When 70-year-old David Gray of Cambridgeshire, England complained of kidney and stomach pain in February 2008, German doctor Daniel Ubani treated him with two injections of diamorphine. Gray died later that evening.

The coroner's inquest into Gray's death and the death of another patient who was treated by Dr. Ubani the following day opened on Thursday, amid questions on how Britain allows foreign doctors to practice in the UK.

Rory Gray, David's son, said his death would not have happened had his father been treated by a UK-trained doctor.

"With Dr. Ubani, he had no knowledge of that drug, and despite that, gave the 100 milligrams without any knowledge that that would be fatal, and 10 times the recommended dose," he said.

European regulations

Ubani, a German national of Nigerian origin, was working for Take Care Now, an "out-of-hours" service providing doctors to patients when general practitioners' offices are closed.

Under current European legislation, doctors may work within the European Union with less stringent checks than doctors with licenses from non-EU countries.

But that law is dangerous, especially when language barriers exist, according to Niall Dickson of the British General Medical Council.

"There is an assumption that there is equivalence across the European Union, and we are not able to challenge, for example, whether a particular country's regulator is working effectively or not," Dickson said, "and secondly we're not able to test whether they are able to speak English."

Dr. Ubani's lack of command of the English language came up several times in criticisms of his case, as did his admitted unfamiliarity with the drug diamorphine.

Ubani case an anomaly

The British government claims it has tough regulations on how foreign doctors can practice in the UK, but that these were not followed in Dr. Ubani's case.

"There are a large number of managers, of GPs and of other clinicians who operate in the out-of-hours service who provide a good quality service in the vast majority of cases," Health Minister Mike O'Brien said. "There are some cases where we need to ensure the rules are tightened up, and we will."

Dr Ubani was convicted in Germany last year of causing David Gray's death by negligence. He was fined and given a suspended sentence. This means that whatever the outcome of the British inquest he will not be charged with manslaughter in the UK.

He continues to run a private practice in Germany as a cosmetic surgeon.

Author: Olly Barratt, London (acb)
Editor: Michael Lawton