The landmark case against Maidstone and Tunbridge Wells NHS Trust and Dr Errol Cornish was dismissed by Mr Justice Coulson at the end of January, stating it would be "unsafe and unfair" to continue. The case relates to Frances Cappuccini, who tragically died after giving birth by emergency caesarean section in October 2012. The anaesthetists involved in her care were charged with gross negligence manslaughter for allegedly failing to protect her airways (causing further complications), and the trust was charged with corporate manslaughter for alleged accountability failures in respect of the allegations against the anaesthetists. The second anaesthetist, Dr Nadeem Aziz fled the country and avoided prosecution.
The trial commenced on 13 January 2016. Following opening submissions by the prosecution and defence, the judge concluded that there was little or no evidence of the doctor's failings contributing to the death and no evidence of systemic failings at the trust. Both defendants in the matter were found not guilty with the judge commenting that the actions of the doctor in this case were "as far removed from a case of gross negligence manslaughter as it's possible to be".
This case emphasises just how crucial it is to ensure that there is sufficient evidence before proceeding with charges of gross negligence and corporate manslaughter. Although the existence of a duty of care was clear, the strict criteria for the criminal offence also had to be satisfied for a successful prosecution. The threshold for such offending is very high and must be distinguished from the usual negligent conduct. In particular, it requires a breach of duty to have taken place, the breach must also have caused the death and must be so substantial that it could be categorised as a criminal act. However, in this case the judge was unable to identify sufficient evidence to support any findings of the actions of the doctor or trust resulting in a breach of duty and causing the death of Mrs Cappuccini.
Interestingly, the prosecution had presented the case on the basis that if one of the doctors concerned was found to be grossly negligent, causing the death of the patient, then the trust could be held liable for corporate manslaughter for employing someone who was not suitably qualified or trained for the role. The judge did not agree with this assessment, confirming that it would have been possible for the trust to have been found guilty, even if the staff were acquitted.
The trust had accepted from the outset of the case that there were aspects of Mrs Cappuccini's care which fell short of the standards expected but that this was not enough to initiate criminal proceedings, as the failings would need to have been far short from the expected standard, causing the death. The CPS's assessment of the evidence and grounds for a criminal prosecution is now called into question. The decision by the judge will not be appealed by the CPS. Not only have the parties concerned incurred costs for the proceedings but it has caused a great deal of distress.
The family may go on to pursue civil proceedings. In addition, the inquest will be resumed. The doctors will still be investigated by the General Medical Council in relation to their actions and could still face action on their registration.