Hospital suspends child heart surgery after deaths

Investigation to examine four deaths within past four months at Oxford site

An investigation has been launched into the deaths of four children who died after undergoing heart surgery at a leading hospital.

All heart surgery for children at the John Radcliffe Hospital in Oxford has been suspended while the investigation into the "small run of four deaths" is carried out. The four fatalities took place within the past four months and have prompted an inquiry because they represent a higher death rate than had been expected.

Families of sick children awaiting surgery at the John Radcliffe Hospital have been contacted by the medical authorities and those most urgently in need of treatment are being sent to other hospitals. A total of 26 children currently awaiting surgery are affected by the decision.

A spokesman for the Oxford Radcliffe Hospitals NHS Trust said: "We have temporarily suspended the paediatric cardiac surgery service while we investigate concerns that have been raised. Any hospital might, at some time, have a run of deaths in a service that provides treatment for patients who are very unwell. However, it is right that we take a pause while we look into the individual cases, to see if there is anything to learn from them."

The outcome of children's heart surgery is audited nationally and there has been no previous cause for concern, with the Oxford hospital falling "within normal outcome ranges", he said.

The four patients who died during or soon after surgery were described as "very sick children" who had congenital heart defects. During the four months the deaths took place it is estimated that 30 to 40 cardiac operations would have been carried out.

The spokesman added: "The families of children awaiting cardiac surgery are being contacted and we will be placing those patients who need to be seen urgently with other hospitals. We are reviewing each of these patients to ensure that they are not put at risk by any delay in their treatment."

A Care Quality Commission spokesman promised the investigation will be monitored "extremely closely" but said it was "reassuring" the hospital had acted to ensure patient safety. He added: "This is high-risk surgery and the trust is taking the right steps in conducting a review."

Leslie Hamilton, president of the Society for Cardiothoracic Surgery, said the temporary suspension of heart surgery suggested the system in place to oversee procedures was working.

Since the public inquiry into standards of heart surgery at Bristol Royal Infirmary was published in 2001, hospitals have been more wary of unexplained rises in deaths. The Bristol inquiry team, led by Professor Ian Kennedy, concluded that a third of patients in the child heart unit received inadequate care and that people who raised concerns were ignored or even threatened.

Death rates among adult patients who underwent heart surgery at the John Radcliffe Hospital were shown in 2005 to be more than twice the national average with 54 fatalities from June 2002 to May 2005. The hospital, which opened in the 1970s, houses the Children's Hospital, which opened three years ago and treats patients with conditions including heart disease, cancer and neurological disorders.