Ebola nurse Donna Wood had unblemished record, tribunal hears

The nurse who was found to have concealed her colleague Pauline Cafferkey’s raised temperature before she tested positive for Ebola risked her life for others in Sierra Leone and has an otherwise unblemished record, a tribunal has heard.

Donna Wood’s lawyer told an independent panel at the Nursing and Midwifery Council that he accepted their findings but said her actions amounted to a brief “lapse of judgment” by a professional who had given almost 30 years of “distinguished” service to the NHS.

Ben Rich was speaking the day after Wood had been found guilty of misconduct following allegations that she knew Cafferkey had a high temperature and that she failed to escalate this during the screening process at Heathrow airport when they returned from six weeks volunteering in Sierra Leone in December 2014.

Before the panel retired to consider whether her misconduct amounted to an impairment in the nurse’s current fitness to practice, Rich told them: “On your findings it would be incorrect to find that any of those professionals, Donna Wood included, really thought that Pauline Cafferkey had Ebola.”

He told the panel that several witnesses including the lead clinician on the screening team, Deepti Kumar, had said that Cafferkey did not seem unwell on the day.

“Had there been the slightest suspicion that actually Pauline Cafferekey was ill, you know that witnesses you found to be honest, thought that Pauline Cafferkey seemed completely well,” Rich said.

Cafferkey initially passed the screening process after her temperature was found to be over 38C but was recorded on a form as normal. When she returned to the screening room her temperature was taken three more times and found to be normal.

Cafferkey had told the manager of the screening process, David Carruthers, a former Metropolitan police officer, that she had taken paracetamol about an hour before, which could have masked her real temperature.

But Carruthers, who had no clinical training, did not understand the significance of this and failed to pass the information on to Kumar, who was assessing Cafferkey in the second screening.

Rich pointed out that Kumar was among several witnesses who had nonetheless said that Cafferkey appeared well despite her temperature.

He told the panel on Thursday that the findings amounted to a “momentary lapse of judgment in a nurse who has an otherwise distinguished record of service to the NHS, to the public, a distinguished period of service to Ebola patients before this during which time she risked her own life for the benefit of others”.

An Ebola treatment centre outside Freetown, Sierra Leone, in December 2014. Photograph: Baz Ratner/Reuters

Wood was brought before the NMC on three misconduct charges, including recording Cafferkey’s temperature reading dishonestly in order to hide it from public health officials.

It transpired during the hearing that the group had decided to take their own temperatures because the screening team were not equipped to do so. They had run out of screening forms and only had four screening cubicles for about 50 people.

On Wednesdsay the NMC found that she had not recorded an incorrect temperature as alleged but found that she had suggested that Cafferkey’s temperature be recorded lower so that the volunteer group could leave the “uncomfortable” and “chaotic” area more quickly.

Wood is facing a professional sanction, which could involve being struck off or a suspension.

Aja Hall, the case presenter for the NMC, told the panel the case was “particularly serious” as “Pauline Cafferkey was in the starting stages of Ebola and in an extremely busy and public place”.

She said it was “well established” that a high temperature was the “first sign that there may be infection which is why so much significance was placed on the taking of temperature, both in Sierra Leone but more crucially through the screening process at Heathrow airport”.

The panel is expected to to conclude its deliberations on Friday.

Ebola nurse Donna Wood had unblemished record, tribunal hears

Ebola nurse Donna Wood could be struck off over Cafferkey screening

A nurse once described as a hero after she volunteered to work in an Ebola treatment centre in Sierra Leone faces the possibility of being struck off after being caught up in a botched screening at Heathrow.

Donna Wood has been found by the Nursing and Midwifery Council to have concealed the high temperature of her fellow volunteer Pauline Cafferkey when they landed at Heathrow a day before the Scottish nurse tested positive for the virus.

An independent panel of the NMC had charged her with recording a temperature for Cafferkey one degree lower than it was during a “chaotic” screening process on 28 December 2014.

At the end of a six-day hearing, the panel found this was not proved, but found that she was guilty of two other charges – that she had known Cafferkey had a high temperature and dishonestly concealed this and had failed to escalate the situation, knowing that a high temperature could be seen as a first indicator of Ebola.

Najrul Khasru, the chairman of the panel, said it had fully accepted that Wood’s desire to get out of the area quickly was the primary motivation of her actions. He said: “The panel found you made the suggestion to record Ms Cafferkey’s temperature 37.2C with the intention to conceal that Ms Cafferkey had a temperature higher than 38C from PHE screening staff in order to allow yourself and your group to leave the area sooner rather than later, and deal with it later.”

The panel will now consider whether the findings against Wood are serious enough to involve a sanction, which range from being struck off to having conditions imposed on her future practice as a nurse in Stoke-on-Trent, where she works in end-of-life care.

Wood categorically denied that she falsified Cafferkey’s records and raised questions about the competence of the screening system, which was described as “chaotic”.

The panel heard that in an attempt to help doctors and staff conducting screening at Heathrow airport, the medics decided they would take their own temperatures. Wood said she recalled seeing volunteer doctor Hannah Ryan with the thermometer, and that she had held it up to her at least once.

She said she could not remember whether she had written on any screening forms herself.

The panel could not prove she had written the incorrect temperature on Cafferkey’s forms but said it was satisfied she had dishonestly suggested it be recorded as such.

After the group left the screening room and made it to the arrivals hall, Ryan reported Cafferkey’s high temperature to another doctor, who recommended the Scottish medic return to be screened again.

Cafferkey’s temperature was checked again three times by a Public Health England consultant and was found to be a maximum of 37.6C, meaning she was given the all-clear to travel on to Glasgow.

But at some point before getting to arrivals, Cafferkey had taken paracetamol, contributing to the lower readings.

Pauline Cafferkey was cleared of misconduct in September. Photograph: Jeff J Mitchell/Getty Images

PHE says it learned lessons from the Cafferkey case, but denies its process was chaotic or deficient or that its system had failed to detect the one person who did come into the UK on a commercial airline carrying the Ebola virus.

“Screening was not designed to catch someone with Ebola. It was about getting relevant information from people and giving them information so they could be clinically referred if necessary,” said a spokeswoman.

Cafferkey, who nearly died twice from Ebola-related complications, also faced NMC disciplinary proceedings but was cleared of all misconduct after a hearing in September.

Wood was brought before the employment tribunal after a third volunteer told PHE, the body that designed the screening process, that Wood had falsified Cafferkey’s temperature on the form she had to fill out on arrival at Heathrow.

The tribunal raises questions about the efficacy of the screening process. With the disease out of control in west Africa at the time, there was fear and panic in some quarters that the virus could easily be brought into the UK by plane.

About 14,500 people, including aid workers, medics, press and Sierra Leoneans, arrived in Heathrow during the Ebola crisis.

The PHE contended that it was the nurses’ fault Cafferkey passed through undetected as they did not comply with the screening process, referring them to their regulatory authorities. However, those who gave evidence at the NMC spoke of deficiencies in the screening process.

Only half the team in Heathrow on the day had any clinical background. The clinical lead, Deepti Kumar, told how volunteers from the “Cabinet Office” and other government departments were drafted in to the process.

Kumar and the screening manager, David Carruthers, a former police officer, told the panel they were not prepared for the high number of volunteers returning, despite the heavy publicity surrounding their trip to Sierra Leone.

Carruthers admitted they were a bit “disorganised” on the day and that they ran out of screening forms and monitoring kits and had just four screening cubicles for about 50 people.

The future of volunteer doctor Ryan is still in the balance as she faces a separate Medical Practitioners Tribunal Service hearing on 20 March.

Ebola nurse Donna Wood could be struck off over Cafferkey screening