7 Jul 2022 Seema Pravin HARIBHAI · Prevention of Future Deaths report Inner North London
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Concerns raised 12 Failure to advise immediate cessation of herbal remedies View source Failure to advise immediate attendance at a hospital emergency department View source Failure to identify prescribed drugs or drug combinations View source Failure to record relevant clinical history and symptoms View source Failure to recognise prescribed medicines as a possible cause of harm View source Lack of routine awareness of possible complications of Ayurvedic treatment View source Insufficient continuing professional development training for Ayurvedic practitioners View source Failure to arrange an in-person physical examination View source Lack of regulation of Ayurvedic practitioners View source Delay in responding to markedly abnormal blood test results View source Lack of quality control for medicines manufactured abroad View source Failure to advise immediate cessation of Ayurvedic medicines View source See 9 more concerns
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AI-generated summary
Seema Pravin HARIBHAI · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Seema Haribhai, who had increasingly disabling psoriatic arthritis, took herbal remedies prescribed by an Ayurvedic practitioner and developed liver failure, dying some weeks later. The investigation determined that she died as a consequence of the administration of Ayurvedic medicines intended to treat psoriatic arthritis. Concerns included the practitioner’s failure to recognise the possible harm from the medicines or advise their immediate cessation, the lack of regulation and evidence of quality control, and shortcomings in the GP’s assessment and response to her symptoms and abnormal blood test.
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× Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Failure to advise immediate cessation of herbal remedies
Wider context from the report “However, when she first discovered that her patient had developed a yellow discolouration, whilst she recognised that the liver was probably responsible, she did not recognise that the cause might be her own prescription. She did not advise the only course of action with the potential to save Seema Haribhai’s life: an immediate cessation of all the herbal remedies.
Even when she gave evidence in court, the Ayurvedic practitioner did not seem to canvass the possibility that the medicines she had prescribed could have caused harm. She had at one stage advised her patient to have a routine blood test, but she had not at any stage advised immediate attendance at a hospital emergency department.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Failure to advise immediate attendance at a hospital emergency department
Wider context from the report “However, when she first discovered that her patient had developed a yellow discolouration, whilst she recognised that the liver was probably responsible, she did not recognise that the cause might be her own prescription. She did not advise the only course of action with the potential to save Seema Haribhai’s life: an immediate cessation of all the herbal remedies.
Even when she gave evidence in court, the Ayurvedic practitioner did not seem to canvass the possibility that the medicines she had prescribed could have caused harm. She had at one stage advised her patient to have a routine blood test, but she had not at any stage advised immediate attendance at a hospital emergency department .
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Failure to identify prescribed drugs or drug combinations
Wider context from the report “I am aware that one of the treating hepatologists from the Royal Free Hospital attempted to report this matter to the MHRA under the yellow card scheme, but was in some difficulty because he could not identify which drugs or drug combinations had been prescribed and had caused the liver injury.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Failure to record relevant clinical history and symptoms
Wider context from the report “However, the GP did not record the detail of the history, he did not record exactly when the yellow discolouration first appeared, and he did not record the absence of any other signs and symptoms . He did not ask for attendance at the surgery so that he could perform a physical examination. He did not advise immediate cessation of the Ayurvedic medicines.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Failure to recognise prescribed medicines as a possible cause of harm
Wider context from the report “However, when she first discovered that her patient had developed a yellow discolouration, whilst she recognised that the liver was probably responsible, she did not recognise that the cause might be her own prescription . She did not advise the only course of action with the potential to save Seema Haribhai’s life: an immediate cessation of all the herbal remedies.
Even when she gave evidence in court, the Ayurvedic practitioner did not seem to canvass the possibility that the medicines she had prescribed could have caused harm. She had at one stage advised her patient to have a routine blood test, but she had not at any stage advised immediate attendance at a hospital emergency department.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Lack of routine awareness of possible complications of Ayurvedic treatment
Wider context from the report “It appears from the evidence I heard in court that Ayurvedic practitioners do not necessarily have the possible complications of Ayurvedic treatment as part of their routine frame of reference . All medicines can cause harm, even those that are herbal based.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Insufficient continuing professional development training for Ayurvedic practitioners
Wider context from the report “I heard evidence at inquest that Ayurvedic practitioners are not in any way regulated. Even those who are members of the Ayurvedic Professionals Association receive as little as two hours of continuing professional development training per annum .
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Failure to arrange an in-person physical examination
Wider context from the report “However, the GP did not record the detail of the history, he did not record exactly when the yellow discolouration first appeared, and he did not record the absence of any other signs and symptoms. He did not ask for attendance at the surgery so that he could perform a physical examination . He did not advise immediate cessation of the Ayurvedic medicines.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Lack of regulation of Ayurvedic practitioners
Wider context from the report “I heard evidence at inquest that Ayurvedic practitioners are not in any way regulated . Even those who are members of the Ayurvedic Professionals Association receive as little as two hours of continuing professional development training per annum.
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Delay in responding to markedly abnormal blood test results
Wider context from the report “The GP consultation was on 5 November, the blood test was conducted on 9 November, the results came back to the surgery on 10 and 11 November, and an appointment was booked for 15 November . Meanwhile, same day admission to hospital was arranged on 15 November solely because a nurse had noted the blood test result at a routine rheumatology appointment .
The blood test result was so abnormal that, even without examination, the consult rheumatologist saw no option but immediate admission .
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Lack of quality control for medicines manufactured abroad
Wider context from the report “The medicines prescribed by Ayurvedic practitioners are manufactured abroad. I did not hear evidence of any quality control .
” Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to Ayurvedic Professionals Association; that does not assign responsibility.
PFD Monitor interpretation Failure to advise immediate cessation of Ayurvedic medicines
Wider context from the report “However, the GP did not record the detail of the history, he did not record exactly when the yellow discolouration first appeared, and he did not record the absence of any other signs and symptoms. He did not ask for attendance at the surgery so that he could perform a physical examination. He did not advise immediate cessation of the Ayurvedic medicines .
” Open source report
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Write to the Indian High Commission suggesting a review of Indian herbal imports and asking it to consider its role in UK imports.
Verbatim wording from the response “In order to prevent future deaths, the APA will, within 90 days, write to the Indian High Commission to suggest that Indian herbal imports could benefit from a review and ask the Commission to consider its role in the import of Indian herbs into the UK.” Source location Response from Ayurvedic Professionals Association
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Source evidence
How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Investigated how the incident occurred to inform members and help prevent recurrence.
Verbatim wording from the response “Ayurveda is not currently regulated in the UK, something the APA had campaigned for in the past. Consequently, the APA has no power to oversee, or control how individual’s practice other than through advice and guidance. However, as an association, the APA has taken this incident very seriously and has investigated as far as possible how this unfortunate event occurred in order to alert its members and prevent a reoccurrence.” Source location Response from Ayurvedic Professionals Association
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation A voluntary approved-herb supplier scheme could not be effectively enforced, and the association has no control over members’ herbs or treatments.
Verbatim wording from the response “The Herbs mentioned in this incident are all of Indian origin and as such they come under the remit of the Indian High Commission and imports. The APA has no control over herbs or treatments given by its members. However, the APA committee has in the past considered an approved supplier scheme of herbs for members, but as APA membership is voluntary it was found that it would be very difficult to enforce.” Source location Response from Ayurvedic Professionals Association
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Overseeing or controlling individual Ayurvedic practitioners’ practice is outside the association’s remit and authority.
Verbatim wording from the response “Ayurveda is not currently regulated in the UK, something the APA had campaigned for in the past. Consequently, the APA has no power to oversee, or control how individual’s practice other than through advice and guidance. However, as an association, the APA has taken this incident very seriously and has investigated as far as possible how this unfortunate event occurred in order to alert its members and prevent a reoccurrence.” Source location Response from Ayurvedic Professionals Association
Open published response
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Providing individual advice on treatment protocols and identifying herbal harms through training are outside the association’s remit.
Verbatim wording from the response “As previously mentioned, the APA is a member’s association for pre-trained professionals who have undergone extensive training that includes them being able to identify situations where they (a BAMS Dr.) may need to advise on whether their patient needs more urgent medical attention, specifically a medical intervention. In the case of the BAMS Dr. involved in this incident, this training is set out in the curriculum set by the National Commission for Indian Systems of Medicine as she held a BAMS degree. Details of the training provided to BAMS doctors can be found at https://ncismindia.org, but it is not within the APA’s remit to provide individual advice on treatment protocols.” Source location Response from Ayurvedic Professionals Association
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Source evidence
How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation AYUSH is identified as the authority able to assess whether the Ayurvedic herbs used could cause harm.
Verbatim wording from the response “Regarding whether the APA can identify if the Ayurvedic herbs used by the Dr. in this instance, who holds a Bachelor of Medicine and Surgery (BAMS) degree from India, had the potential to cause harm, AYUSH is likely to be the only authority able to answer this question and it may be helpful if the PFD could also be directed to AYUSH via the Indian High Commission. AYUSH can be contacted via its website at:
https://www.ayush.gov.in
https://main.ayush.gov.in
https://www.hcilondon.gov.in
If it will assist the Coroner, the APA will be happy to make this representation to AYUSH.” Source location Response from Ayurvedic Professionals Association
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Information checked against published PFD reports and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations