Sam Poyser explores the case of Benjamin Green and the role of statistics in ‘medico-miscarriages of justice’
On Tuesday 30th June 2020, Mick Geen tweeted:
‘7 years of waiting – Is this finally going to be the week we hear good news for our son Ben? …17 life sentences for crimes that did not occur’.
By the end of the week, he had his answer…and it was ‘no’. The miscarriage of justice watchdog, the Criminal Cases Review Commission (CCRC) announced that it would not be referring Ben Geen’s conviction to the Court of Appeal, effectively dashing his hopes of exoneration. So, is Geen a murderous medic or has he suffered an appalling miscarriage of justice which the authorities have failed to recognise?
Between December 2003 and February 2004, something strange seemed to be going on at Horton General Hospital in Banbury, Oxfordshire. Eighteen individuals visited the Accident and Emergency (A & E) department and shortly after arriving, suffered unexpected respiratory arrest. These individuals came to A & E with very different health conditions, however they had one thing in common – they were all cared for by Nurse Ben Geen. Whilst 16 patients recovered from their ordeal, 2 died. Hospital staff brought their suspicions about this seemingly ‘unusual pattern of events’ to the attention of the police and on 9th February 2004, Geen was arrested. When Geen was apprehended, he was on his way in to work and police found that he had a syringe on his person. A suspicious item at face value? However, it has been argued that it not unusual for health professionals to have such paraphernalia in their pockets. Additionally, Geen’s girlfriend (also a nurse, whom he lived with) later testified that he had found the syringe in his scrubs at home and was returning it to work in order to dispose of it appropriately in a sharps bin (Robins, 2016).
At his trial in April 2006, it was alleged that Geen had deliberately administered potentially lethal doses of muscle relaxant drugs through injections given to patients in order to stop them breathing – the suspected motive being the thrill he gained from resuscitating them. It was suggested that Geen suffered from ‘hero-syndrome’ – a phenomenon where individuals create devastating situations so that they can ‘rush in and save the day’. The jury found Geen guilty and he was sentenced to serve a minimum of 35 years in prison.
As far as most of the media were concerned, Geen had joined an ever-growing list of medical professionals who have abused their positions of trust whilst working with vulnerable people. Such individuals have provided newspapers with opportunities to resurrect some of their most attention-grabbing headlines such as ‘Killer Nurse…’, ‘Angel of Death…’ and ‘Dr Death…’. They include Dr Harold Shipman, a Manchester GP (thought to be the most prolific serial killer in modern history) convicted in 2000; nurse Beverley Allitt, convicted in 1993 of murdering 4 children and attempting to murder another 3 over a 59 day period whilst working in a Lincolnshire hospital; and more recently nurse Victor Chua, found guilty in 2015 of murdering 2 patients and poisoning 19 others at Stepping Hill Hospital, Stockport.
However, there have also been what might be called ‘medico-miscarriages of justice’ in the UK and in other jurisdictions, whereby health professionals have been wrongly arrested and/or convicted of similar offences. For example, in the UK, Nurse Rebecca Leighton spent 6 weeks in a remand prison after having been arrested in July 2011 in connection with poisoning patients and nurse Lucia de Berk spent 6 years in prison before her convictions for the murder of 7 children at a hospital in The Hague, were quashed in 2010. At Lucia’s trial, Dr Henk Elffers had opined that more children had died on this nurse’s shifts than appeared possible by chance. Indeed, Elffers put the odds of Lucia’s presence being just a coincidence at 1 in 342 million. Subsequent expert witness testimony at her appeal demonstrated how Lucia’s conviction had been based on ‘wrong statistical data, wrongly analysed and wrongly interpreted’, raising the possibility that the children had not been murdered, but had died of natural causes (Hawkes, 2010, n.p). Could a similar problem lie at the heart of Ben Geen’s case? What of the ‘unusual pattern’ of events at its core?
It is true that Ben seems to have been the last person to have treated the individuals who appeared to inexplicably go into respiratory arrest after coming into A & E during that 3-month period in late 2003/early 2004. However, it also seems to be the case that Ben worked more shifts and more over-time than any of the other A & E nurses working at the hospital at the time. Having been a lieutenant in the territorial army, Ben was also someone who characteristically ran towards problems, rather than away from them; someone who was keen to get involved in as much emergency work as possible. Additionally, the investigation into the ‘unusual pattern’ of events may have suffered from cognitive bias in terms of the evidence-gathering process. Police began investigating the events on Friday 6th February and by Monday 9th they had arrested Geen (Werner and Webb, 2016). It has been argued that during that short period, investigators only examined the notes of Geen’s patients and did not look for events outside of his shifts. There is also the possibility that at least some of the incidents focused upon may have been misclassified, i.e. some of the ‘arrests’ were so brief that they should not have been called arrests at all (Robins, 2020). Perhaps an unusual pattern or ‘cluster’ was seen, where one did not exist.
Following a failed appeal in 2009, several leading statisticians gave their support to Geen’s application to the CCRC arguing that the cluster of events at Horton Hospital when he was present was far from unusual. Indeed, bearing in mind the number of hospitals in the UK, ‘it is almost certain’, they argued ‘that there will be several instances of exactly this kind of abnormally high sequence of respiratory events…[and] actually quite likely that, purely by chance, in at least one such sequence there will be the same nurse present at each event’ (Robins, 2019, n.p). Thus, ‘from a purely probabilistic viewpoint, there was always a problem with the assumption that such a cluster of incidents, happening in such a short period of time, with the same nurse on duty each time, could not have happened by chance’ (Robins, 2020, n.p).
So, is Ben Geen the victim of a gross miscarriage of justice? The CCRC did not conclude so and will publish its ‘Statement of Reasons’ for this, shortly. However, just like any other institution, it is not infallible. It has made erroneous decisions in the past (Newby, 2014). It may also have done so in this case. Meanwhile, Ben’s fight against his conviction, supported by the ‘London Innocence Project’ and ‘The Committee for Ben’ (a group of experts who believe that he has suffered a serious injustice) goes on.
Sam Poyser is a lecturer in criminology at Aberystwyth University specialising in miscarriages of justice?