, a few hours after he was given the massive overdose of diamorphine on February 16 2008.

His inquest heard Dr Ubani had failed a language test with the NHS in Leeds where he was rejected by health chiefs but passed a less strenuous test in Cornwall.

A General Medical Council Fitness to Practise Panel concluded it had "grave concerns" about Dr Ubani's clinical competence in his treatment of three patients on that date and warned there was a risk of him repeating his errors.

Today, the panel ruled that a period of suspension was not sufficient in the case.

Panel chairman Dr Brian Alderman said: "In all the circumstances, the panel is satisfied that erasure is the only means of protecting patients and maintaining public confidence in the profession."

Dr Ubani, 67, a specialist in cosmetic medicine based in Witten, Germany, admitted causing the pensioner's death after confusing the morphine with another drug.

He was given a nine-month suspended sentence in Germany for death by negligence but still works as a doctor in that country, the GMC panel heard.

The doctor - who did not attend the disciplinary hearing in Manchester - remains free to continuing practising in his home country despite today's ruling.

The GMC also looked at Dr Ubani's treatment of two other patients on the same day - Sandra Banks, 59, who was given the wrong medication for a migraine, and Iris Edwards, 86, who was found dead in her care home a few hours after he treated her.

Dr Ubani had flown into the UK the day before and only had a few hours' sleep before starting a 12-hour shift, the panel heard.

He was working for SuffDoc, part of the out-of-hours GP service provider Take Care Now, for 45 an hour.

The evening before he started the shift, he was given several hours' training on the firm's computer system at its headquarters in Colchester, Essex, the hearing was told.

He was also given an induction by a doctor, who gave him a sheet listing all of the available drugs and for which illnesses to administer them.

That doctor expressed concerns that Dr Ubani had no experience of working for the NHS, did not know the area, and that he did not have enough time to properly train him.

But his report was not read until two days after Mr Gray's death.

Following the announcement, Health Secretary Andrew Lansley said: "I support the panel's verdict, which ensures that Dr Ubani can never practise medicine in this country again.

"This was a tragic case resulting from a failing out-of-hours system and I offer the Gray family again my sincere condolences.

"There is no doubt that out-of-hours care needs urgent reform.

"GPs are best placed to ensure patients get the care they need, when they need it. If GPs are responsible for commissioning out-of-hours care, I believe many will also decide to play an enhanced role in providing these services themselves.

"Empowering GPs in this way will achieve better services for patients and more control of local services for GPs.

Niall Dickson, chief executive of the GMC, said: "On the general issue of doctors coming to work here from the European Union, the GMC remains extremely concerned that the current arrangements do not provide patients with the protection they need.

"Patient safety must come first and we need to plug the gaping hole in our current procedures."

Dr Ubani's employers, Cimarron UK Ltd, had no evidence of his experience as a GP and relied instead on the certifications produced by him as a result of the reciprocal registration arrangements with the European Union.

Cimarron made assumptions about Dr Ubani's experience and competence based on the fact that he was registered with the GMC, was on the Cornwall & Isle of Scilly's PCT performers list and was classified by the GMC as exempt from UK vocational training requirements for general practice, the panel said.

Chairman Dr Alderman said: "The panel has concerns that, whilst there may be a perception that registration with the GMC is an automatic indication of competence, it notes that the GMC is not in a position to test either the medical competence or language skills of doctors from the EU.

"The panel notes that, following this incident, Cimarron no longer employs doctors from the EU."

Before the hearing, Dr Ubani sent an email to the GMC, saying: "I shall not be attending said hearing. I feel it should not serve any positive purpose."

Dr Alderman concluded: "Dr Ubani's conduct over a period of one day demonstrated numerous and particularly serious departures from the relevant professional standards as set out in Good Medical Practice.

"The panel has taken into account the totality of the findings against Dr Ubani and has concluded that his misconduct and conviction is fundamentally incompatible with his continuing to be a registered medical practitioner."

At the conclusion of the inquest into Mr Gray's death, Cambridgeshire North and East coroner William Morris said the doctor was "incompetent" and ruled Mr Gray was unlawfully killed.

He said his death amounted to gross negligence and manslaughter.

Mr Gray's family recently accepted 40,000 compensation from sources which remain confidential as part of the payout agreement.