Bristol team was unprofessional, says surgeon

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The Independent Online
THE ENTIRE surgical team at Bristol Royal Infirmary was responsible for the disaster that befell children having complex heart operations there and not just the surgeon wielding the knife, a heart specialist at the hospital said yesterday.

Janardan Dhasmana, who was found guilty of serious professional misconduct by the General Medical Council last year, told the public inquiry the surgical team was "unprepared" and "unprofessional". Cardiologists had failed to diagnose problems and nurses created an "uncomfortable" atmosphere. He said he found himself trying to solve problems with patients on the operating table that should have been planned for and taking longer over surgery than he should have done.

On the second day of his evidence, Mr Dhasmana said: "I had a set-up that was not well rehearsed. I felt it was not professional, things were not there." Referring to a "high" incidence of pre-existing cardiac problems in his patients, he said: "It took longer to correct, trying to work out a programme on the operating table, rather than working it out beforehand. Some of the abnormalities I found out on the table."

Earlier the inquiry had been told a review of 80 cases operated on by Mr Dhasmana and his senior colleague, James Wisheart, found only nine in which the surgery was at fault. However, in half the operations the overall standard of care, including pre and post-operative care, was found to be inadequate.

Admitting that he could be cross and irritable in theatre, Mr Dhasmana said: "Some of the nurses in the theatre were very uncomfortable with me. I didn't want chit-chat, I wanted things done and that was not popular with many nurses."

The 57-year-old surgeon said he began performing the complex switch operation, in which the main arteries of the heart are switched round, in 1988, and his first five patients all died. Despite his initial death rate, he said he was "full of confidence" in his work and was "unlucky" to be confronted with so many patients with pre-existing cardiac problems.

Questioned by inquiry counsel Brian Langstaff QC, he admitted that he was "expecting a mortality rate of 20 to 30 per cent" rather than 100 per cent. Asked if he considered stopping the procedure, he said: "Every time I lost a patient I asked myself, did I do anything wrong? I was always questioning myself. But at the time I was full of confidence in my own work and what I was achieving."

The inquiry continues.