Ban remains on child heart surgery
A hospital where four babies died under the care of one surgeon must not resume heart surgery until it improves, a report has said.
The paediatric heart surgery unit at John Radcliffe Hospital in Oxford should remain closed until the right mix of doctors is in place or until it links up with another unit.
All four babies died within a few months of surgeon Caner Salih starting work at the hospital. After the fourth death under his care, in February, he raised the alarm and decided to stop operating, having already complained about the age of equipment and poor working practices at the unit.
The investigation, by the South Central strategic health authority (SHA), said Mr Salih was not to blame for the deaths. It pointed to issues within the Oxford Radcliffe Hospitals NHS Trust, including a lack of preparation for his arrival and no senior cover to help him.
When the doctor raised his concerns, the trust failed to act for at least 11 days and there was "no evidence" of a "clear plan of action". The report said: "On the contrary, there seems to us to have been attempts to minimise the scale of the problem and to restrict knowledge of it."
It was only when journalists began to investigate the incidents that the trust took action.
SHA chairman, Dr Geoffrey Harris, apologised to the families of those 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 investigation reviewed death rates and found that among 15 babies operated on by Mr Salih, the death rate was 4.8 times higher than would be expected from a national rate. However, "all the cases were complex and surgery was high risk".
The report said: "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." It said it was "an error of judgment for him to undertake the fourth case" but the baby was so poorly it would have been very likely to die anyway.
The paediatric unit, which was temporarily suspended in March, is the smallest in England, carrying out just 120 or so operations a year. Surgeons need a high enough caseload to maintain expertise but at Oxford there was a "fragile" situation, with just one surgeon handling the cases and leading a team with a low workload.