Tafida Raqeeb: Parents Step Up Bid to Overrule NHS Doctors

Peter Russell

August 06, 2019

The High Court will be asked to decide next month whether to overrule UK doctors and allow the family of a seriously ill 5-year-old London girl to take their daughter to Italy for treatment.

Doctors at the Royal London Hospital in Whitechapel have said there was no hope that Tafida Raqeeb would recover from arteriovenous malformation, and that it was in her best interests to be allowed to die.

However, her parents, Shelina Begum and Mohammed Raqeeb, from Newham in East London, have launched a fundraising campaign as part of their fight to take their daughter to Gaslini Children's Hospital in Genoa, where they said doctors had offered to care for her.

Shelina Begum told Sky News last week: "Our world has been turned upside down. A perfectly healthy, bubbly child goes to sleep and wakes up the next morning and that's what has happened."

Tafida has been in a coma since the traumatic brain injury in February. Her mother described the intervening months as "extremely challenging". She added: "The hospital has given up on her. We need to give her time. She is improving, yes it's a slow improvement, but she is improving. If they take the ventilator off, she will die."

In a statement, Barts Health NHS Trust said: "This is a sad situation, in which our teams continue to work very closely with the family to include them and offer our support.

"Our expert clinicians caring for Tafida consider, in discussion with additional medical experts from specialist centres outside of the Trust, that further medical treatment would not improve her condition and would not be in her best interests.

"We recognise how difficult this is for all involved and, in accordance with national guidance from the General Medical Council in complex cases, are seeking the expert opinion of the High Court to ensure the Trust and the family provide the most appropriate care."

Five Day Court Hearing

Tafida's family is also bringing a separate legal challenge, seeking a judicial review of the hospital's refusal to allow them to remove their daughter and take her to Genoa.

Both cases have been scheduled for a 5 day hearing at the High Court in London in September.

The Trust said that following a review of Tafida’s medical records, including brain imaging, four medical experts in Italy unanimously advised that they were unaware of any treatment that could improve her condition.

Experts have commented via the Science Media Centre. Alastair Sutcliffe, professor of general paediatrics at University College London, said: "A ruptured vessel in the brain, due to arteriovenous malformation, can be a catastrophic event which can make the brain irreversibly damaged.  It is similar to a huge stroke.

"Arteriovenous malformation is a situation whereby the blood vessels in a part of the body have not formed correctly and grow into a knot of vessels, some vein and some artery. The problem is worse in a contained space such as the cranium. The vessels take up space, potentially squeezing other tissues. If such a malformation bleeds a lot, catastrophic [brain] damage usually occurs."

Laura Davidson, barrister at No.5 Chambers in London, who specialises in medical welfare decisions, said that court involvement was required in serious treatment cases where parents and doctors cannot agree.

She said that Italian doctors who had 'examined' Tafida by videolink would almost certainly only have seen a snapshot of her clinical picture: "If they have not been formally invited by the court to examine her, it is also unlikely that they will have read all, or any, of Tafida's medical notes.

"As she has been in hospital for 5 months, there will be a large volume of medical and nursing notes to absorb before a proper and careful opinion on her treatment and recovery prospects could be reached by clinicians not currently involved in her care."

Dr Daniel Sokol, a medical ethicist and barrister, commented: "It is imperative that any doctor who comments on what can be done for Tafida be suitably qualified and well informed. They should have access to all the relevant medical records and they should examine the patient. Only then should they offer their opinion. 

"To do otherwise is irresponsible and, in my view, unethical. We have seen the harms that a remote, ill-informed 'expert' can cause in past cases."

Parents Appeal for Money

Tafida's parents have launched a fundraising campaign to raise £400,000 to help cover legal expenses and the costs of transporting Tafida to Italy if they win their case. By Tuesday morning, 137 donors had pledged £13,820, with one anonymous donor offering £10,000.

Ms Begum, a solicitor, told The Sun on Monday: "The Italian doctors said she is not brain dead and we just need to give her a chance.

"She needs to get out of the bed and into a chair to get her out and about, they will give her rehabilitation treatment and therapy.

"If we can raise the money to get her to Italy it could make a huge difference and wouldn't cost the NHS any money."

Tafida's case has been compared to that of British baby Charlie Gard who died in July 2017 after his parents lost a legal fight to take him to the US for experimental treatment for mitochondrial depletion syndrome.

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