An anaesthetist slapped a patient, who was scared of needles, round the face and told him to “stop f*****g around” as he tried to put him to sleep before surgery.
Dr David James, 57, was putting the last patient of the day under anaesthetic ahead of gallbladder surgery in August 2019 when he “lost his temper”.
The assault at Guys and St Thomas Hospital in London was reported by operating theatre technician Michael Cousins and junior doctor Kathyrn Singh.
The Welsh-born consultant anaesthetist denied the offence but was convicted of assaulting the patient, William Wright, at Croydon Magistrates’ Court this afternoon (Tuesday, October 19).
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The court heard James, who lives in Richmond, has not worked since the assault and now faces a disciplinary hearing at the General Medical Council.
Prosecutor Angela Mahadeo said: “Dr James was the senior consultant anaesthetist and Michael Cousins was assisting in theatre that afternoon and describes that he saw Dr James slap the patient. He describes he slapped him three times on the left side of the face and shouted ‘stop messing around you f****r’.
“Dr Catherine Singh was the junior anaesthetist. She was in the theatre and she describes that Dr James appeared stressed, she describes that she was trying to put a cannula in Mr Wright’s left hand.
“She said she heard Dr James say ‘stop f*****g around now’. She then said that she heard a slap sound.
“She asked Mr Cousins if Dr James had just slapped Mr Wright and he replied that he had.”
(Image: Tim Merry)
District Judge Nigel McLean said he “wholly rejected” James’ account that he only made contact with the patient’s face while struggling to get an oxygen mask on him.
The judge said: “I found the evidence of Mr Cousins cogent and credible, as was the evidence of Dr Singh.
“Having worked non-stop since the start of day, you found yourself in an unexpected position and you did act wholly out of character.
“Dr James has served the community and National Health Service for a number of years and this is a dramatic fall from grace.
”The court heard the patient was difficult to cannulate as he was morbidly obese and had a phobia of needles. James said he had to use a mask to help get the patient to sleep – but this can cause patients to enter a “twilight state” where they become agitated and move “involuntarily”.
He admitted he “may have sworn” as the patient was “thrashing around violently” but any contact made with the patient’s face was only to get the mask back on.
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Mr Cousins disagreed the patient was “thrashing”, and said: “The patient was agitated and moving his upper body around – his head and his shoulders. I felt he was nervous, anxious and agitated and needed some reassurance.
“Dr James removed the mask and slapped the patient on the left side of the face. I had a direct view. It was three strikes. The patient asked ‘did you just hit me?’
“Everyone was quiet – in disbelief I would say. It was such a shocking action that you would never expect.
“He said the incident made him feel “anxious and upset” and he ignored James when he later asked him if he was “going to say anything”.
Dr Kathryn Singh told the court it was her first day at the trust and James “seemed quite stressed” throughout the day. She said: “Dr James was trying to insert a needle into the patient’s left hand. He was struggling to do this because the patient was moving. Dr James seemed a little frustrated.”
Dr Singh said James asked her to “have a go” and as she struggled with this, one of the surgeons came over and was able to get the cannula in the patient’s hand.
She said: “I was fixated, making sure it didn’t fall out. I was going to secure the cannula down by fixing a dressing on it.
“I’m looking down and it’s at that point I hear him shout at the patient in his Welsh accent ‘stop f*****g around will you?’.
“I remember we were all quite shocked. It was silent. It seemed a bit unnecessary.
“After he had that outburst, I was looking down and the next thing I remember was just hearing a massive slap.
“I looked up at Dr James and at Michael in front of me and Michael looked pale. He looked like he was going to faint. He just lost all the colour in his face and looked visibly shocked.
“I’m quite scared at this point, I sort of mouthed it because I was too scared to say it, I quietly said ‘did he just hit him?’ and Michael just nodded.”
‘I found him quite bullying and intimidating’
Dr Singh said James came up to her later and said: “Sorry about that, but he was being a f*****g t**t”.
She also heard him say to Mr Cousins: “You are not going to say anything about that are you?”
She said: “I took that to mean he was guilty and knows what he’s done and doesn’t want anyone to find out about it. In my view he lost his temper and lost control of the situation.
“I didn’t think it was needed, it was aggressive. I found him quite bullying and intimidating but I was in a position where I was new at the trust, I didn’t know who to speak to about it and also scared to say something as I’m on placement for a whole year in that trust.
”The pair reported the matter to senior hospital staff around two weeks later. Dr Singh also said James’ demeanour was “quite odd and unprofessional” throughout that day – and he made her feel “uncomfortable” by calling her “poppet” and “sweetheart”.
Responding to this in his evidence, Dr James said: “I don’t think we had a good working relationship. Possibly I referred to her as a poppet or a sweetheart.
“Operating theatres are not the most politically correct area in the hospital and there is a lot of light-hearted banter that goes on in operating theatres and all sorts of things are said inappropriately or appropriately. I could well have said something like that.”
James was handed a conditional discharge for 18 months and ordered to pay costs of £746.