Posts Tagged ‘Oxford’

UPDATE: Radcliffe Hospital Investigation

March 6, 2010

The inquiry into Oxford’s John Radcliffe Hospital continued today, as the British Press found a “suspect” and news came that the investigation is a lot bigger than initially thought.

All four of the children who died had Congenital Heart Defects and all were operated on by the same surgeon, Mr. Caner Salih. (British surgeons are traditionally referred to as “Mister”). Not only was Salih the doctor in all four cases, he has since left the hospital… so obviously, he must be the guilty party.

No so fast – early reports indicate that Salih may have been the person who sounded the alarm and that all aspects of patient care will be examined, not just the surgeons.

Radcliffe has a history of difficulties in cardiac surgery, dating back to the year 2000. Internal problems and surgeons failing to work together were highlighted as the main cause of the difficulties then.

The hospital also performs a low number of procedures (Estimated to normally be “between 30 and 40” in a four-month period, which would be approximately 100 per year.) The National Specialist Commissioning Group is expected to report in July that the proper thing to do is consolidate eleven Cardiac Surgery Centers down to five or six – Centres of Expertise that should have a minimum of four surgeons who perform 400 operations per year in each Center.

That’s the proper thing to do – the only way to get really good at something is to continually practice doing it. The problem at Radcliffe Hospital may prove not to lie with the surgeon, but rather with the entire Cardiac Care Unit.

Hospital Suspends Heart Surgery Program

March 5, 2010

An alarming story is coming out of Great Britain today, where all pediatric heart surgery at the John Radcliffe Hospital in Oxford has been suspended after the deaths of four children in three months.

All four of the children had Congenital Heart Defects and had been receiving care for some time before their operations. With the unusually high number of deaths, officials at Radcliffe decided to stop everything and review their procedures. The shutdown has affected twenty-six children awaiting surgery, but all are being transferred.

When something like this happens, it is a good idea to review procedures and try to learn if the problem is arising locally. The Health Secretary is obviously concerned, but also notes that heart surgery is “high-risk”. Heart surgery is an exacting science; there is little (if any) room for error…. which is why the President of the Society of Cardiothoracic Surgery has been concerned about the number of specialized surgical units.

“There are 25 to 30 surgeons involved in the whole country. We feel they are spread too thinly across those units. Everyone is working hard to provide a good quality of care but we don’t think it is sustainable.”

While it is quite possible to just have “a run of bad luck” (try explaining that to grieving parents) could overworked surgeons be the root cause of the problem? Or is it a local issue? Radcliffe Hospital has had problems before – an investigation in 2005 found that the death rate after a coronary artery bypass graft was “higher than expected” and there have been previous concerns.

Hopefully this time the investigators will be able to remedy the problem.