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Professional misconduct: the Bristol case
1Department of Anaesthesia, Perioperative Medicine and Pain Management, Geelong Hospital, Vic. steveb@gh.vic.gov.au
Insights
A whistleblower exposed serious professional misconduct by three Bristol Royal Infirmary doctors. Their operations led to 29 deaths and brain damage in children, with high mortality rates and undisclosed risks.
Area of Science:
- Medical Ethics
- Surgical Accountability
- Patient Safety
Background:
- The Bristol Royal Infirmary case involved serious professional misconduct allegations against three senior medical practitioners.
- The case centered on 53 pediatric cardiac operations performed between 1988 and 1995, resulting in 29 deaths and four children with brain damage.
Purpose of the Study:
- To detail the professional misconduct case concerning pediatric cardiac surgery at Bristol Royal Infirmary.
- To highlight the role of a whistleblower in initiating a six-year investigation into surgical outcomes and communication.
Main Methods:
- The Professional Conduct Committee of the General Medical Council conducted an eight-month hearing, reviewing 65 days of evidence.
- Allegations included performing high-risk operations with known high mortality rates and failing to disclose accurate risks to parents.
Main Results:
- All three accused medical practitioners were found guilty of serious professional misconduct.
- The investigation followed a whistleblower's report, leading to a lengthy and costly inquiry.
Conclusions:
- The case underscores the critical importance of transparency and accurate risk communication in pediatric cardiac surgery.
- Accountability for surgical outcomes and adherence to professional conduct are paramount for patient safety.
Abstract:
In June 1998, the Professional Conduct Committee of the General Medical Council of the United Kingdom (the body which regulates British doctors) concluded the longest-running case it has considered this century. Three medical practitioners were accused to serious professional misconduct relating to 29 deaths (and four survivors with brain damage) in 53 paediatric cardiac operations undertaken at the Bristol Royal Infirmary between 1988 and 1995. All three denied the charges but, after 65 days of evidence over eight months (costing 2.2 Pounds million), all were found guilty. The doctors concerned are Mr James Wisheart, a paediatric and adult cardiac surgeon (appointed in 1976, now retired), and the former Medical Director of the United Bristol Healthcare Trust (the hospital group that includes the Bristol Royal Infirmary); Mr Janardan Dhasmana, paediatric and adult cardiac surgeon (appointed in 1986); and Dr John Roylance, a former radiologist, and Chief Executive of the Trust from its creation in 1991 until his retirement in 1995. The central allegations were that the Chief Executive and the Medical Director of the Trust allowed to be carried out, and the two paediatric cardiac surgeons carried out, operations on children knowing that the mortality rates for these operations, in the hands of these surgeons, were high. Furthermore, the surgeons were accused of not communicating to the parents the correct risk of death for these operations in their hands. Stephen Bolsin, a cardiac anaesthetist, "blew the whistle" and then had the courage to follow through until a full investigation was carried out. The process took over six years. Here he tells his story.