UK Ebola nurse Pauline Cafferkey cleared of misconduct

A Scots nurse who survived Ebola has been cleared of misconduct charges by the Nursing and Midwifery Council.

Pauline Cafferkey, 40, was infected while working in Sierra Leone in 2014.

She faced charges for allegedly allowing a wrong temperature to be recorded during the screening process at Heathrow on her arrival in the UK.

The conduct and competence panel dismissed the charges after hearing she had been impaired by illness. Another charge of dishonesty was withdrawn.

• Profile: Pauline Cafferkey

• What is Ebola?

Afterwards, Ms Cafferkey's lawyer, Joyce Cullen, said her client was "relieved" to have been cleared of wrongdoing after "willingly" putting her life at risk to help people suffering from Ebola.

She said that the medics returning from Sierra Leone had encountered "chaotic scenes" and put the focus on Public Health England for the ordeal her client had endured.

"Public Health England were unprepared for the volume of people returning from countries affected by Ebola," Ms Cullen said.

"There were also serious failures in communication amongst the Public Health England staff.

"It is perhaps ironic that given the criticisms made about Public Health England processes, it was their complaint which led to the Nursing and Midwifery Council investigation and these proceedings being initiated against Pauline."

'Lucky to survive'

Ms Cullen concluded by saying that Ms Cafferkey would "never have knowingly put anyone in danger".

"Pauline was lucky to survive and since her return from Sierra Leone has continued to suffer from ill health," she said.

"The NMC disciplinary process has been very upsetting and stressful for Pauline. However, she's delighted that the panel has made the decision that she has no case to answer and that she's now able to continue her nursing career in Scotland, where she will carry on looking after families in Blantyre, who've been very appreciative of her skills and dedication."

How the case against Pauline Cafferkey collapsed - BBC Scotland reporter Philip Sim

Pauline Cafferkey has come out of her misconduct hearing with a clean bill of health - but the same can't be said for any of the other parties involved.

The Nursing and Midwifery Council had lodged a series of charges against her, including that she had been "dishonest", but was forced to reconsider after medical evidence came to light.

This saw the group's lawyer actually arguing against her own charges, in a bid to have mention of dishonesty scrapped.

In fact she made such a convincing case that the remaining, watered-down charges were never likely to win over the panel.

And if the NMC looked bad, it was even worse for Public Health England - ironically, given they raised the original complaint against Ms Cafferkey.

The hearing was told of "chaotic" scenes at PHE's Heathrow screening centre, with patients being told to administer their own tests. There were constant miscommunications between doctors, including one who left messages at the wrong hospital. In the end, many present at the hearing were puzzled as to why it was Ms Cafferkey who was under the microscope and not one of several others who appear to have let her down.

It now seems as if the case against Pauline Cafferkey had fallen apart before the hearing even began - raising questions as to why she had to go through it in the first place.

After Ms Cafferkey was cleared, First Minister Nicola Sturgeon tweeted: "Sending my very best wishes to Pauline Cafferkey. Her bravery is an inspiration to all of us."

Last month it emerged that Ms Cafferkey would face charges from the Nursing and Midwifery Council (NMC) over alleged misconduct when she returned to the UK in December 2014.

When the panel hearing got under way on Tuesday, the NMC withdrew a charge of dishonesty, leaving her facing three charges.

Ms Cafferkey contracted Ebola while working at a treatment centre in Sierra Leone two years ago

The first charge alleged that while in a Public Health England screening area, inside Terminal 4 at Heathrow, she allowed an incorrect temperature to be recorded on her screening form.

The second charge alleges that she left the screening area without reporting her true temperature to medics.

The third charge alleged that she did not tell a doctor she had recently taken paracetamol.

After deliberating overnight, the panel ruled on Wednesday that Ms Cafferkey had not been guilty of misconduct in relation to all charges.

'Exhausted state'

Panel chairman Timothy Cole told Ms Cafferkey that in her "exhausted and increasingly unwell state" she did not set out to mislead staff.

He said Ms Cafferkey's conduct in leaving the screening area without flagging up her elevated temperature could only be explained by illness and exhaustion.

Commenting on the outcome, NMC chief executive and registrar, Jackie Smith, said: "As the independent panel recognised, the NMC has an overarching duty to protect the health and wellbeing of the public and need to ensure the maintenance of public confidence in the profession.

"The referral from Public Health England showed a highly unusual set of circumstances that clearly required a thorough and proper investigation. In circumstances like this, it is right for an independent panel to hear all the evidence to decide if any action is required."

The decision to clear Ms Cafferkey was based on an agreed narrative of facts which had been presented to the panel on Tuesday.

These characterised the screening area at Heathrow airport as "busy, disorganised and even chaotic" when Ms Cafferkey and other medics arrived back from Sierra Leone.

They showed that the nurse's temperature was recorded twice by a doctor, in the presence of another person referred to as "registrant A", at more than 38C.

The doctor claimed that "registrant A" stated that she would record the temperature as 37.2C on Ms Cafferkey's screening form and then they would 'get out of there and sort it out'".

Ms Cafferkey recalled the words "let's get out of here" being used but could not remember who said it or who entered the incorrect temperature on her screening form.

The panel also heard that Ms Cafferkey accepted that her temperature had been measured at above 38C, yet allowed a reading of 37.2C to be recorded, after which she continued to the arrivals area.

It was heard that a temperature above 37.5C "is an elevated or pyrexial (feverish) temperature that requires further assessment and should be reported to a consultant".

Ms Cafferkey admitted taking paracetamol at some point but did not mention it to a doctor when she returned to the screening areas.

Severe viral load

That doctor found her temperature to be normal and cleared the nurse to fly back to Scotland.

Hours later she was diagnosed with one of the most severe viral loads of Ebola ever recorded.

Doctors' evidence to the panel stated that early symptoms of Ebola would have impaired Ms Cafferkey's judgement and that there was no evidence she had been deliberately dishonest to staff.

The nurse, from Halfway, Cambuslang, contracted Ebola while working as part of a British team at the Kerry Town Ebola treatment centre in 2014.

She spent almost a month in isolation at the Royal Free hospital in London at the beginning of 2015 after the virus was detected when she arrived back in the UK.

Ms Cafferkey was later discharged after apparently making a full recovery, and in March 2015 returned to work as a public health nurse at Blantyre Health Centre in South Lanarkshire.

In October last year it was discovered that Ebola was still present in her body, with health officials later confirming she had been diagnosed with meningitis caused by the virus.

However, in the months that followed, her health suffered as she had issues with her thyroid, her hair fell out and she had headaches and pains in her joints.