Family of film make-up artist call for inquest after treatment by physician associate

Christopher Tucker (left) on the set of The Company of Wolves

The family of a celebrated film make-up artist has urged the coroner to investigate his death amid concerns over his treatment by a physician associate (PA).

Christopher Tucker died aged 81 from sepsis caused by a bladder infection on Dec 14, 2022.

A PA at the Royal Berkshire Hospital had performed a cystoscopy, an invasive bladder procedure, on him less than 48 hours before his death, despite signs of infection.

The PA afterwards failed to document the need for antibiotics or to request them from the ward doctor.

Mr Tucker’s prosthetics on The Elephant Man had inspired the Academy of Motion Picture Arts and Sciences to create a make-up Oscar.

Royal Berkshire NHS Foundation Trust’s internal investigation found that the PA was not responsible for any errors, and that even if a urology doctor had been available, it was “unlikely” Mr Tucker’s treatment would have changed.

But eight senior doctors who examined the report told The Telegraph they disagreed.

Baroness Brinton says she intends to raise the ‘extremely worrying’ details of Christopher Tucker’s case – Getty/Finnbarr Webster

Four urology specialists said they would have rescheduled Mr Tucker’s procedure due to his high risk of “life-threatening” sepsis.

There are also concerns about the report’s objectivity, given the name of the physician associate on the review team matches the initials of the PA who gave medical notes to the probe.

His brother Lynton Tucker said: “Christopher would have wanted this investigated, and would have been very troubled by it.

“[He] was an artist who was demanding of himself and consequently had trenchant and forthright views. He had a passion for ensuring that the right thing was done.”

On Monday, peers will vote on a motion that could derail the government’s plan for the doctors’ regulator, the General Medical Council, to licence this workforce.

Baroness Brinton, the former Lib Dem health spokesman, said she intended to raise the “extremely worrying” details of Christopher Tucker’s case at the debate, as they “provide yet more evidence why the government’s proposals risk undermining patient safety”.

It is understood that the associate who co-authored the review, and has since left the trust, has not denied performing Mr Tucker’s cystoscopy.

The hospital did not dispute this apparent breach of NHS protocol, which specifies that inquiries “are not led by staff who were involved in the patient safety incident itself” – or by their managers.

A trust spokesman said there had been a “full investigation” into Mr Tucker’s case, and “learnings have been shared across the organisation”.

‘Shocking prevarication’

But his niece Catherine Tucker, a professor at Massachusetts Institute of Technology, said it contained a “shocking amount of prevarication, extraneous information, a lack of transparency, a lack of plain language – and then the thing that really killed him was missed out of the report”.

The bladder procedure, she explained, was not presented as “something that maybe should have been a decision point”.

However, Jude Dockray, consultant urological surgeon, said it was critical as, “in a patient with recent urosepsis, who demonstrates both deteriorating observations and biochemical markers of infection, the risk of life-threatening sepsis is significantly increased”.

She added: “Personally, given the information provided, in this case I would not have gone ahead and I would have postponed the procedure until the patient had recovered.”

Having previously declared him fit for discharge, on Dec 12, the day of his cystoscopy appointment, staff noted Mr Tucker’s rapid, shallow breathing and “worsening” bloods. The last entry on his notes before the procedure recorded elevated infection markers.

Eight senior doctors disputed the trust’s finding that these “would not have given cause for concern for the PA to seek further review”.

‘Stringent supervision’

Prof Partha Kar, consultant endocrinologist, said: “There does not appear to have been a discussion of the risks versus the benefits of this invasive procedure, and this is important when we consider what happened next.”

Last month, Dr Janet Lippett, the trust’s CMO, told BBC Radio 4 that senior doctors “are always available for [PAs] to discuss cases” – and a hospital spokesman reiterated this “stringent supervision”.

But Dr Matt Kneale, co-chair of Doctors’ Association UK, who debated Dr Lippett on the programme, said “the fact the trust’s own report questions whether having a urology doctor available could have ‘changed the outcome’ makes it difficult to argue that this PA was constantly supervised”.

He added: “Mr Tucker’s case tragically demonstrates the problem with putting PAs in roles traditionally held by doctors.

“But the scenario is not unique. Doctors nationwide tell us PAs are performing complex procedures and running outpatient clinics independently.”

Royal Berkshire NHS Foundation Trust said: “We send our deep condolences to Mr Tucker’s family and our clinical leadership team would be pleased to meet with them if they wish to discuss the case in detail.”

It added that PAs have “a very clear code of practice and rigorous governance” and are “subject to thorough competency-based assessments” to monitor safety and work standards.

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