A GP who breached his professional duty towards Baby P in the months leading up to the toddler's death faces being struck off after a disciplinary panel ruled today that his fitness to practise was impaired.
Dr Jerome Ikwueke failed to consider the possibility that unusual bruising was a result of child abuse, the General Medical Council found.
He also failed to carry out a full examination, refer him for a paediatric assessment or alert other professionals involved in the toddler's care after noticing a "marked change" in his demeanour eight days before his death, a hearing in central London was told.
The GMC today ruled that Dr Ikwueke's fitness to practise was impaired but would decide on what sanction to impose at a later date.
One of the options available to the disciplinary panel is ordering Dr Ikwueke to be struck off the medical register.
Baby P - now named as Peter Connelly - died aged 17 months in Tottenham, north London, on August 3 2007 after suffering sustained abuse.
He suffered 50 injuries despite receiving 60 visits from social workers, doctors and police over the final eight months of his life.
His mother, her boyfriend Steven Barker, and his brother Jason Owen were jailed at the Old Bailey in May last year for causing or allowing his death.
Peter had bruising on his chest and head when he saw Dr Ikwueke, 63, at his north London surgery on October 13 2006 but he accepted his mother's claim that he had fallen down the stairs the day before at "face value", the GMC concluded.
At an earlier hearing, GMC chairman Judith Worthington said: "If you had considered the possibility of child abuse, you would have put yourself in a position to take appropriate steps for the care of the child.
"The interests of the child are paramount.
"You did not prioritise the welfare of the child who presented with unusual bruising and with a report from the mother that he had fallen down the stairs.
"You deprived yourself of the opportunity to protect this child and this was a serious breach of your professional duty towards Peter Connelly."
At an appointment on December 11 2006, the GP referred Peter to hospital with further bruising but the panel found he failed to inform Whittington Hospital that the child's mother had previously said he bruised easily or mention the October injuries because he "did not make the link".
Mrs Worthington told Dr Ikwueke: "You were in a unique position as the only clinician aware of this consultation and so you should have shared this important information with the hospital."
The panel highlighted Dr Ikwueke's failures when he saw the child for the last time on July 26 2007.
During that appointment, eight days before Peter's death, the GP observed that Peter seemed "withdrawn", "completely different" from the boy he had known before, and a "sorry sight" with head lice, bleeding to his ear and scabs on his scalp.
"His changed appearance and demeanour on this occasion, coupled with all that you knew about his past, should have alerted you to the very high likelihood of serious child abuse," said Mrs Worthington.
The panel concluded Dr Ikwueke's only action was to book a follow-up appointment a week later when he should have referred Peter for urgent paediatric assessment and alerted others involved in his care.
Mrs Worthington said: "The panel considers that there was a duty on you to take the initiative and proactively contact social services and the health visitor and you did not do this."
This failure was reiterated when Tracey Connelly visited the GP without her son on July 30 and told him he had grab marks and she kept getting accused of harming Peter.
The panel said that, given the "alarming" state of Peter at the previous appointment and the mother's first mention of grab marks, the doctor should have been "alerted" to the possibility he was in danger of harm and asked to see him urgently and informed other professionals.
Dr Ikwueke, who qualified in Nigeria and has worked as a GP for nearly 20 years, denied misconduct.
Speaking in support of Dr Ikwueke, West Drayton-based GP Dr Anthony Grewal described his "huge personal respect for him" and said he would have "no hesitation" in registering with him as a patient.Reuse content