Ebola nurse Pauline Cafferkey cleared of misconduct by independent panel

Ebola nurse Pauline Cafferkey will be allowed to continue to practise after being cleared of misconduct over her return to the UK with the virus.

Published 14th Sep 2016

Ebola nurse Pauline Cafferkey will be allowed to continue to practise after being cleared of misconduct over her return to the UK with the virus.

An independent panel at the Nursing and Midwifery Council (NMC) in Edinburgh found three charges against Ms Cafferkey were not proven and therefore her fitness to practise was "not impaired".

The Scottish medical worker, 40, became infected with Ebola while working in Sierra Leone in 2014.

The NMC had alleged Ms Cafferkey allowed an incorrect temperature to be recorded during the screening process at Heathrow Airport towards the end of December that year and that she left a screening area without reporting her true temperature.

The panel said Ms Cafferkey had not set out to mislead Public Health England.

Ms Cafferkey, from Cambuslang, South Lanarkshire, was among a group of doctors and nurses returning to Heathrow on December 28 2014 after a six-week deployment to the west African country.

In agreed evidence put before the panel, it was said screening staff from Public Health England (PHE) at the airport "were not properly prepared to receive so many travellers from at-risk countries", and this resulted in the area being described as "busy, disorganised and even chaotic".

The hearing was told that a doctor took Ms Cafferkey's temperature and found it to be up to 38.3C (100F). A high temperature can be an early sign of an infection.

"Dr one says that registrant A (someone else in the group) stated at this point that she would record the temperature as 37.2 degrees on Ms Cafferkey's screening form and then they would 'get out of here and sort it out'," the evidence states.

The facts show Ms Cafferkey stated she cannot remember who said it or who entered the lower temperature on her form.

She admitted taking paracetamol after she realised she had an elevated temperature.

The nurse was eventually cleared for onward travel, arrived in Glasgow late in the evening and awoke feeling "very unwell" the following day, December 29 2014.

She was diagnosed with Ebola - with one of the highest viral loads ever recorded - and spent almost a month being treated in an isolation unit at London's Royal Free Hospital.

Medics said the early symptoms would have impaired her judgement and an allegation she had acted dishonestly at Heathrow were dropped on Tuesday.

In submissions on Tuesday, the NMC said Ms Cafferkey "potentially put the public at risk" through her actions and that her conduct had "undermined" public trust and confidence in the nursing profession.

Anu Thompson, representing the NMC, did not dispute Ms Cafferkey had been acting for the public good in providing humanitarian assistance in Sierra Leone.

Mrs Thompson said there were significant mitigating circumstances in Ms Cafferkey's case but told the panel: "The fact that she was suffering from the early onset of the virus cannot absolve her of all responsibility for her conduct, nor can it remove her understanding or knowledge of the disease."

Describing the potential risk as "significant", she asked the panel to make a finding the nurse's fitness to practise is impaired "to protect the public and protect the public interest".

The nurse's legal team pointed to her "previously unblemished record" and insisted the legal threshold for a finding of misconduct against her has not been met.

Joyce Cullen told the panel that, in going to Sierra Leone, Ms Cafferkey had strengthened the reputation of the profession.

Ms Cullen pointed to the fact that, at the time of the screening, Ms Cafferkey was exhausted after completing a 22-hour journey to London.

She was "very likely to be substantially impaired" as a result of exhaustion and the early effects of the Ebola virus, the panel was told.

Ms Cafferkey went on to have two further admissions to hospital - one with a relapse of the Ebola virus and the other with chronic meningitis.

Ms Cafferkey was present at the session to hear the decision of the panel and appeared to smile as she left the hearing room.

On the taking of paracetamol at the airport by Ms Cafferkey, the panel said it was satisfied she did not ''set out to mislead any health professional or withhold information''.

''The panel is not satisfied that your actions can be characterised as misconduct,'' Mr Cole said on that aspect.

Turning to the charges of allowing an incorrect temperature to be recorded, Mr Cole pointed to the nurse's ''medically-impaired state'' at the time.

It was ''not disputed'' she was ''experiencing the early effects of a significant viral load of Ebola'', he told the hearing.

He said her health was ''going rapidly downhill at that time'' and the events ''occurred in circumstances characterised as disorganised and chaotic''.

Mr Cole went on: "The panel is of the view that in your diminished mental state you were swept along by events and it was satisfied that in order to make a finding of misconduct it would be necessary to find a degree of participation."

He went on: "The panel is not satisfied that your actions could properly be characterised as misconduct."

The chairman then turned to the charge of leaving the screening area without reporting her true temperature to staff.

He said that, as a professional with knowledge of the importance of recording temperature, it was "inconceivable" she would "leave the safe environment of the PHE screening area but for the fact that you were already seriously ill".

"The panel therefore concludes that your judgement had already been significantly impaired involuntarily and therefore could not properly be characterised as misconduct," Mr Cole said.

He added the fact she was unable to accept she was ill when she returned to Glasgow pointed to her "diminished reasoning" caused by the virus.

"For all the reasons outlined, the panel has concluded that your actions ... did not amount to misconduct."

The question of whether her fitness to practise was impaired did not therefore arise.

Concluding the hearing, Mr Cole wished Ms Cafferkey "a full recovery and every success for your future".