Family compensation claim: Eric Ayling v Doctor Gosai

Clinical Negligence case report: £146,000 Eric Ayling v Doctor Gosai

Doctor's application for restoration to the register of doctors rejected.

Doctor banned from making further applications - first such ban under new rules.

Brief Summary
This case involved an application by Dr Pratapgar Gosai to be restored to the Register of Medical Practitioners. Dr Gosai's name was erased from the Register on 31 October 1997.

Dr Gosai had been found guilty of serious professional misconduct following the death of his patient Maria Ayling in January 1995 of a pulmonary embolism.

At a hearing before the Professional Conduct Committee of the GMC of 16 May 1997 the committee found that Dr Gosai had not examined the patient or taken steps to progress her treatment. Evidence given to the committee showed that Maria Ayling would have lived if such steps had been taken.

On 11 March 1999, Dr Gosai made his first application to be reinstated to the Register. This was rejected.

On 11th January 2002, Dr Gosai made a second application for his name to be restored to the register. This was also rejected and Dr Gosai forbidden to make further applications for restoration without permission.

Background to the Case:
Dr Gosai was the GP for Maria Ayling who was born on 22 March 1974. In the autumn of 1994, Maria Ayling consulted Dr Gosai over pain in her legs. She was referred to King Georges Hospital Goodmayes for an investigation on her right knee.

In December 1994, she developed a swollen lower left leg, pain in the left knee and impaired mobility. On 24 December 1994, Dr Gosai visited Maria Ayling at home, but failed to examine her and prescribed a painkilling gel.

In January 1995, Maria's condition worsened. Her father, Eric Ayling, made increasingly frantic efforts to get help from Dr Gosai. Dr Gosai did not make any further visits to see Maria Ayling. She was awaiting an appointment for the arthroscopy on her right knee at King Georges Hospital, and attempts were made to bring forward that appointment.

Maria's Death
On 24 January 1995, Maria collapsed in the bathroom at home. She was taken by ambulance to Romford Hospital, but was dead on arrival.

The cause of death was a pulmonary embolism following a deep vein thrombosis in her left leg. Maria had been taking an oral contraceptive pill and had a condition known as lupus erythemitosis which were contributing factors.

A post mortem was performed and the coroner, Dr Harold Price of Walthamstow Coroners Court, decided that an inquest was not required as death was from natural causes. Mr Ayling consulted Hodge Jones & Allen solicitors for advice. Our response was that there should be an inquest, and Dr Price was asked to reconsider his decision not to hold one.

However, Dr Price considered that his original decision was correct. Mr Ayling was granted legal aid to bring judicial review proceedings of the Coroner's decision not to hold an inquest.

In November 1995, leave was granted by the High Court for judicial review of the Coroner's decision.

Inquest
On hearing that leave had been granted, Dr Price agreed that an inquest should be held. It took place at Walthamstow Coroners Court on 6 February 1996. Dr Gosai gave evidence. A verdict of accidental death was recorded. Contrary to Dr Gosai's evidence, the coroner decided that the doctor had not examined Maria Ayling on 24th December and that Dr Gosai had not been telling the truth in relation to his account of the visit.

He decided to refer Dr Gosai's conduct in the case to the GMC. In the meantime, an enquiry was held by the Medical Services Committee who found that Dr Gosai was in breach of his terms of service, and fined him £3,000.

GMC Hearing - Doctor Struck Off The GMC decided to bring charges against Dr Gosai and a hearing took place at the GMC between 12 and 16 May 1997.

The findings of the Professional Conduct Committee were that Dr Gosai was guilty of serious professional misconduct for failing to examine Maria Ayling on 24 December 1994failing to take adequate steps to assess her condition failing to respond to the requests of the family in January 1995 for urgent help failing to arrange an investigation and failing to tell the truth in relation to the facts of the 24 December at the inquest and at the GMC.

They ordered that Dr Gosai's name be erased from the Register. This did not take place until 31 October 1997, pending an appeal by Dr Gosai against the decision which was later dropped.

Settlement of Compensation claim
In May 1998, the solicitors for Dr Gosai wrote to confirm that breach of duty by Dr Gosai causing Maria's death was admitted. In December 1998, the family's claim for compensation against Dr Gosai was settled for £146,000.

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