http://bmj.com/cgi/content/full/324/7352/1476/b
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Clare Dyer legal correspondent, BMJ
A consultant urologist and a locum surgical registrar who went on trial for manslaughter last week were guilty of "gross negligence" in removing their patient’s only functioning kidney, Cardiff crown court was told.
Prosecuting counsel Leighton Davies QC told the jury the actions of consultant John Roberts and locum surgical registrar Mahesh Goel "fell so far below the standard of care expected of a reasonably competent surgeon" that they "deserved to be condemned as gross negligence and therefore a crime."
Graham Reeves died aged 69, five weeks after the operation at Prince Philip Hospital in Llanelli, Carmarthenshire, in January 2000, when his healthy left kidney was removed instead of his diseased right kidney.
Mr Davies told the court: "It was a drastic surgical error described by Mr Roberts himself in the aftermath as the worst thing he had done in his life. He says it was an appalling error."
The surgery was carried out by Dr Goel, aged 40, under the supervision of Mr Roberts, aged 60. The court was told that the wrong kidney was identified on the hospital admittance slip, and the error was transferred to the operating theatre list. The case notes and consent form carried the correct information, but neither surgeon had looked properly at the case notes, said Mr Davies.
Mr Roberts later said that he thought he might have looked at the x ray back to front. A medical student who was observing the operation looked at the x ray on the wall of the theatre and said she thought it was the right kidney that was not functioning, but Dr Goel allegedly told her she had got it wrong.
The mistake came to light two hours after the operation when Mr Reeves was producing no urine. But by then the good kidney had been put in a jar of sterilising agent.
Mr Roberts performed a second operation to put a tube in the diseased kidney. But Mr Reeves developed septicaemia and had to undergo a third operation to remove the diseased kidney.
Mr Davies said the surgeons could not blame anyone else. "The organ grinder cannot blame the monkey. Their duty is to ensure the correct operation is performed. The buck stops with them." He said Dr Goel had "gambled" that Mr Roberts had carried out all the checks.
A senior recovery nurse told the court that procedures had since changed and surgeons were required to check the consent form against the operation list to see that they corresponded.
Mr Roberts, of Tycoch, Swansea, and Dr Goel, who now works at Burnley General
Hospital in Lancashire, both deny manslaughter. The trial is expected to last
three weeks.
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Collections under
which this article appears:Medicine
and the law (incl forensic medicine) Professional
conduct and regulation Patient
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