Last month, a three-judge panel granted English surgeon David Sellu the right to appeal his conviction. He has already served 15 months in prison.
In this space 2 years ago, I blogged about Sellu, who was charged with manslaughter in the death of a patient at a private hospital in London.
If you do not want to read that entire post, here’s a brief summary:
While recovering from a total knee replacement, a man died from sepsis secondary to an intestinal perforation. Sellu had been asked to consult on the patient.
Although I pointed out that many other caregivers must have contributed to this tragic outcome, no one else was blamed. According to the judge’s sentencing remarks, Sellu did not aggressively investigate and treat the cause of the patient’s abdominal pain and his accounts of the events surrounding the patient’s death were inconsistent.
Accounts of the case were not detailed, but I assumed Sellu was at fault.
“…even if Sellu wins the appeal, his reputation has been ruined, and he will probably never practice again.” – Skeptical Scalpel
Some commenters from the UK pointed out that not all of the facts were known. A website in support of the doctor, whose career had previously been exemplary, was created. Many friends and colleagues said that he had been railroaded and called for the case to be reopened.
Last summer, the Daily Mail [a newspaper and website which has been scorned by journalists and readers alike, but shined this time] ran a story revealing the results of a root cause analysis done by hospital staff that found multiple system failures regarding the performance of emergency surgery. The corporation that owns the involved hospital had withheld this information before the trial.
Some of the problems were as follows: an x-ray and CT scan ordered by the doctor were not done in a timely way; staff did not adequately monitor the patient; the surgery was delayed because no anesthesiologist was available. Apparently, the hospital had no emergency call roster for anesthesia at the time and still does not.
A house physician diagnosed the problem as a muscle spasm and gave the patient a muscle relaxant several hours before Sellu was asked to see the patient.
The patient had been on dabigatran, an anticoagulant drug, which at the time of this incident in 2010, had no antidote. The prosecution had told the court that the patient’s chances of survival from a bowel perforation with sepsis was 2.6%—overly optimistic for a 66-year-old man requiring surgery.
The hospital’s medical advisory committee also investigated the incident and found Sellu was not culpable for anything that happened and that the hospital should not be doing emergency surgery. Minutes of this meeting were also not divulged at the doctor’s trial.
Should this conviction be overturned, it will be another blow to the “Captain of the Ship” doctrine, which assumes that a surgeon is responsible for everything that happens to his patient.
However, even if Sellu wins the appeal, his reputation has been ruined, and he will probably never practice again.
Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and critical care and has re-certified in both several times. He blogs at SkepticalScalpel.blogspot.com and tweets as @SkepticScalpel.