Two patients left with horrific injuries after being “mutilated” by an NHS surgeon have called a review into what happened “pathetic” and “invalid” after their views were not taken into account.
The Norfolk and Norwich Hospital Trust has now published a previously secret report by the Royal College of Surgeons (RCS) into the actions of Dr Camilo Valero, who harmed three patients in a matter of days at the beginning of last year.
The report found “significant concerns” with his decision-making after he carried on operating despite getting into problems and did not ask for help. But it concluded he had demonstrated insight and now acknowledged he would seek help in similar situations.
Lucy Wilson, aged 33, has been left incontinent and diagnosed with post-traumatic stress disorder while Paul Tooth, 64, a former RAF veteran has been left with tubes permanently going in and out of his body to recycle bile produced by his liver.
Both of them were admitted for emergency gall bladder surgery in January 2020 and were operated on by Dr Valero who mistakenly removed both their bile ducts and severed parts of their livers, as well as connections between the liver and intestines.
The alarm was raised by staff at Addenbrookes Hospital after Ms Wilson and Mr Tooth were transferred there as emergency cases. The RCS report does not address why Dr Valero did not report the injuries as incidents.
The RCS relied on Dr Valero’s description of his communication with patients and how he obtained consent but did not interview either Ms Wilson or Mr Tooth. They have both raised concerns about the surgeon’s communication, attitude and behaviour towards them while in hospital.
Mr Tooth told The Independent he had submitted a 57-page report to the hospital days before the RCS carried out its review but this was not submitted to the experts.
He said: “It’s appalling. I used to write reports for the RAF. This report by the Royal College of Surgeons was written without all the facts and therefore is invalid.
“We need a new investigation. The trust had my report and did not pass it on to the RCS. Had they heard my side of the story they would have come to a very different conclusion.
“The report confirms Dr Valero is arrogant and has shown he does not have the ability to self-regulate. He carried on with the surgery to the detriment of his patients.”
Ms Wilson, who is facing more surgery in coming months to try and repair some of the damage caused by Dr Valero, added: “We are the people that it happened to and we have to live with this for the rest of our lives.
“We should at least have been consulted but as soon as the trust realised something had gone wrong they closed ranks around him.
“It is a pathetic job. We haven’t had any input and there is nothing about him not reporting the incidents. That fact that I was lying in hospital for nine days with leaking bile and progressively getting worse isn’t addressed either. It makes me really angry, he should have stopped when he realised he needed help.
“When he couldn’t identify the correct anatomy he should have backed off. If he had done that I would not be where I am now.”
According to the RCS report Dr Valero, who is still operating at Norfolk and Norwich Hospital Trust under supervision, was clinical governance lead for general surgery at the time of the incidents.
The review highlighted wider problems in the trust’s service with patients experiencing long delays for surgery, and operations being repeatedly cancelled. It also said that in the case of the third, unidentified, patient Dr Valero only saw them in the anaesthetic room before surgery which the RCS said was unacceptable practice.
The report concluded Dr Valero’s “failure to recognise the need for and to consult with a consultant surgeon colleague was a shortcoming”, adding that “it was difficult to understand why he had not called for assistance when complications arose”.
It said the injuries to both patients “were hugely significant” and the review team “had significant concerns regarding [Dr Valero’s] intraoperative decision-making in these two cases. He had failed to recognise that an alternative strategy was required and the need to consult with a consultant surgeon colleague”.
But it added his colleagues had given “consistently positive” feedback and he had since “demonstrated insight and reflection”, with the RCS concluding it had no ongoing safety concerns about his practice.
It recommended he undergo training to improve his skills and also made recommendations to the trust to improve its wider surgical service handovers and delays.
The Norfolk and Norwich Hospital Trust has admitted liability in both cases and apologised to Ms Wilson and Mr Tooth for the standard of care both during and after their surgery.
A spokesperson told The Independent the RCS had reviewed three sets of clinical records and the patient complaints as well as the formal response from the trust.
The Royal College of Surgeons said its reviews work to the specific terms of reference agreed with each hospital with the people involved decided on a case-by-case basis.
They added: “This can include interviews with patients or patient representatives, and will also consider patient feedback or written patient complaints.
“As per the agreed terms of reference, patient feedback and complaints were considered as part of the review at Norfolk and Norwich Hospital Trust. Each of our individual and service reviews also has a lay reviewer with a specific mandate to represent the patient and public interest.”
The spokesperson said that once the review was complete it became the property of the NHS trust, adding: “It is our expectation that healthcare organisations should be as open and transparent with patients and the public about the review as possible, taking into account patient consent and confidentiality.
“We expect organisations to share and discuss the findings of invited review reports with those patients whose episodes of care have been reviewed as early as possible following issue of the report.”
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