James Wisheart, a cardiac surgeon and former medical director of the Bristol Royal Infirmary, told the public inquiry into the deaths that he and his colleagues worked long hours, day and night, to meet the demand in a service that was under-resourced.
Later, the NHS Litigation Authority confirmed that the infirmary had admitted a breach of its duty of care over Ian Stewart, a heart patient now aged six, who is confined to a wheelchair with severe disabilities. The hospital's admission paves the way for Ian's claim - likely to run into millions of pounds - and heralds further claims from other children who suffered damage in heart operations.
The United Bristol Healthcare Trust, which manages the infirmary, has offered an interim payment of pounds 100,000. A spokeswoman said: "The Trust regrets that in its treatment of Ian it fell below the standards of care it aspires to provide and that this failure resulted in damage to Ian. The Trust extends its apologies to Ian and his family for their distress and accepts it is liable to compensate Ian for his injuries."
The boy's parents, James and Bronwen Stewart, had earlier sat cradling him in the public gallery, listening to Mr Wisheart's evidence. Mr Stewart held a placard claiming the inquiry was "a cover-up".
The litigation authority revealed that there are 193 actual or potential damages claims involving Mr Wisheart and a fellow Bristol Royal Infirmary surgeon, Janardan Dhasmana.
In more than 130 cases, the children died in heart operations. Solicitors are currently pursuing just over 100 of the cases. Some 29 other cases of baby fatalities have already been settled for undisclosed sums but they are believed to total more than pounds 550,000. It is thought at least half-a-dozen of the cases are likely to involve brain-damaged children
Both surgeons were found guilty of serious professional misconduct, with the hospital chief executive John Roylance, by the General Medical Council last year for continuing to operate on babies when they should have realised the death rate was too high. The GMC case focused on 53 operations in which 29 children died and four were brain damaged. The public inquiry has cast its net much wider, examining all complex heart operations performed between 1984 and 1995.
Mr Wisheart told the hearing in Bristol that he worked an 11-hour day from 8am to 7pm but denied trying to take on too much. "I think I did work hard. I think it was clear that in a service that was growing as ours was there were times when the workload was greater. We accepted that." Asked whether his involvement with management affected his work as a surgeon, he replied: "When I operated I was doing exactly that, I was just concentrating on the surgery. Everything was put out of one's mind until the operation was complete. I can really say that going to the operating theatre was my refuge."
He added: "I reviewed my position in my own mind from time to time and I was satisfied that I could cope with the responsibilities. I don't regard myself as a being any different from ... my colleagues who work very hard."
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