Date of Professional Conduct Committee Hearing: 30 May 2002

Name of respondent doctor: Kaul, Richard Arjun

Number on Register: 3290387

Registered qualifications: MB BS 1988 Lond

Panel: Mr Shaw (Chairman)Dr AndersonMs HibbsDr Hine

Dr Montgomery

Legal Assessor: Mr David Jeffreys QC

Committee Secretary: Linda Quinn

Type of Case: Conviction (Resumed hearing)

Representation:

GMC: The Council was represented by Mr Adrian Derbyshire, Counsel, instructed by Field Fisher Waterhouse, Solicitors to the CouncilDoctor: Dr Kaul was not present and was not represented.

Charge:

"That you were on 22 February 2001 in the Crown Court at Central Criminal Court convicted of manslaughter. You were sentenced to six months imprisonment, suspended for twelve months."

Determination:

On 22 February 2001 at the Central Criminal Court Dr Kaul was convicted by a jury of the offence of manslaughter and sentenced to six months imprisonment suspended for twelve months. The basic circumstances leading up to his conviction were:

1. On 9 March 1999 a patient, Mrs B, underwent dental treatment at a dental practice he owned at 1 Balls Pond Road, London N1. The treatment was to be carried out by a dentist, who was also medically qualified, while Dr Kaul’s function was to administer intravenous sedation to Mrs B, and he did so.

2. At the end of the treatment Mrs B suffered a cardiac arrest. She did not regain consciousness and died in hospital on 15 March 1999.

3. The cause of death was given by the pathologist as 1a) hypoxic brain injury 1b) asystolic cardiac arrest during anaesthetic.

4. The hypoxic brain injury and the cardiac arrest were caused by Dr Kaul’s failure adequately to monitor Mrs B’s blood oxygen level which had fallen during her treatment. This failure amounted to gross negligence.

It is clear that Mrs B was heavily sedated. Apart from the need for the careful monitoring of any patient while under such sedation, there was a need for additional care in the case of Mrs B because she suffered from a degree of obesity. The conviction demonstrates that Dr Kaul failed adequately to monitor Mrs B’s condition, with the tragic consequences that followed. Indeed, despite his denial of responsibility at his trial, Dr Kaul has said in documents submitted to the Committee:

“On the 9 March 1999 I had a duty of care to Mrs B. I was grossly negligent in delivering that duty and as a result Mrs B died. I accept full and total responsibility for my actions that day and accept without reservation the guilty verdict delivered on 22 February 2001 at the Central Criminal Court.”

“I would also like to apologise to the profession for not maintaining the standards that are to be expected of its members. In behaving the way that I did on 9 March I brought the profession into disrepute and for that I am deeply sorry.”

The Committee have considered the full transcript of the trial judge’s summing up and are now fully aware of the circumstances which obtained in the practice at the material time. The Committee have also taken into account Dr Kaul’s apology to the family of Mrs B, his expressions of remorse and the several testimonials from doctors and patients to his otherwise competence and good character. The Committee have borne in mind their overriding duty to protect the public interest by preserving public trust in the profession and maintaining high standards of conduct as well as protecting members of the public. The Committee have also balanced the need to protect the public interest in this way against the consequences of any order that would prevent Dr Kaul from continuing to practise. The circumstances of Dr Kaul’s conviction of the offence of manslaughter demonstrated not only gross negligence on his part but a grave departure from the standards which the public has a right to expect of members of the medical profession, as Dr Kaul himself acknowledges.

The Committee are satisfied that neither conditions nor a further period of suspension from practice would be sufficient to meet the

gravity of the offence Dr Kaul committed, or to protect the public interest in the way they have described. The Committee have accordingly concluded that they have no option but to direct the Registrar to erase Dr Kaul’s name from the Medical Register.

Having invited and heard submissions from you as to whether they should make an order for immediate suspension of Dr Kaul’s registration under Section 38 of the Medical Act 1983, the Committee again paid careful regard to the circumstances of the offence and material submitted to them by Dr Kaul. They are satisfied that it is necessary for the protection of members of the public and in the best interests of Dr Kaul for such an order to be made.

The effect of the foregoing order and the direction for erasure is that Dr Kaul’s registration will be suspended from the Medical Register from the date that this notice is deemed to have been served upon him and unless he exercises his rights of appeal, his name will be erased from the Register 28 days after that date.

The Order imposed by the Interim Orders Committee is hereby revoked.