Adrian Darbishire QC and Selva Ramasamy QC were instructed by the Medical Protection Society (through RadcliffesLeBrasseur and BLM, respectively) to represent two anaesthetists. They were each granted a Temporary Advocate's Licence, permitting them to appear in the Courts of the Isle of Man for the purposes of this unusual and serious case.
In December 2021 four anaesthetists were charged with the manslaughter by gross negligence of a patient who suffered a cardiac arrest following elective surgery on the Isle of Man. The circumstances of the death were that, after uneventful surgery under general anaesthetic, the patient had struggled to breathe. The theatre alarm was activated, which caused three consultant anaesthetists to rush to theatre to assist. Efforts to reintubate and ventilate the patient were unsuccessful and within a few minutes of the consultants’ arrival the patient went into cardiac arrest and died later that morning.
The prosecution case was that the four attending anaesthetists had collectively failed to identify that the endo-tracheal tube was mis-sited (an allegation which would have been in issue at trial). The prosecution alleged that that failure was capable of amounting to a gross breach of duty and that it was properly to be regarded as causative of death.
In contested committal proceedings before the Deputy High Bailiff, it was submitted that there was not even prima facie evidence of either gross negligence or of any causative breach of duty (following cases such as Broughton (CACD)  1 WLR 543). Dismissing the case against the four doctors, the Deputy High Bailiff agreed with the submission advanced, ruling that there was no proper evidential basis upon which a jury could find the actions of any of the four doctors to have amounted to gross negligence. Accordingly, he refused to commit the case to the Court of General Gaol Delivery (the equivalent of the English Crown Court) for trial.
In an interesting aside, earlier in the case the police had sought and obtained a production order against the IoM health trust for a wide range of records relating to the defendant doctors, including personnel and training materials. The grant of this order raised important issues of both policy and law, which resound equally in English law. Adrian and Selva commenced an appeal against the grant of the order, essentially on judicial review grounds. In the event, these matters were not litigated, as the production order was quashed by consent, following the refusal of the Summary Court to commit the case against the doctors for trial.