A Nigerian-born senior surgeon with "poor vision" accidentally removes...
The United Kingdom resident doctor of Nigerian origin, Dr. Lawal Haruna, 59, has been struck off after mistaking the patient’s reproductive organs for her appendix when she was admitted to hospital with abdominal pain.
The unnamed “Patient B,” who was not of child-bearing age, also had her fallopian tube removed during the bungled procedure.
The incident in March 2015 was one of a series of botched operations carried out by Haruna over two years, which were so poorly executed colleagues described them as ‘never events.’
Another man, known as Patient A, who had acute appendicitis, had been on a list for emergency surgery, yet Haruna mistakenly removed a pad of fat, meaning he was forced to undergo a further operation a month later.
Haruna removed a skin tag from a third patient who had been admitted with a cyst.
An expert report read: “Dr. Haruna was mistaken in his identification of the appendix and removed the ovary and tube in error.This is a serious omission and a breach of duty of care.
“To have mistaken a fat pad for the appendix and to have failed to deal adequately with the pathology suggests a standard of care which is seriously below that expected of a reasonably competent Staff Grade in General Surgery.”
Haruna, who says he has 25 years’ experience, dismissed the incidents as “trifling errors” and said the appendix and fallopian tubes were similar “worm-like structures which lie in a similar area.”
But at the Medical Practitioners Tribunal Service, a disciplinary panel found him guilty of misconduct and banned him from treating patients.
Chairman Clare Sharp told Haruna his treatment of one patient was “reckless” and added: “You were asked to put yourself into your patients’ shoes, and to consider how your actions made them feel.
“Whilst you have apologised to the patients in question, you showed a lack of empathy for them, as well as for the serious consequences of your failings.
“Patient A was in pain for a month after your operation, and had to undergo a further operation to remove his appendix after you failed to do so the first time. Had Patient B been of child-bearing age, your removal of a fallopian tube and ovary could have been incredibly serious and potentially life-changing for her, but you showed no recognition of these potential consequences.”
Ms Sharp said another patient had suffered a post-operative infection and later said she had “lost confidence” in the safety of surgery for her or her family.
“You had no real concept of how your patients felt, and the impact which your actions had on them post-operatively,” she said.
“The Tribunal did not believe that your misconduct was deliberate, but it concluded that there was a continuing risk to patients.”
The incidents occurred between 2013 and 2015 whilst Dr Haruna was working for the Sheffield Teaching Hospitals Trust, which oversees six hospitals.
Patient A was admitted on September 4, 2013 with suspected appendicitis and was diagnosed two days later and added to a list for emergency surgery.
But on September 7, Haruna failed to identify Patient A’s appendix and removed a pad of fat. He also failed to ask for assistance when he experienced difficulty with Patient A’s surgery.
Patient B was admitted on March 8, 2015 with abdominal pain which was later diagnosed as appendicitis. On March 10 Hauruna mistakenly removed her ovary and fallopian tube when performing an open appendectomy, leaving the appendix in situ.
The hearing was told the NHS Trust investigated the incident as a ‘Never Event’ and in a report recommended he be restricted in what operations he carried out. But on August 25 of that year, Patient C was referred to Haruna with a small lump on an intimate part of her body.
He failed to identify the site of the lesion to be removed, and removed a skin tag instead.
Haruna apologised to Patients A and C personally and to Patient B via his medical team.
The surgeon, who represented himself, told the Manchester hearingthat he had been suffering from “poor vision” at the time and claimed it would be ‘harsh’ to strike him off.
He added: “I want to apologise to all the patients. I didn’t experience operative difficulties in removing whatever I removed. Everything had gone along fine and it was not difficult to remove.
“It was only later I realised it was not the appropriate part. The operation itself, the technicality, was fine but the wrong specimen was removed.
“I have performed hundreds of appendectomies. This was due to lapse of judgement.”
But expert witness, Dr. Michael Zeigerman, said: “If you feel you are not capable for any reason, then you should not perform the procedure. If you are over tired or feel you are impaired in any way, your duty is to the patient.
“You must say, ‘I can’t do this, I must ask for help.’ There’s always someone at the end of the phone.
“If your vision is impaired and you are tired, you need to ask for help to lower the risk of ‘never events’.
“Your responsibility is to your patient and if you feel impaired, you should seek help. If you are visually not good, you shouldn’t be operating. If your ability is impaired you shouldn’t start an operation; or if you become unwell, then you should ask for help.
“Sometimes your visibility does start to get a bit blurred and you stop and go for a cup of tea, but you don’t just carry on.
“You need to make sure what you are taking out is the right thing. It makes it stranger that somebody with that experience would mistake the appendix for a pad of fat in one case and the Fallopian tube in another case. It should make you more likely not to miss them.
“A never event is something that should never, ever happen. It’s so serious that Jeremy Hunt himself has every single one of them written in his office – and we have three of them here.”
Source: UK Telegraph
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