Patient hospitalised after seeing relief doctor who killed man on first shift
• Woman taken ill after 'inappropriate' treatment
• Inquiry launched after errors by exhausted GP
David Gray died after Dr Daniel Ubani administered him with 100mg of diamorphine - 10 times the recommended maximum dose A woman patient had to be taken to hospital after receiving "inappropriate" treatment from the foreign doctor who killed a man with a lethal overdose on his first shift providing out-of-hours GP cover.
The woman's case came to light as police investigated a possible manslaughter charge against Dr Daniel Ubani, a German national of Nigerian origin, over the death of 70-year-old David Gray last year.
The woman in her 50s ended up at Addenbrooke's hospital, Cambridge, within hours of being seen by Ubani. She was the patient Ubani visited immediately before the fatal housecall.
She said: "I class myself as extremely lucky … it made me worried about calling out-of-hours doctors. I am of the age where doctors are still God."
It has also emerged that a woman in her 80s died after being visited by Ubani on the same day as the other two cases. Ubani was called after the woman suffered low blood pressure and a fast heart rate at a care home in Ely, Cambridgeshire.
Ubani reportedly left a prescription but the woman died before staff at the home could get it filled. Police and medical experts concluded that the woman would still, most probably, have died but in all three cases it would have been more appropriate if the patients had been sent to hospital immediately.
The Guardian revealed how Ubani had been on his first UK shift and admitted in a letter of apology to Gray's family that he had been "too tired" to concentrate when he visited Gray in a Cambridgeshire village, Manea, and administered him 100mg of diamorphine, 10 times the normal recommended maximum dose. The case has prompted an investigation by the NHS watchdog, the Care Quality Commission.
Ubani, who flew over from Germany the day before his shift, was self-employed, recruited by an agency called Cimarron, and inducted and assessed by Take Care Now (TCN), the day before his first shift.
The woman has a medical condition called temporal artertitis, an inflammatory disease of blood vessels in the head. Ubani gave her a drug, but after her family became concerned she was taken to hospital and admitted for two days. There were concerns about her treatment but the police did not open a separate inquiry.
The woman was taken ill on the afternoon of 16 February 2008, suffering a headache. She was upstairs in bed when Ubani arrived after her partner and daughter had called the out-of-hours service.
"I felt terrible … your head is exploding in pain. He took my blood pressure and said it was too high. He injected me with this drug and said it would help bring my blood pressure down, which was the reason for my headache. I felt better for a couple of hours but ended up in hospital."
She had been taken there by ambulance after the family raised the alarm and stayed there two days. "The only thing I really remember was there was a problem with the language. I felt Dr Ubani did not speak good English, which doesn't help when you are lying in bed going gaga."
TCN has said its response to the accidental killing of David Gray "has been focused on doing everything we can to ensure such a tragedy could never happen again". When approached to respond to aspects of the woman patient's treatment it said it could not comment on aspects of the investigation concerning Ubani because these might emerge in evidence in any civil action Gray's family might take, or at a coroner's inquest. The Guardian tried to contact Ubani at his surgery in Germany to ask him about the second patient but got no reply.
The case, which has prompted an investigation into out-of-hours services. It came as health services in Cambridgeshire sought to reassure the public. NHS Cambridgeshire has insisted the incident involving Gray was "not a true representation of the quality of care provided by our healthcare professionals 24 hours a day, every day".
Chris Banks, chief executive, said: "The actions of one doctor should not deter anyone from seeking appropriate care. It is important that people do not feel concerned about seeking advice outside of normal surgery hours."
MPs familiar with the Gray case welcomed the inquiry, while Eurojust, the Hague-based European body that mediates between justice systems in member states, confirmed it was trying to set up a meeting between the UK and Germany into how the investigation was handled.
The doctor has been given a nine-month suspended jail term and fined €5,000 (£4,700) by a German court for causing death by negligence. The Department of Health said it was "very disappointed" Ubani was not held to account in the UK.
The scope of the NHS inquiry has not yet been announced but the commission said was "aware of a number of concerns" in relation to care provided by TCN.
