Junior surgeon ‘did not question’ mentor

A JUNIOR surgeon at Our Lady’s Hospital for Sick Children in Crumlin fought back tears yesterday as he described how he had removed the wrong kidney from a six-year-old boy.

In emotional evidence, Sri Paran said he could not explain why he had never checked the patient’s X-rays before performing the surgery on March 21, 2008. However, he stressed that he had been following the instructions of senior paediatric consultant, Professor Martin Corbally, whom he assumed had looked at the X-rays.

A hearing of the Irish Medical Council was informed that Mr Paran had three opportunities to look at the X-rays before removing a healthy kidney from the boy. Questioned why he failed to check the radiological records, Mr Paran replied: “I have been asking myself that question for two years and I don’t know.”

Mr Paran told the fourth day of the IMC hearing that he was “taken aback” to be asked to carry out what he considered major surgery at less than five minutes notice by Prof Corbally as he had only been scheduled to do minor day case procedures.

However, Mr Paran said he felt he could not refuse such a request by his “mentor”.

He had previously formed 11 nephrectomies – the removal of a kidney – but just two or three on his own.

The IMC’s Fitness to Practise Committee has heard there is a serious dispute between the two surgeons about the amount of notice that Mr Paran was given that he would perform the operation, as well as on the complexity of the surgery.

Prof Corbally maintains that his colleague had at least 30 minutes to prepare for the operation which he regarded as “a very straightforward procedure”.

However, Mr Paran observed yesterday: “If I was told one hour earlier I would have dropped everything else and I would have looked at the X-rays.”

Both surgeons faced a series of charges of professional misconduct over the events which left the now eight-year-old boy with a kidney with 9% of its normal function after the removed healthy kidney could not be re-implanted.

Mr Paran recalled how Prof Corbally had pointed out to him prior to the surgery where the incision should be made on the patient’s body to remove the left [healthy] kidney.

The junior surgeon explained that he had not questioned if it was the correct kidney because he assumed that Prof Corbally would have already checked the patient’s X-rays.

“As a mentor, it is not only your job to train a person, you also have a job to protect the person. I trusted what I was told,” said Mr Paran.

He admitted being baffled during the operation to find the kidney due for removal appeared normal.

However, he was assured that it was the correct organ after an assistant had checked Prof Corbally’s notes which had erroneously recorded the wrong kidney for removal.

Asked how he felt afterwards, Mr Paran remarked: “Bad. Not as bad as the parents, but bad.”

The surgeon said he wanted to speak to the boy’s parents “for my own sanity” but was told they already had enough “on their plate”.

Mr Paran eventually spoke to them three days later when they were surprised to learn that he had physically performed the operation as they were under the impression that Prof Corbally had done the surgery.

He recalled how the boy’s father had asked him why he had never checked his son’s X-rays.

“I said ‘I really don’t know why. I was led into it. I definitely had a chance and I didn’t take it’.”

Under cross-examination by Patrick Leonard for the IMC, Mr Paran said he accepted mistakes had been made, but he disputed any accusation that his standards had fallen seriously below what was expected of him as a surgeon.

Mr Paran told the committee that there had been “tremendous” changes to hospital practices and protocols since the incident.

In other evidence, Mr Paran said he had met the boy’s parents outside the operating theatre before the surgery where they had expressed some concern.

The surgeon said he had checked the handwritten notes of Prof Corbally and the consent form to reassure himself that the left kidney was to be removed. Mr Paran said he felt the parents’ concerns had been addressed after he had spoken to them.


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