Doctor ‘risked lives’ to test medical students

Nov 20 2007 by Caroline Innes, Liverpool Daily Post

A LEADING doctor put a heart patient’s life in danger when he switched off the power to an anaesthetic machine during cardiac surgery and went for a coffee break, a tribunal heard.

Consultant anaesthetist James Murphy, 49, later explained his actions to his registrar saying it was part of a training exercise to test whether he would spot his deliberate mistake.

It later emerged Dr Murphy had previously undertaken similar tests on two other specialist registrars without the patients’ consent, with one of them subjected to the test twice.

The doctor at Liverpool’s Cardiothoracic Centre, who helped save the life of former Liverpool FC manager Gerard Houllier in 2001, faces allegations his behaviour was “inappropriate”, “unacceptable”, “not in the best interest of patients” and “below the standard that would be expected of a registered medical practitioner”.

During the General Medical Council hearing, it emerged one specialist registrar was left to manually ventilate an anaesthetised patient with emergency oxygen supplies when his machine shut down without any back-up battery.

None of the patients on the operating table at Broadgreen’s Cardiothoracic Centre during the alleged “test” had given their consent prior to surgery. Dr Murphy had not checked whether the machine was equipped with a back-up battery and whether it was working.

The “Cato” anaesthetic machine has a battery back-up in case of any loss in electricity supply which sounds an alarm alerting the anaesthetist to the problem.

In one operation there was no battery back-up and the patient was left without anaesthetic while Dr Murphy went for a coffee.

The GMC fitness to practise panel, sitting in Manchester, heard how patients could have been starved of oxygen or even felt sensation during surgery as a result of the stunt.

Timothy Smith, for the GMC, told the panel the allegations related to “unusual and orthodox and dangerous” training procedures on patients who had not given consent.

The panel heard how Murphy was also responsible for the supervision of 12 registrars.

In May, 2005, fifth-year registrar, Dr Hoo Kee Tsang, was accom-panied by Murphy in a cardiac bypass procedure when he used the procedure.

The panel heard how the machine used had monitors showing levels of gas and oxygen given to the patient. Not all machines have back-up batteries that would supply electricity in the event of a power failure.

Mr Smith said: “If there was no such battery back-up, then all systems would have shut down.

“As far as their electrical power was concerned, the machine could not provide automatic delivery of gas, oxygen and ventilation.”

The panel heard how Dr Tsang was monitoring the machine when he had to disconnect it to allow the surgeon to saw through the patient’s breast bone as planned.

The machine’s alarm sounded as expected when it was disconnected, and the procedure went without a hitch.

Mr Smith said: “It was at or about this point that Dr Murphy told Dr Tsang that he was leaving the theatre in order to get a coffee.

“As he left the theatre, Dr Murphy switched off the anaesthetic equipment at the mains and walked out.

“The consequence of that was that the equipment then shut down and the internal alarm sounded.

“That particular machine did not have a back-up power source.

“As a consequence the internal displays shut down and the external monitors present would also have shut down.

“The automatic gas delivery systems stopped.”

The panel heard how Dr Tsang called for emergency oxygen supplies and commenced man-ually ventilating the patient while theatre staff called for Murphy.

Mr Smith said: “It was up to five minutes later that he arrived and asked him if he was all right. Dr Tsang told him that the anaesthetic machine had lost power and needed to be replaced. Dr Murphy revealed he had disconnected the power supply in order to test Dr Tsang.

“He turned the power back on and the patient was reconnected to the machine and ventilation and automatic administration of anaesthetic was continued.”

The panel heard how it later emerged Murphy had previously undertaken similar tests on two other specialist registrars without the patient’s consent.

Mr Smith said: “This training exercise involved the deliberate creation of a critical incident which, if allowed to continue unchecked, would or could result in harm to the patients.

“These training exercises did not place the care of the patient as the first concern.

“They were entirely irrelevant to the care of the patient.

“In the circumstances, the patient was therefore exposed to a wholly unnecessary risk.

“It is the GMC’s case that there was no need at all for this type of exercise to have been undertaken.

“This process would not have been condoned as proper or acceptable by any responsible body of medical opinion.”

Dr Murphy denies misconduct.

The hearing, which is expected to last two weeks, continues.

carolineines