An A&E doctor failed to diagnose a woman with a severe infection hours before she died — and he then tried to cover up his mistake. Dr Allen Demanya's failings at Royal Glamorgan Hospital near Talbot Green amounted to serious misconduct, a medical tribunal has found.
Dr Demanya was working as a locum middle-grade doctor at the A&E in the early hours of February 26, 2019, when the woman arrived by ambulance. The 75-year-old's symptoms included diarrhoea, fever, a fast heart rate and low blood pressure. A nurse wrote a note that the woman had "possible sepsis".
The doctor then examined the patient at 3am and prescribed medication. At around 4am she fell off her trolley and was found on the floor of her cubicle by a nurse. Dr Demanya was among the staff who treated her during the night. At 7am another doctor expressed concern over her condition. The woman died at 12.40am the following day.
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Expert witness Dr Victor Ameh told the tribunal that Dr Demanya made a "reasonable" diagnosis of gastroenteritis — a potentially serious infection of the abdomen — but failed to diagnose sepsis. And Dr Michael Atkinson, who was working in the A&E that night, said Dr Demanya failed to let him know the "gravity" of the woman's condition.
When the inquest took place in 2020, Dr Demanya told a coroner he had prescribed antibiotics after his 3am assessment of the patient, as well as intravenous fluids and paracetamol. But nurse Claire Roberts said that when she administered the paracetamol, there was no prescription for antibiotics written up. "She was clear that had there been, she would have administered it," said the tribunal chairman Gerry Wareham.
The tribunal found that Dr Demanya did not prescribe antibiotics until almost three hours after the initial assessment. The panel also found he failed to include a catheter in the treatment plan. "It is clear that a catheter was only fitted after 6.30am after Dr Atkinson had inquired whether [the patient] had passed urine," said Mr Wareham.
Mr Wareham said Dr Demanya retrospectively changed his treatment plan to give the "false impression" that it had included antibiotics and catheter use. "No other explanation was offered by Dr Demanya or was apparent to the tribunal on the evidence presented," the tribunal chairman added.
The tribunal heard that Dr Demanya later crossed out the prescription for antibiotics, "possibly at the point he had begun to realise that there were questions being raised about his treatment". The panel found the doctor had a "clear intention" to mislead the coroner in the inquest.
Dr Demanya spent time in training positions at hospitals in Ghana before moving to the UK. Since 2004 he has worked at Hillingdon Hospital in London, alongside locum work at other hospitals including the Royal Glamorgan. Last year he was offered a locum consultant position at Hillingdon Hospital — "a long-term locum role which he has held since", the tribunal heard.
The General Medical Council (GMC) argued that even if Dr Demanya had not tried to cover up his failings at the Royal Glamorgan, those failings alone would still have amounted to serious misconduct. "[The patient] was very ill, and it cannot be known what the outcome would have been if she had been given the appropriate treatment in a timely manner," said the GMC's barrister Charles Garside KC.
Christopher Mellor, representing the doctor, said his client "fully appreciates the seriousness" of the dishonesty findings, despite the fact he had denied them. Mr Mellor pointed out Dr Demanya has done a "considerable amount" of CPD (continuing professional development) work including on sepsis management, referrals and ethical standards.
The barrister also pointed to the doctor's "previously unblemished" medical career of nearly 20 years. "The extensive testimonials provided on behalf of Dr Demanya were strong evidence that dishonesty was out of character for him, and the clinical failings found were inconsistent with his proven ability as a doctor," said the tribunal chairman.
But the panel found that Dr Demanya's dishonesty "related to serious matters at the heart of his professional duty and was of a sustained and calculated nature". They concluded that Dr Demanya’s fitness to practise was impaired by his misconduct. The case was adjourned to December when the tribunal will consider a potential sanction.
A spokesperson for Cwm Taf Morgannwg University Health Board said: “Dr Demanya has never been an employee of Cwm Taf Morgannwg UHB, and no longer works with us in a locum capacity.”
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