Thursday, May 18, 2017

Medical mayhem 7

After years of questions and complaints about surgeries that he carried out on breast cancer patients, British breast surgeon Ian Paterson has been found guilty in a criminal court of 17 counts of "wounding with intent" and three counts of "unlawful wounding."

The surgeon had denied all charges against him, and he sobbed when the verdict was announced, according to press reports. He will be sentenced next week and is expected to be imprisoned.

The verdict comes after a 7-week trial at Nottingham Crown Court, at which a sample group of nine women and one man gave evidence. The prosecution argued that the surgeries they had undergone had been unnecessary, inasmuch as they did not have breast cancer. One woman underwent 12 operations in 16 years. In other cases, a biopsy instead of invasive surgery would have been more appropriate, the prosecution argued.

The patients who appeared in court had been treated privately and were selected by the West Midlands Police, which began a criminal investigation of the surgeon in 2012. The criminal investigation involved only patients who had been treated by Mr Patterson (surgeons in England are traditionally addressed as Mr or Ms instead of Dr) in his private practice at private clinics run by Spire Healthcare, situated in Solihull and Little Acton (in the Birmingham area).

Separately, there were concerns over surgery that he carried out while working for the National Health Service (NHS) at Solihull Hospital in Birmingham; eventually this led to his suspension from the hospital post in 2011. The issue with his NHS work was that he was leaving behind breast tissue in an operation that he devised himself and described as a "cleavage-sparing mastectomy."

However, the issue with the surgery he carried out privately was that he was carrying out mastectomies on patients who did not need such extensive surgery because they did not have breast cancer.

A senior officer involved in the investigation, Department Chief Superintendent Mark Payne, said in a statement: "The procedures carried out by Ian Paterson on vulnerable patients were unnecessary and caused physical suffering, scars, and wounds to the patients.

"Also, as a result of his greed and arrogance, many of the patients have suffered psychologically, believing they needed to undergo the procedures because they were at risk from breast cancer."
But "none had breast cancer, and yet he led them to believe they were at risk," the officer is quoted as saying in the Birmingham Mail.

"Paterson was a renowned and experienced surgeon who instilled complete confidence in his patients and therefore abused his position of trust.

"This was cruel and unnecessarily led to many people suffering and living in fear," the police said. "Paterson was a controlling bully who played God with people's lives so he could live a luxurious lifestyle."

The 10 patients who testified at the criminal trial are just the tip of the iceberg. A further 350 patients who were treated by him privately (under Spire Healthcare) are also seeking compensation…

He acquired a reputation as being fast; he was able to complete two or three operations in a morning, whereas other surgeons would perform only one in that time.

In 2003, colleagues began to question why patients were being left with breast tissue after undergoing mastectomies.

One colleague, Dr Andrew Stockdale, reviewed 100 cases and raised concerns over relapse rates, but he said those concerns were "swept under the carpet."

In 2007, a newly appointed surgeon, Hemant Ingle, raised concerns with his managers, and as a consequence, two reports were commissioned. The investigators found "justifiable concerns" that the cleavage-sparing technique was leaving patients at risk for relapse, the BBC reports.

The Heart of England Foundation Trust (HEFT) stopped the cleavage-sparing mastectomies in 2007.
However, it was only after an external review of his surgeries, conducted by Sir Ian Kennedy and commissioned by HEFT, concluded that there had been irregularities that Trust suspended Mr Patterson in May 2011. At the same time, it invited all patients who had undergone a mastectomy with Mr Paterson "to see an alternative surgeon for a review of their treatment and care." That notice also said that he had used a technique that "was not usual procedure."

In an announcement on May 4, Secretary of State for Health Jeremy Hunt said there will now be a major inquiry into why the NHS did not stop the surgeon sooner (however, this is dependent on his party, the Conservatives, being reelected in the forthcoming general election). "The conviction of Ian Patterson, and the recent disclosures about the seriousness and extent of his malpractice, are profoundly shocking,” Hunt commented.

"No one has got to the bottom of his motive. The NHS issue was about not taking away enough tissue and leaving behind cleavage," Taft said. "It was quite the opposite in the private sector, taking too much away and doing multiple, unnecessary operations.

"I think it must have been financial and possibly he even had a bit of a god complex. He had patients hanging off his every word. He was pulling strings and coming to the rescue, almost like a knight in shining armor," the lawyer commented.


http://www.medscape.com/viewarticle/879279

4 comments:

  1. Unexpected deaths and safety fears in private hospitals should be made more transparent for patients in order to prevent more cases like that of the rogue surgeon Ian Paterson, the Royal College of Surgeons has said.

    The college called for a review of safety standards in the private sector after it emerged that Paterson – who was convicted last month of unlawfully wounding private patients by carrying out needless operations – was allowed to continue working as a surgeon for more than a decade despite concerns being raised about his practices.

    In an letter to the government, the RCS said private healthcare patients had less information about safety concerns in privately run hospitals than those in the NHS.

    In April a jury at Nottingham crown court found Paterson guilty of 17 counts of wounding with intent and three of unlawful wounding. Paterson carried out thousands of needless breast operations on patients who trusted his “brilliant bedside manner”.

    “The Ian Paterson case raises the question of how standards of practice, consent and patient safety are assured, particularly in the private sector where many of his patients were treated. In particular there is a question about the data available from private hospitals,” the letter states.

    The body welcomed Jeremy Hunt’s call for an inquiry into how Paterson was able to practise for so long. The letter adds: “In particular we need to ask how and why those working closely with Ian Paterson did not spot his behaviour or were unwilling to challenge it. We will continue to support a culture in the health service which encourages staff to speak up.”

    The private sector should be forced to report similar patient safety data as the NHS, including unexpected deaths and serious injuries, said the surgeons. They said private hospitals should report “never events” – mistakes so serious they should never happen – in the same way as NHS hospitals.

    https://www.theguardian.com/society/2017/may/17/surgeons-call-for-review-of-safety-standards-in-private-hospitals-ian-paterson

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  2. More than 100 new victims of butcher breast surgeon Ian Paterson have come forward since he was convicted of mutilating women after falsely telling them they had cancer.

    Lawyers who won £1.9m damages for 89 NHS patients are now suing a private health firm on behalf of 453 people operated on by the warped consultant.

    Paterson, 59, was accused of “playing God” as his trial heard how he raked in fees for needless mastectomies and other painful procedures over 14 years.

    He invented or exaggerated the risk of cancer to convince them to go under his knife, with one left looking like a “car crash victim”.

    Last month he was convicted of 20 counts of wounding nine women and a man whom he treated at two Spire Healthcare clinics in the West Midlands.

    At the time of the crimes he was also a respected NHS consultant working at Solihull Hospital.

    Police said after his conviction there could be “hundreds” of other victims and they had taken statements from 248 patients as part of their investigation.

    https://www.thesun.co.uk/news/3602103/100-new-victims-butcher-breast-surgeon-ian-paterson-mutilated/

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  3. Jeremy Hunt has announced plans to hold an inquiry into the rogue surgeon Ian Paterson, who was last week convicted of carrying out “completely unnecessary” operations on patients.

    The breast cancer surgeon was found guilty of 17 counts of wounding with intent and three of unlawful wounding against 10 patients after a seven-week trial at Nottingham crown court. He was granted conditional bail and is expected to be sentenced later this month.

    The jury heard that Paterson, 59, exaggerated or invented the risk of cancer to persuade patients to go under the knife. He also routinely left breast tissue behind for cosmetic reasons while performing mastectomies.

    The NHS has so far been forced to pay out almost £10m in compensation to more than 250 of Paterson’s patients. He could have more than 1,000 additional victims, among them hundreds of private patients who may never be compensated because the surgeon’s insurance cover was withdrawn.

    A statement from the health secretary – issued by his spokesman, not the Department of Health, because of the upcoming general election – said that if the Conservative government returned to power, it would hold an inquiry to establish how Paterson was able to operate for so long.

    Hunt’s statement said: “The conviction of Ian Paterson, and recent disclosures about the seriousness and extent of his malpractice, are profoundly shocking. A highly qualified medical professional, with a duty of care for his patients, totally neglected that duty and instead performed unnecessary procedures on a huge number of women.

    “As a result I have agreed that, if returned to government, we will hold a comprehensive and focused inquiry to ensure that any lessons are learnt in the interests of ensuring patients are protected in future. We will take any testimony from those affected, their families, and others who may wish to come forward.”

    Paterson was employed by the Heart of England NHS trust in 1998 despite having previously been suspended from Good Hope hospital in Sutton Coldfield, Birmingham. He also practised at Spire Healthcare hospitals in the Midlands over a 13-year period.

    As early as 2003, Paterson’s colleagues started raising serious concerns that he was not removing enough breast tissue during lumpectomies and mastectomies, increasing the risk of cancer recurring. But it took four investigations, four reports and nine years before Paterson was finally suspended by the General Medical Council in October 2012.

    https://www.theguardian.com/society/2017/may/04/hunt-announces-plans-for-inquiry-into-rogue-surgeon-ian-paterson

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  4. Breast surgeon Ian Paterson has been jailed for 15 years after carrying out unnecessary cancer operations.

    Paterson, 59, was convicted over operations on nine women and one man, but there were hundreds of other victims.

    He was found guilty of 17 counts of wounding with intent and three of unlawful wounding, after his trial.

    Jurors at Nottingham Crown Court heard last month Paterson had exaggerated or invented the risk of cancer.

    The NHS has paid almost £10m in compensation to his victims, while more than 600 private patients will pursue civil action against him later this year...

    What Ian Paterson cost the NHS
    17.8m Total damages and defence costs
    £9.49m Damages paid
    £8.31m Legal costs
    256 NHS patients awarded compensation
    25 Still waiting for a payout
    Source: Heart of England NHS Foundation Trust...

    The specialist prosecutor said: "He knew the procedures were not needed but carried on regardless, inflicting unlawful wounds on his patients.
    "The impact of Paterson's actions on his victims has been devastating, from the unnecessary distress of undergoing procedures they did not need, to the scars that will always serve as a physical reminder of what their doctor, Ian Paterson, did to them."

    http://www.bbc.com/news/uk-england-birmingham-40108558

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