German medical authorities re-examine Daniel Ubani competence

The German GP who accidentally killed a patient on his first UK visit faces written and oral examinations on his medical competence next month as his home country's medical authorities investigate a case that has helped force an overhaul of out-of-hours care in England. The tests will be the first stage in a disciplinary process that could end Daniel Ubani's medical career in Germany, where he is still allowed to practise, despite being barred from working in Britain within days of his mistake. Details of the action in Germany coincided with the publication of a devastating report by the NHS watchdog in England on Take Care Now, the defunct firm that employed Ubani as a locum for the fateful Saturday in February 2008 on which he killed David Gray, 70, at his home in Manea, Cambridgeshire, with a lethal overdose of the painkiller diamorphine. It revealed that there had been two non-fatal cases involving the same drug, administered by German-trained doctors working for the same company contracted by the NHS in neighbouring Suffolk the previous year. The medical association in Westfalen-Lippe in Germany, which covers the town where Ubani works, said he had been called to a special hearing on 18 August. "Dr Ubani will have to retake his medical examinations in both oral and written form," said Volker Heiliger, the organisation's spokesman. Ubani will also be questioned by a group of experts. "We've called Ubani ... so that we can ascertain why the things that happened in England actually happened, and how they might have been avoided," said Heiliger. "Either he was stressed and exhausted from his journey, there was a language barrier or he was lacking the necessary professional competence. The third point is most important for us. If he doesn't pass the exam, he cannot be allowed to have access to patients ever again." If Ubani failed to turn up.... "then we would have to conclude that he is too scared to face the exam, and we would have little choice but to take moves to strike him off." Diamorphine, a powerful painkiller, is a more tightly controlled drug in Germany where, unlike in Britain, it is never administered during house visits and is never included in the contents of a doctor's emergency medical bag. Wilfried Kunstmann, drug addiction expert at the federal medical association, said only highly-qualified doctors were allowed to administer the drug in Germany. "They have to undergo a 50-hour course in addiction drugs as well as a further six hour session which concentrates almost solely on diamorphine," he said. The medicine can only be used in registered institutes and only given to heroin addicts. Heiliger of the medical association in Westfalen-Lippe said: "What we fail to understand in Germany is how it was possible that this medicine was contained in an emergency medical bag. "At the same time if Dr Ubani had no knowledge of it he should have admitted as such, and should have sent the patient to hospital." Ubani was suspended from practising in the UK days after the incident and struck off this month. In between he was convicted in Germany of causing Gray's death by negligence. German authorities say they were compelled by their own laws to deal with Ubani, scuppering any chance of him being prosecuted in Britain There are nearly 1,000 German-qualified GPs among the 3,450 doctors from the country on the UK medical register, although that does not mean that they have all worked here.