A harrowing account of the investigation of a post-operative death, made all the worse because it is true and it has to be told.
Did he save lives? A Surgeon’s Story
by David Sellu
Sweetcroft Publishing, London, 288pp. £7.89, paperback (Amazon)
This is a troubling indictment of British justice, an institution many of us believe to be the best in the world, but this case shows clearly how fallible it can be and it chronicles the harm done to innocent people.
David Sellu’s career would have been a remarkable story itself without the encounter with British justice. From the most unpretentious beginnings he rose to become a highly successful surgeon valued and admired by patients and colleagues alike. His beginnings could hardly have been more humble, born in Sierra Leone his birth was not even registered. When it was clear that he was a very bright young boy and was found a place at school they had to guess how old he was and created a date of birth for him.
He studied under the most difficult of circumstances, having to read in the evenings and nights under a street lamp, as electricity was expensive. Through natural ability and hard work he won a place at Manchester University medical school and following standard British postgraduate training became a consultant in Ealing Hospital in west London.
One standard busy day he was asked to see a patient with abdominal pain in the nearby BMI run hospital. He describes how he assessed the patient, gave management instructions, including nil by mouth, antibiotics and a CT scan. He returned to see the patient had a perforated colon and later discovered that the instructions he had given were not carried out. Owing to the lack of an anaesthetic rota and a theatre dedicated for emergencies, there were delays in performing the operation beyond Sellu’s control.
Despite the standard operation for the perforation and full treatment in ITU the patient died.
Post-operative deaths are reported to the coroner and an inquest duly followed. Death following colonic perforation is not unusual but the inquest was. The normal order of events was changed so that Sellu was questioned earlier in proceedings and rather than following the standard procedure of establishing a chronological sequence of events, the coroner asked a rapid fire string of questions, making it hard to give a full answer to each of them. Sellu was then asked to leave the inquest and with no explanation it was announced that there was to be a criminal investigation.
The questioning by the police was forceful, relentless and prolonged. This was not a case of someone being considered innocent until proven guilty. It had all the hallmarks of interrogators doing their best to catch out a witness through repeated questioning in order to demonstrate some inconsistency, which could then be used against them.
The court case again shows that British justice has much room for improvement. The prosecution used expert witnesses to describe an ideal situation, although this actual case was far from ideal and the judge gave directions, which the jury could not understand. In fact the jury was so confused that they came back to ask the judge for help but he did not help them.
The result was that Sellu was found guilty of gross negligence manslaughter and sent to Belmarsh, one of the toughest prisons in the land. His account of his prison stay, moving from Belmarsh to eventually being in an open prison, is a clear and well-documented account of what could only have been a truly dreadful experience.
This book describes what I previously thought was unthinkable, that a doctor dealing with the far from perfect realities of medical life should be judged against standards described by witnesses who had taken no account of the actual circumstances.
Colleagues and patients who knew David Sellu and who were astonished by the verdict rushed to give support, an appeal was eventually lodged and the verdict overturned.Every aspect of this case was also forensically examined by the Medical Practitioners Tribunal Service over a 6 week period in 2018 and he was totally exonerated.
However he and his family have suffered, justice has not been done and the bereaved family of the patient have not been helped.
It is still hard to believe that this has happened and that an innocent man has been put through such an ordeal without even an apology, let alone any compensation.
The book describes what happened, but unfortunately it cannot explain why. The natural question is, how was this allowed to happen and what steps will the authorities take to ensure that more innocent people, only doing their jobs with no malice or intention to harm patients, are not convicted through failures in our legal system?
If a patient suffers harm in healthcare, there is, rightly, investigation and a number of measures may be taken to deal with the workers involved and to protect future patients. Doctors are not above the law. If an innocent person is wrongly convicted, what do the authorities do to address the failings by members of the legal team?
Have the coroner or the judge been asked to explain their actions? Those who hold us to account should themselves be accountable.
Sellu has the comfort of knowing that the Royal College of Surgeons, the expert body best placed to comment, have finally supported him, welcoming the news that the judges found him to have been wrongly convicted.
More important is that he should not have been convicted in the first place. The medical and legal professions have become concerned that criminal law places too much emphasis on blaming one and only one person for events that often have numerous contributory causes. Change is coming and the new role of the Medical Examiner should help to establish a better system.
Currently Sellu works part time in the UK and this is primarily to help keep his name on the medical register, to enable him to continue doing voluntary medical work in Sierra Leone. The authorities there require that all practitioners working in the country are registered with their base medical regulators.
A follow-up book is being prepared by one of the doctors, Dr Jenny Vaughan, who helped organise the successful appeal.
In the meantime this book details the extraordinary story, which shows a real need to improve the investigation and management of post-operative deaths.
[David Sellu will be speaking about this in “An Evening with David Sellu” to be held at Northwick Park Hospital, London, from 6 to 8 pm Wednesday , 18th September. Details: www.DavidSellu.com]