Alexander McAuslan’s Land Rover Discovery Sport was seen “drifting across” into the oncoming lane before crashing with a Ford Fiesta driven by Rodica Pamphilon.
Romanian-born Mrs Pamphilon, 46, died after sustaining head and chest injuries in the crash on August 5, 2016 on the A68 Edinburgh to Lauder road, near Fordel Mains, Midlothian.
McAuslan, 65, a consultant orthopaedic surgeon, was also injured and later told police in hospital: “I don’t know what happened. I may have fallen asleep.”
He was originally charged with causing the death of Mrs Pamphilon, of Ormiston, East Lothian, by driving dangerously and falling asleep.
On Thursday, at the High Court in Edinburgh, he pled guilty to the lesser offence of causing death by careless driving after the Crown amended the charge and deleted the allegation that he had fallen asleep.
McAuslan, of Edgehead, Dalkeith, admitted driving without due care and attention or without reasonable consideration for others, failing to pay proper attention to the road in front of him, crossing onto the opposing carriageway and colliding with the Fiesta.
Advocate depute Owen Mullan said the surgeon was driving north in daylight in conditions of good visibility.
Others were travelling behind and one couple, Gordon and Rossalyn Ford, described his driving as “entirely normal” and within the speed limit.
Mr Mullan said: “On approaching the Fordel Mains junction northbound the accused’s vehicle failed to negotiate the slight uphill left hand bend and crossed the central line onto the opposing carriageway before colliding head on with the southbound Ford Fiesta driven by the deceased.”
“The Fords describe the accused’s vehicle ‘drifting across into the opposite carriageway’,” said the prosecutor.
Both vehicles spun following the collision and the Fiesta suffered “catastrophic” damage to its front offside, said Mr Mullan.
The prosecutor said that McAuslan’s inattention appeared to have lasted for a few second before the collision.
He was taken to Edinburgh Royal Infirmary with injuries to his head, chest and legs, including broken ribs and a broken ankle.
Mr Mullan said Mrs Pamphilon held dual citizenship after moving to the UK and studying for a masters degree in Edinburgh. She later worked as a teacher and as an interpreter and translator.
Defence counsel Euan Dow told the court: “The accused acknowledges and recognises the impact his conduct has had on the deceased’s family and has repeatedly expressed his remorse for his conduct and the consequences of it.
“As far as the explanation for why he was inattentive for those seconds there is simply a gap as to why that took place.
“It is his position there was no reason for him to feel tired or drowsy and in fact did not feel tired or drowsy.”
He said McAuslan was working that day at Borders General Hospital but on a relatively short shift.
Mr Dow said that the first offender spent a significant part of his career working in New Zealand before returning to Scotland and his wife is currently ill in hospital. He added that McAuslan, who retired last year, was of “hitherto unblemished character”.
The judge, Lord Burns, deferred sentence on McAuslan for the preparation of a background report and continued his bail.
Lord Burns said: “I have to say that I cannot rule out any form of sentence at all.”
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