GMC v Shokouh-Amiri: tribunal's fact-finding on ureter injury and sexual misconduct allegations quashed on appeal

The Administrative Court has quashed a medical tribunal's findings that a consultant gynaecologist did not fail to check a patient's ureters during surgery and did not act inappropriately toward another patient during two consultations, holding that the tribunal failed to grapple with central expert evidence and gave reasons that were, in places, unintelligible or contrary to the record.

In General Medical Council v Shokouh-Amiri [2026] EWHC 2226 (Admin), handed down on 28 August 2026, Morris J allowed two of the four grounds of the GMC's appeal against a Medical Practitioners Tribunal determination of February 2025. The tribunal had found the doctor guilty of misconduct in several respects, including failures to use a chaperone and the removal of two patients' ovaries without consent, but concluded that his fitness to practise was not currently impaired and made no direction, issuing only a warning.

On the first ground, concerning a patient who suffered a ureteric injury during a hysterectomy, the tribunal accepted the doctor's evidence that he had checked the ureters and found any injury must have been an undetectable indirect one. Morris J held this overlooked the central plank of the expert evidence, that the patient's presentation two days after surgery was, on balance, indicative of a direct injury inflicted at the time. The tribunal's determination made no reference to that presentation at all. Its reasoning, the judgement found, also risked circularity, assuming the answer to the very question the allegation posed.

Reasons found unintelligible on key sexual misconduct findings

The second ground concerned findings that a doctor's conversations with a patient about her sex life, described in one exchange as touching on masturbation, and further allegations of inappropriate touching during an examination, were not proved or were not inappropriate. Morris J found repeated and serious errors: the tribunal wrongly treated one consultation as involving a gynaecological examination when the evidence showed it did not, selectively quoted an expert's opinion while omitting the sentence that supported the opposite conclusion, mischaracterised a police interview as a later statement, and relied on the patient's evidence of self-doubt as undermining her credibility when, read properly, her doubt concerned why a trusted doctor would behave that way rather than whether the events had occurred.

The judgement was critical of the tribunal's reliance on inherent improbability, that the doctor would not have continued inappropriate conduct after being told the patient had discussed an earlier consultation with her partner, noting this reasoning could not logically apply to comments the tribunal's own timeline showed were made before that disclosure. Applying the principles on appellate deference to fact-finding summarised in the court's own earlier decision in Byrne v General Medical Council [2021] EWHC 2237 (Admin), and on the duty to give reasons drawn from Southall v General Medical Council [2010] EWCA Civ 407, several findings were held so out of tune with the evidence as to be unreasonable, and the tribunal's reasons inadequate to discharge its statutory duty under the Fitness to Practise Rules.

Cross-admissibility and impairment grounds fail

The GMC's third ground, that the tribunal had either failed to direct itself on cross-admissibility of evidence between complainants or given itself private advice in breach of the Legal Assessors Rules, succeeded in identifying a procedural irregularity but failed to show injustice. Applying the framework in Professional Standards Authority v General Medical Council [2025] EWHC 318 (Admin), the court found no error in the tribunal declining to direct itself on rebutting coincidence, given extensive evidence of contact and potential contamination between three complainants, and held that unproven, unchallenged findings concerning two other patients could not have been rescued by propensity evidence without risking findings made wholly or mainly on the strength of bad character. The fourth ground, challenging the impairment finding, also failed, the court affording the specialist tribunal the deference appropriate to an evaluative judgement.

The matter is remitted to the Medical Practitioners Tribunal Service for a differently constituted tribunal to redetermine the allegations found wrong or unjust, and to reconsider impairment in light of any fresh findings.