A doctor convicted of killing a patient through gross negligence has been told that he can return to work in the NHS.

Amit Misra, 37, fled to India after being found guilty of the manslaughter of Sean Phillips, a 31-year-old sales executive, who died from a common infection while recovering from routine knee surgery.

A court was told that the trainee surgeon had failed to diagnose the infection and was “too proud” to ask senior doctors for help until it was too late. He was suspended from working for a year and avoided a jail term after his barrister pleaded that his career was in ruins.

Yet despite failing to prove himself in a series of medical assessment tests, the General Medical Council has ruled that Dr Misra should now be allowed to return to Britain to work, seven years after Mr Phillips’s death.

Under the law all cautions and convictions given to doctors have to be examined by the governing body, but in many cases the GMC allows those convicted of serious crimes or unprofessional conduct to work again.

The case comes two years after the Shipman inquiry called for a radical overhaul of the GMC, which was accused of “looking after its own” and failing to protect patients.

A fitness-to-practise panel of the GMC announced a series of conditions that Dr Misra will have to adhere to over the next three years.

But the family of Mr Phillips said yesterday that there was no way that the doctor should be allowed to work in Britain again. The father of one from Southampton had been expected to leave hospital the day after the operation on June 23, 2000.

Four days later he was dead, after developing toxic shock syndrome from staphylococcus aureus, a common but virulent bacterial infection. Southampton University Hospitals Trust was fined £100,000 over failures in his care. Dr Misra and a fellow doctor, Rajeev Srivastava, 40, were convicted of manslaughter due to gross negligence at Winchester Crown Court in April 2003 after it was found that they had failed to monitor the patient’s abnormal temperature and pulse.

Despite checking on the patient at least four times, Dr Misra, a senior house officer with nine years’ experience, made only one note of the problems in Mr Phillips’s records, the court was told.

In an interview last year, Mr Phillips’s former partner, Annabel Grant, 33, who lives in Southampton with the couple’s son, Mitchell, 9, said that the doctors had never apologised. Ms Grant said: “I feel I deserve an apology from both doctors. Sean was everything I could have wished for – a soulmate, best friend and a fun-loving, caring partner. Losing him has torn my life apart but what makes the pain still harder to accept is knowing that his death was so unnecessary.”

Dr Srivastava, 40, of Invergowrie, Dundee, is understood to be working as a trainee registrar at Ninewells Hospital in the city, but has no contact with patients. Dr Misra sparked outrage when he began working at the Freeman Hospital in Newcastle upon Tyne just nine months after his conviction. He was banned from working in Britain for a year in November 2005. The doctors were given 18-month suspended sentences but not struck off.

Last year Dr Misra was ordered to undergo a performance assessment, but a team of senior doctors declared that many elements of his practice were still “unacceptable”. Speaking at a hearing to adjudge Dr Misra’s fitness to practise this week, Brian Gomes da Costa, its chairman, said: “It notes that knowledge gaps were identified in three out of the four areas of Dr Misra’s assessed professional performance.

“The Panel has noted the gross negligence in postoperative care that led to Dr Misra’s conviction for manslaughter, but it has also heard of efforts that Dr Misra has made with his mentors in India to rectify the deficiencies in his clinical skills.

“The overall conclusion of this assessment is that Dr Misra’s core clinical skills are at a minimum but acceptable level.”

The conditions on the doctor’s registration include informing the GMC as soon as he is back in the country, taking a course in basic surgical skills, working with a senior doctor and applying only for trainee posts.

Dr Misra must also inform all future employers of the findings against him, is not allowed to do any private work and is not allowed to do any out-of-hours work or on-call duties.

The GMC is set to review the case in 18 months. A spokeswoman for the GMC said: “Our primary concern is not protecting doctors but patient safety. There are indicative sanctions that we refer to when doctors have a criminal conviction and in this case these have been taken into account.”

Case notes

In the past two years, doctors allowed to continue working after misconduct hearings have included:

Christopher Vella Bonnici, an anaesthetist found guilty of failing to realise a 35-year-old patient was awake during surgery at a Birmingham hospital. He was suspended for a month by the GMC;

Graeme Holt, suspended for three months after punching a woman patient in the face and being convicted of assault in Glasgow;

Richard Archer, a partner at the Heacham, Norfolk, group of surgeries, which cover the Queen’s Sandringham estate, who pleaded guilty to stealing morphine, pethidine and diamorphine in 2003 and received a 12-month suspended jail sentence. The GMC later ruled that Dr Archer could work under supervision for 12 months.

— The Government is proposing changes to the make-up of the GMC and the standards of proof required in fitness-to-practise cases as part of the Health and Social Care Bill. The changes are opposed by doctors’ groups such as the British Medical Association.

Source: GMC, Times database

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