Toll in Bristol heart baby scandal is trebled

More than three times as many babies died or were severely damaged as a result of the poor standard of care they received at Bristol Royal Infirmary than previously thought, according to the first expert assessment of the extent of the heart surgery fiasco.

It now appears that at least 90 babies were affected, left dead or damaged as a result of the sub-standard treatment they received at the hospital in the late 1980s and early 1990s.

The scale of the tragedy in Bristol, the subject of the biggest public inquiry in NHS history, is far greater than indicated during the General Medical Council case against the doctors involved. At that time, it was thought 29 babies died or were brain damaged.

At the conclusion of the GMC case in June 1998, James Wisheart, the senior surgeon, and John Roylance, former chief executive of the hospital, were struck off the medical register. Janardan Dhasmana, the second surgeon, was banned from operating on children for three years and later sacked by the hospital.

The public inquiry into the disaster, chaired by Ian Kennedy, Professor of Medical Law and Ethics at University College, London, opened in September 1998 and is nearing completion. On Thursday, it released the Final Clinical Case Notes Review, an analysis of 1,800 heart operations carried out at the hospital from 1984 to 1995, on its website.

The review, by paediatric surgeon Leslie Hamilton and cardiologist Eric Silove, is one of the most detailed ever carried out, and examined every aspect of the care children received. It concludes that in 30 per cent of cases - 540 children - the care given was "less than adequate" and in 5 per cent - 90 children - "different management would reasonably be expected to have made a difference to outcome".

The findings have been extrapolated from an earlier interim review, published last November, based on 80 children who underwent 100 operations. It blames "overall organisation" of care, rather than problems with individual doctors, including "delays" in obtaining treatment, "shortcomings" in cardiology, "weaknesses" in surgery, "shortcomings" in intensive care and "shortage" of staff and equipment.

A second document released by the public inquiry, which has assessed more than 500 witnesses and 900,000 pages of evidence, says that the statistical data, though flawed, provided "strong evidence of poor performance".

The evidence suggested that the death rate at Bristol was twice that in the other 12 children's heart surgery centres in the country, and that while death rates in other centres fell during the period, as expertise improved, they did not fall in Bristol.