Childrens heart surgery to stay shut after deaths

7/29/2010 08:20:01 AM

LONDON – Children's heart surgery at a leading Oxfordshire hospital will remain suspended until improvements are made, after four babies died there in the space of three months, a report said on Thursday.

The heart unit at the John Radcliffe Hospital in Oxford was closed temporarily after four babies treated by the same surgeon died between last December and February.

An investigation conducted by the NHS South Central Strategic Health Authority shows that hospital managers were trying to increase the unit's capacity to take more patients, in an attempt to prevent its closure.

Caner Salih, the consultant who operated on the four babies who died, was appointed in December 2009 as part of the expansion drive.

Today's report cleared Salih of any wrongdoing but said he was not given adequate supervision.

"All the cases were complex and surgery was high risk," the report stated.

The panel?s experts, however, considered that "several cases may have had a better outcome with different surgical management."

"In Mr Salih?s four cases we found no evidence of poor surgical practice, but that he would have benefited from help or mentoring by a more experienced surgeon," they said.

The decision for Salih to undertake the fourth operation was found to be "an error of judgement".

Salih had complained about the age of equipment and poor working practices at the unit, asking for operations to be halted, the SHA found.

The SHA's chairman, Dr Geoffrey Harris, apologised to the families of the babies who died.

"We offer our sincere condolences and we apologise that, in the cases, the standards of care were not what was expected," he said.

The report found that arrangements for clinical management were "less than adequate".

It recommended an overhaul of the system for dealing with "serious untoward incidents", improvements in clinical and managerial leadership, and efforts to identify adverse trends in surgical outcomes earlier.

Oxford Radcliffe Hospitals NHS Trust, which runs the hospital, is one of the largest NHS teaching trusts in the country but its children's heart unit is the smallest in England, carrying out around 120 operations a year.

The Trust said in a statement:"We know that the last few months have been very difficult for the families of the children whose deaths resulted in this investigation, for the families of patients involved with our children's cardiac team, and for staff."

But it stressed that children's heart surgery had been carried out at Oxford since 1986, "with good outcomes".

"In April we started a review of clinical governance and risk management processes within the Trust to streamline our internal systems and reporting lines," the statement added.

"We recognise that in such a large organisation, processes can become over-complex and we are working to address this issue and ensure that we adopt a more uniform approach across the whole Trust in the future."

The Trust has until September 17 to present an action plan to the SHA.

www.oxfordmail.co.uk