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UK coroner calls German doctor ‘incompetent’ for lethal overdose

A UK corner on Thursday said a German stand-in doctor was grossly negligent for killing a British man with a mistaken overdose.

Published: 4 February 2010 17:10 CET

UK coroner calls German doctor 'incompetent' for lethal overdose

Photo: DPA

David Gray, 70, died after being injected with 100 milligrammes of diamorphine – 10 times the recommended daily dose – by Dr. Daniel Ubani in February 2008, a 10-day inquest heard.

The German doctor was on his first out-of-hours shift as an overseas “locum” doctor in Britain – typically used to provide care when a regular family doctor is unavailable, for example at night or on the weekend.

Coroner William Morris described Ubani as “incompetent and not of an acceptable standard,” and criticised the out-of-hours arrangements, saying: “Weaknesses remain in the system.”

Gray’s family called for the German doctor to face trial in Britain. Ubani cannot be extradited to Britain because he has already faced trial in Germany, where he was given a suspended prison sentence, British media reported.

The Briton’s son Stuart, who is also a doctor, said his father died because of Ubani’s actions and due to “serious failings” in the Cambridgeshire Primary Care Trust and Take Care Now, the local health authority and medical provider.

“We want to see him tried under UK law for his death but we also want safeguards put in place nationwide to prevent this happening again,” he added.

The head of NHS Cambridgeshire, the National Health Service authority in England where the incident occurred, admitted failings.

“We accept that the systems failed, in that someone with Dr. Ubani’s qualifications and experience should not have been put in a position where he was able to make this type of mistake,” said Dr. Paul Zollinger-Read.

Out-of-hours health care in Britain has repeatedly come under the spotlight in recent years, following reforms of the system and a number of incidents involving uncoordinated and substandard medical care.

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Should you take vitamin D supplements in Germany?

Vitamin D is a vital nutrient for overall health and well-being, and most people are aware that it can be absorbed via sunlight.

But as long-time residents in Germany know all too well, sunlight is often hard to come by in the autumn and winter months. In December, there’s only a few hours of daylight per day, typically when most people are at work (and it often isn’t even sunny).

This makes it much harder to get enough vitamin D. A deficiency in vitamin D can lead to several health problems in the long run. Muscle weakness and cramps, fatigue and depression are among the symptoms of not getting enough of this vitamin.

How do I get the most vitamin D in Germany?

It mostly involves getting outside in the warmer months. Germany’s disease control agency, the Robert Koch Institute (RKI), says that vitamin D production happens from March to October and this is when the body builds up reserves for the winter.

“During this time, the body is not only able to cover its acute needs, but also to build up vitamin D reserves in fat and muscle tissue for the winter months,” says the RKI.

READ ALSO: Your guide to getting through the German winter

The RKI adds that to counteract low vitamin D levels all year round in Germany, current recommendations suggest “exposing your face, hands and arms to the sun uncovered and without sun protection two to three times a week between March and October”.

However experts add that sun protection measures, like wearing sunscreen, must be taken when spending longer periods of time in the sun.

Meanwhile, the German Nutrition Society (Deutsche Gesellschaft für Ernährung or DGE) states: “It is recommended to expose the body to the sun for a total of around five to 25 minutes per day with face, hands and large parts of arms and legs uncovered.”

A number of foods provide some vitamin D. It’s mainly found in fatty fish, roe and fish liver, but red meat, egg yolks and liver are other sources.

Vitamin D is also added to some foods in Germany, such as some milk or vegan milk drinks, yoghurt and other snacks. The nutritional label on food packaging will let people know how much vitamin D they are consuming.

Although eating foods rich in vitamin D is generally recommended in moderation as part of a varied diet, the DGE says the main focus should be on the body’s own production of vitamin D through exposing skin to sunlight.

READ ALSO: Essential phrases and customs to survive the German winter

What about supplements?

Another way to improve your vitamin D status is to take supplements.

The German Nutrition Society recommends going down this route if an improvement in vitamin D status cannot be achieved through other routes like getting out and about in the sunlight.

But be aware that experts also say that taking larger doses over a long period of time can be harmful.

Pictured are Vitamin D capsules.

Pictured are Vitamin D capsules. Photo by Michele Blackwell on Unsplash

During the height of the Covid pandemic in 2021, the Federal Institute for Risk Assessment (BfR) warned of the health risks of taking vitamin D supplements without taking to a medical professional first.

“Higher doses should only be taken under medical supervision and taking the individual vitamin D status into account,” the institute said.

“Anyone who wants to take vitamin D on their own should only use supplements with a daily dose of up to 20 micrograms (800 international units),” said the BfR. “With this amount, health impairments are not to be expected.”

According to the BfR, regular daily intake of vitamin D via high-dose preparations – for reasons other than medical reasons – increases the risk of health damage such as the formation of kidney stones or kidney calcification. There have also been cases of acute kidney failure as a result of uncontrolled self-administration of vitamin D preparations, experts said.

There are a number of people deemed to be more at risk of a vitamin D deficiency.

From the BfR’s point of view, a general vitamin D intake of the upper limit of 20 micrograms per day should only be considered for nursing home residents and other risk groups.

“This is because vitamin D is produced in the skin under the influence of sunlight. However, many older people hardly exercise outdoors,” the BfR said. Vitamin D production also decreases significantly with age.

READ ALSO: 8 tips for enjoying the cold like a true German

The risk groups for an inadequate vitamin D supply also include people who rarely or never spend time outdoors or who – for cultural or religious reasons – only go outside with their bodies completely covered. Some people who suffer from chronic gastrointestinal, liver or kidney diseases or who take medication that impairs vitamin D metabolism are also more at risk.

If you suspect that you’re not getting enough vitamin D, go to your GP. They can test for various deficiencies, but bear in mind that these tests are not usually covered by statutory health insurance.

Even if you don’t test, GPs will be able to advise you on whether you should take a supplement in winter – or all year round – depending on your individual case.

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