Parents’ kidney alert should have raised a ‘red flag’

AN independent medical expert said a “red flag” should have been raised among medical staff at Our Lady’s Hospital for Sick Children in Crumlin when a boy’s parents had expressed concern that his wrong kidney had been selected for removal.

Robert Wheeler, a consultant paediatric surgeon based in Southampton, told an Irish Medical Council (IMC) hearing yesterday that someone should have carried out a review of the patient’s X-rays before the surgery.

Two surgeons at Our Lady’s who were involved in the removal of a perfectly functioning kidney from the six-year-old patient in March 2008 were criticised by Mr Wheeler during the hearing of the IMC’s Fitness to Practice Committee.

Professor Martin Corbally, consultant paediatric surgeon and registrar, Sri Paran, are accused of professional misconduct over their treatment of the young patient.

However, Prof Corbally had seven of 15 allegations against him withdrawn yesterday due to lack of evidence, while Mr Paran had one of 13 allegations dropped for the same reason.

Both doctors still face a series of charges that their standard of care fell below what was expected after the boy was left with a diseased kidney that functioned at 9% of its normal rate.

Last May, the boy’s parents gave evidence of how they had repeatedly expressed concern to doctors and nurses in the run-up to the operation that the wrong kidney had been selected for removal.

Mr Wheeler, who carried out a review of the case on behalf of the IMC, said he believed serious consideration should always be given to any concern voiced by parents about surgery to their child. “It’s a real red flag,” he remarked.

“Any moment where there is a doubt, whether raised by a parent, nursing staff or colleague, is a serious matter and should lead to a pause for thought,” said Mr Wheeler.

He suggested there were too few consultants at Our Lady’s to allow for surgeons to always review a patient’s file before performing an operation.

Mr Wheeler said it would be a serious breach of professional care if there was inappropriate delegation of the surgery or control of the procedure. However, he was uncertain what was the custom and practice within Our Lady’s regarding delegation and the transfer of responsibility between medical staff.

However, he said some questions might also need to be asked about practices in the hospital. “I feel there was quite a firmly established hierarchical system in this hospital,” he added.

The surgeon said he would have expected Mr Paran to review the patient’s X-rays before surgery. Mr Paran claims he was only given five minutes’ notice that he was to perform the operation. “If you are the operating surgeon you need to know the correct side,” remarked Mr Wheeler.

However, he added that Mr Paran’s responsibility would be reduced if he had been informed by Prof Corbally to remove the left kidney although he still had a duty to check the patient’s file.