Inquiry told of doctor's fears over ecstasy girl

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A surgeon strongly denied yesterday that she had refused a liver transplant on moral grounds to a teenager who had taken the drug ecstasy.

Dr Hilary Sanfey told a fatal accident inquiry into the death of Michelle Paul, 15, that her family had misunderstood the reasons for refusing her the pounds 60,000 operation. However, she admitted that behavioural problems such as drug-taking had to be taken into account when considering which patients were suitable for transplant.

Dr Sanfey,45, giving evidence on the fifth day of the inquiry at Aberdeen Sheriff Court, said she had met Michelle's mother and grandmother at the request of her colleague, Dr Niall Finalyson, who had told them that Michelle had suffered irreversible brain damage and was not suitable for transplant.

She said: "He told me the family were extremely anxious and had somehow got it into their heads that the decision was based purely on the basis of her behaviour and asked if I could come and clarify that and reinforce our position.

"The gran asked me why did Dr Finlayson say that we were not transplanting her because of her behavioural problems.

"I said she must have misunderstood what he said. I did say these were issues I would have to consider. I also said I've transplanted patients in the past who had taken ecstasy and that was not the reason in itself."

The doctor, who now works in the US, said the selection of patients for transplant was made by the whole team and it was "crazy" to suggest that she alone had the power to decide. She at first raised the possibility of Michelle having the operation but warned that she might suffer severe brain damage and the family could be faced with having to switch off the ventilator in intensive care. "The gran interrupted and said it would not be what Michelle wanted. Although they were clearly distraught, they understood and were agreeing with me."

Michelle, died in November 1995, 23 days after taking half a tablet of ecstasy at a rave near her home in Aberdeen. Originally taken to Aberdeen Royal Infirmary with suspected hepatitis, she was later airlifted to Edinburgh when her condition deteriorated.

Dr Sanfey said she first saw Michelle on the morning after she was admitted to the Edinburgh hospital. She said she had noted the impression that the girl had an "extremely poor prognosis" and given her history of drug use and unstable family background - Michelle's mother and sister were known to use drugs - she should be excluded from transplantation.

However, she agreed with Dr Finlayson that they would seek further background information and review the situation. Within 24 hours, Dr Finlayson had met with her to express concerns over possible irreversible brain damage caused by severe pressure in her head.

The hearing continues.