Professor tried to get surgery stopped.

cardiac surgery at Bristol University, tried to get complex heart surgery on children at Bristol stopped because “we were no good at this kind of surgery,” he told the inquiry into Bristol paediatric cardiac surgery services last week. It had been “a mistake” on his part not to have passed on to the cardiac team at Bristol an offer from Great Ormond Street Hospital in London to do the more complex operations there. But he felt that he was not in a position to influence decisions on referrals because “nobody gave a toss about what I was saying.” Professor Angelini, who specialises in adult cardiac surgery, outlined his attempts to get the surgery stopped after he took up his chair at Bristol in 1992. He was speaking at the inquiry into surgery at Bristol, which was set up after 29 children died during heart surgery there between 1983 and 1995. The General Medical Council found two heart surgeons, James Wisheart and Janardan Dhasmana, and the former chief executive, John Roylance, guilty of serious professional misconduct. Professor Angelini’s opinion that complicated surgery in the department should cease was not based solely on an unofficial audit by the anaesthetist Stephen Bolsin, which, he said, was “just the final piece of the jigsaw.” He explained: “My opinion was the result of what I was seeing every day of the week in intensive care. At audit there was almost inevitably a dead child or a child with complications. There had already been many meetings—audit meetings where mortalities were occurring and children who had died in very strange circumstances had been discussed.” He found it hard to get across to Mr Wisheart, the senior surgeon and medical director, that his surgical results were unacceptable: “Mr Wisheart was a very influential individual with the trust. There was apprehension about what it would mean for one’s future career.” Talking to John Roylance, the chief executive, “was like listening to a tape recorder: ‘This is not a matter for me. This is a matter for the clinicians.’” Professor Angelini had pressed for the appointment of a new paediatric cardiac surgeon, and in 1994 it was decided to appoint one. He was due to start in March 1995, but in January 1995 the existing team decided to go ahead with an arterial switch operation on 18 month old Joshua Loveday, although it was not an urgent case. Professor Angelini rang colleagues, spoke to the Department of Health, and wrote to Mr Wisheart as medical director. But the team decided to go ahead and the child died. Professor Angelini said that he was later told that “when the right coronary of the child was inadvertently cut, that was the end of the operation.”