Professor Roy Meadow struck off

One of Britain's most eminent paediatricians was ordered to be struck off the medical register last week, a decision that surprised many in the medical profession.

The General Medical Council found Roy Meadow—an internationally recognised child abuse specialist who was knighted for his services to paediatrics—guilty of serious professional misconduct over evidence he gave at the trial of the solicitor Sally Clark for the murder of her two sons.

Mrs Clark was convicted of killing both her baby sons and served three years in prison before she was freed and her conviction quashed in 2003 after a second appeal (BMJ 2003;326: 304).

In a damning judgment, the GMC told Professor Meadow, 72, that he had acted beyond the limits of his expertise and abused his position as a doctor in giving erroneous and misleading statistical evidence at Mrs Clark's trial about the likelihood of two cot deaths in one family.

Mary Clark-Glass, chair-woman of the GMC's fitness to practise panel, told him he had undermined public confidence in doctors who play a pivotal role in the criminal justice system as expert witnesses.

In his statement to police, at committal proceedings, and at the trial in 1999, he had said that the chances of two cot deaths in one family were one in a million. He was unable to tell the fitness to practise panel where this figure had come from.

Then during the trial he was sent a prepublication copy of the report of the confidential inquiry into stillbirths and deaths in infancy and sudden unexplained death in infancy, which stated that the chances of one cot death in an affluent, non-smoking family like the Clarks' was one in 8543.

In his evidence he squared this to reach the figure of 1 in 73 million for two cot deaths, adding that such an occurrence would happen “once in every 100 years” and that the odds of both children dying natural deaths could be compared to four different horses winning the Grand National in consecutive years at odds of 80 to 1.

Yet, the panel found, the confidential inquiry's report gave evidence that one cot death increases the risk of a second in the same family and that a cot death is more likely than murder. Professor Meadow had failed to explain the limited significance of the statistic.

The panel accepted that he had not intended to mislead but was “an eminent paediatrician whose reputation was renowned throughout the world.” His eminence and authority, which gave the misleading evidence such great weight, carried with it a unique responsibility to take meticulous care in a case of this grave nature. His errors, compounded by “repetition over a considerable period of time, were so fundamental and so serious it is the panel's view that a period of suspension would be inadequate, not in the public interest and would fail to maintain public confidence in the profession.”

Alan Craft, president of the Royal College of Paediatrics and Child Health, a position once held by Professor Meadow, described the GMC's decision to strike him off as “astonishing.”

Professor Craft added: “The one thing it will do is frighten any sensible doctor away from doing expert witness work, and the more eminent you are and the more important you are in terms of providing expert evidence the less likely you will be to provide it in future.

“There will be a huge knock-on effect on expert witnesses, both in child protection, which is bad for children, and right across the whole field of medicine, which is bad for the public.”