A doctor has admitted misleading other medics by concealing Pauline Cafferkey’s raised temperature before she became seriously ill with Ebola.
Hannah Ryan, who volunteered in Sierra Leone in her first year after graduating from medical school, was one of the medics who assessed Cafferkey following the Scottish nurse’s return to the UK in 2014.
Ryan wrote down a temperature 1C lower than it actually was during a “chaotic” screening process at Heathrow airport on 28 December 2014, a medical practitioners tribunal heard on Monday.
A raised temperature can be the first sign of Ebola, which can kill within five days. Cafferkey, who twice nearly died from the virus, went on to develop one of the worst cases on record for people treated in the west.
Cafferkey was cleared of misconduct over the recording of her temperature in September.
The tribunal in Manchester heard on Monday that Ryan recorded Cafferkey’s temperature as being 37.2C despite knowing it was at least 38.2C – above the average body temperature of 37C and higher than the 37.5C threshold requiring further assessment by a consultant in infectious diseases.
She later told another doctor there were no abnormalities in the temperatures of Cafferkey’s group of returnees, according to a written summary of the allegations by the General Medical Council.
Dr Bernard Herdan, the tribunal chair, was told Ryan’s conduct was “misleading and dishonest” and that her “fitness to practise is impaired because of [Ryan’s] misconduct”.
Ryan admitted misleading others and “acquiesced” in the wrong temperature being given but denies misconduct by her actions at the airport and during a subsequent investigation by Public Health England.
Fraser Coxhill, representing the General Medical Council, said Ryan and Cafferkey were one group among many British medics who put their own lives at risk by volunteering their medical skills and going to west Africa to help fight the outbreak.
Deployed on 22 November 2014, they were based at an 80-bed treatment centre in Kerry Town, working “tirelessly in dangerous and highly pressurised conditions” during which they “formed a strong bond of friendship”, Coxhill said.
But about a month later when they returned to the UK on the afternoon of 28 December, the Ebola screening area at the Heathrow terminal was “crowded, noisy and chaotic”.
In the queue to get clearance from PHE medics to be allowed to leave “murmurings of discontent and frustration” grew, the tribunal heard. There were concerns some Scottish medics would miss connecting flights to Glasgow due to delays in the screening process.
Trying to help PHE staff with the process, they agreed to take and record their own temperatures. Ryan took Cafferkey’s temperature, which was 38.2C – a warning sign for the Ebola virus.
The two medics and another nurse with them, Donna Wood, discussed the reading, “during which someone said, ‘Let’s get out of here’,” Coxhill told the tribunal.
Cafferkey’s temperature was then recorded as 37.2C, the form was passed to PHE staff and the medics went on their way.
However, in baggage reclaim there was further discussion between the medics, and PHE staff were contacted.
When Cafferkey’s temperature was taken again it was below the threshold. However, by this time she had taken paracetamol, which lowers body temperature. Cafferkey returned to Glasgow but the next day fell seriously ill with Ebola.
Four days later, Dr Nick Gent, from PHE, called Ryan to investigate what had happened at the airport. Ryan later admitted not telling him she had taken Cafferkey’s temperature and that it was above the threshold for possible Ebola infection.
Coxhill added: “Whilst there is no doubt that Dr Ryan is a practitioner of hitherto unblemished character who undertook important selfless work in Sierra Leone, it is submitted that the events of 28 December 2014 and 2 January 2015 appear to demonstrate someone whose first instinct is to mislead and be dishonest.”
Ryan’s involvement emerged during a misconduct hearing for Donna Wood, another volunteer medic who was suspended for two months in November after being found to have concealed Cafferkey’s raised temperature.
In evidence to the Nursing and Midwifery Council, Ryan said she was in shock after taking Cafferkey’s temperature in her left and right ears and finding it raised.
She told the NMC hearing in a written witness statement: “I asked Pauline if she was feeling OK. She said she was feeling fine.
“I stood there in shock. It was like I was paralysed. I had no clear thought process. Ebola is such a horrible disease that every time you have a high temperature you worry, even when you know there’s no reason to.”
Ryan said only the three medics were present and that Wood “broke the inertia by saying something like, ‘I’m just going to write it down as 37.2 degrees’” so they could “get out of here and sort it out”.
The tribunal is expected to last 10 days.