The pathologist who first ruled that newspaper seller Ian Tomlinson died from natural causes at the G20 protest was today said to be unfit to continue practising at a disciplinary hearing.
A General Medical Council (GMC) Fitness to Practise Panel yesterday found that Dr Freddy Patel had behaved "irresponsibly" during three other post-mortem examinations.
Simon Jackson QC, representing the GMC, told the hearing today that Dr Patel's lack of understanding or ability to recognise his "serious failings" in the cases suggested he could make future errors of judgment.
He said Dr Patel's failure to spot marks which suggested a five-year-old girl had been the victim of violence prior to her death "created a potential risk of a loss of crucial evidence".
Mr Jackson said the pathologist had a duty to act as a "gatekeeper", adding: "There may be no further opportunity to find and report such findings if the body were to be cremated."
Mr Jackson said Dr Patel should have reported marks on the young girl's body, especially one over her left shoulder blade, which would have prompted further investigation as they raised the "index of suspicion" about her death in 2002.
"This would probably have prevented the distressing events which followed, without the need for the child being buried then having to be exhumed," he said.
The girl's body was dug up so a second post-mortem could be carried out.
Yesterday the panel found Dr Patel was irresponsible and failed to meet professional standards when he carried out a post-mortem examination on a four-week-old baby in 2003.
He did not obtain full skeletal X-rays prior to the examination as recommended by the Royal College of Pathologists' guidelines.
Mr Jackson said this was a "significant failure" and if the X-rays had been carried out first, "it would have completely altered the way this post-mortem examination would have been completed".
Dr Patel carried out the post-mortem at 7.20am, before the 9am start time for the radiologist, and Mr Jackson said the decision "brings into question his whole judgment and approach".
Mr Jackson said Dr Patel's decision to change his finding on a woman's cause of death in 2005 went "to the very heart of his fitness to practise".
Dr Patel carried out the post-mortem examination in January 2005 and decided the woman had died due to a blood clot in the coronary arteries.
A month later, following a second post-mortem by another pathologist, he prepared an addendum to his report, changing the cause of death to a brain haemorrhage in line with the new findings.
He told an inquest he had changed the primary cause of death "to satisfy the family".
The disciplinary panel said he had not adequately explained his reasons for doing so and had behaved irresponsibly.
They said he had not met professional standards and had behaved in a way liable to bring the profession into disrepute.
Mr Jackson told the hearing today that Dr Patel's skills and experience counted "for nothing" if he could not be relied upon to report his independent findings.
He added: "The risk remains. Dr Patel has not reflected on this serious departure from required professional standards."
Adrian Hopkins QC, for Dr Patel, told the panel, who will decide the pathologist's future, that their ruling must be based his current circumstances and not his past.
He said post-mortems on children were now carried out by specialist paediatric pathologists and Dr Patel had not undertaken any examinations on a child since 2004.
Even if the panel decided his behaviour amounted to misconduct in those two cases, it did not mean his future fitness to practise was impaired, Mr Hopkins argued.
He also no longer worked with the police or Home Office so any misconduct in relation to that sort of examination should not affect his fitness to carry out other work for coroners, the barrister said.
Dr Patel's decision to change the woman's cause of death was made out of "misguided sensitivity" for her family in "unusual circumstances", he said.
The pathologist was told to halt his examination after finding the clot so did not see the brain haemorrhage for himself but Dr Patel had no reason to doubt the findings of an eminent colleague who carried out the second post-mortem, Mr Hopkins said.
He said the incidents were all in the past and did not represent a fair sample of Dr Patel's work so could not suggest "deficient professional performance".
The panel has yet to decide if Dr Patel's behaviour amounted to misconduct or whether sanctions - which could include striking him off the register - should be made.
Dr Patel, whose full name is Mohmed Saeed Sulema Patel, has already been suspended from the Home Office register of forensic pathologists amid questions about his post-mortem examination of Mr Tomlinson last year.
The 47-year-old newspaper seller died during London's G20 riots in April 2009 after being pushed to the ground by a police officer.
Dr Patel's competency was called into question after two other pathologists agreed that Mr Tomlinson, who was an alcoholic, died as a result of internal bleeding, probably from his diseased liver, after falling on his elbow.
The shortcomings in Dr Patel's examination of Mr Tomlinson's body were revealed by prosecutors as they announced that no charges would be brought over the death.
Metropolitan Police Authority member Jenny Jones wrote to the Director of Public Prosecutions today to ask him to reconsider the decision not to charge anyone over Mr Tomlinson's death.
Last month Keir Starmer said there was "no realistic prospect" of a conviction although there was evidence that the officer, a member of the Metropolitan Police's territorial support group, assaulted Mr Tomlinson.
Mr Starmer said a manslaughter charge could not be brought because of "irreconcilable" differences between doctors over what caused his death.
Dr Patel's evidence that Mr Tomlinson died of natural causes could undermine any prosecution, said Mr Starmer, who was aware that the doctor faced the GMC disciplinary hearing.
Ms Jones, a Green Party member of the London Assembly, said witnesses during the GMC hearing had called into doubt Dr Patel's "professional integrity and ability as a pathologist" in her letter to Mr Starmer.
"The fact that there is disagreement among the medical witnesses is an insufficient reason not to pursue a conviction, given the information now known about Mr Patel," she wrote.
She urged Mr Starmer to reconsider what she called his "disastrous decision" and to allow a jury to decide about Mr Tomlinson's death.
A Crown Prosecution Service spokeswoman said Mr Starmer had not yet received Ms Jones' letter.Reuse content