Interesting articles from the British Medical Journal

BMJ. 2004 December 11; 329(7479): 1364. doi: 10.1136/bmj.329.7479.1364-a.

Doctor jailed for “culpable homicide” and possessing child pornography

A Dutch paediatric cardiologist has been found guilty of "culpable homicide" after a 7 month old baby girl died following heart catheterisation. He was also found guilty of possessing a large quantity of child pornography and has been banned from practising medicine for six years and jailed for 18 months, with six months suspended.

Dr Paul H, 45, had, the court accepts, intended to help Charlotte Floor, who had been born with a severe heart abnormality. But his "gross carelessness" and "irresponsible decisions" meant he is to blame for her death.

In 2001, Dr H had operated at Utrecht's Wilhelmina Children's Hospital, to insert a stent into one of the infant's arteries. Expert witnesses told the court that such a high risk operation was then "scarcely known" in a child under 12 months, although it would be possible in extreme circumstances. But Charlotte did not present as an emergency.

She died because of a chain of events, the most important of which were damage to an artery during surgery and conservative treatment for later bleeding.
Charlotte had had a double aortic arch with coarction. Angioplasty had not resolved her problems and Dr H discussed the option of a stent with his most experienced colleague. His colleague said, "Keep all options open."

When Charlotte was admitted for further angioplasty, tests showed that placing a stent was possible. Dr H chose this option without informing her parents of the risks involved. Colleagues observing the operation had not objected, although the most experienced paediatric cardiologist was not present because of a personal row. Dr H was helped by a junior doctor who had never previously done a heart catheterisation (BMJ 2002;325:1318).

Dr H found that the sheath used in placing the stent was too long and he cut it using a lancet and the underside of a metal beaker. On removing the sheath, he noticed that where he had cut it was a rough edge. He advised nursing staff that echocardiography should be done because of the risk of thrombosis but did not specifically report his concerns to the anaesthetist responsible for Charlotte's aftercare.
Later "a lump the size of an orange" was discovered in her abdomen. She was taken to intensive care but died.

The court judged that Dr H had used the wrong sized stent and sheath, did not ensure the correct materials were available in the heart catheterisation room, and had not requested help from the most experienced paediatric cardiologist

His defence argued that the decisions taken were not black and white but about a medical consideration of risk. He acted in the interests of the infant, whose condition could have resulted in sudden death.
The next year a police investigation discovered an estimated 400 000 pornographic images of children aged 0 to 16 at Dr H's home. The prosecution allege that both cases show his "fundamental lack of respect for children." The court said the "bizarre combination" of the two cases had created public alarm. "Patients and their parents," it noted, "put trust in doctors and their profession."

http://ukpmc.ac.uk/articles/PMC535485

http://ukpmc.ac.uk/ukpmc/ncbi/articles/PMC535485/pdf/bmj3291364a.pdf

That's just too awful.
Can't believe he was banned from practising for only 6 years... it should have been life long, disgusting creature.

MJH1901 wrote:That's just too awful.
Can't believe he was banned from practising for only 6 years... it should have been life long, disgusting creature.

MJH I agree.

MJH1901 wrote:That's just too awful.
Can't believe he was banned from practising for only 6 years... it should have been life long, disgusting creature.

There's more:-

BMJ. 2005 October 22; 331(7522): 926.

Dutch doctor who was jailed for culpable homicide has his sentence cut

A former paediatric cardiologist in Holland who was jailed for culpable homicide after a 7 month old girl died from complications of a heart catheterisation has had his sentence reduced on appeal. Under Dutch law the names of defendants are not disclosed, so the doctor is known only as Dr Paul H.

The Arnhem Appeal Court reduced his six year ban on practising medicine to a suspended three year ban on condition that he did not work in paediatrics, and it reduced his 18 month prison sentence to six months, four of which were suspended. Dr H was also convicted of possessing a large amount of child pornography found after police searched his home (BMJ 2004;329:1364).

The court accepted that Dr H was responsible for the baby’s death but took a more lenient view of his guilt, describing it not as "gross" negligence but involving "considerable carelessness and/or negligence." It stressed that he did consult more experienced colleagues before carrying out the heart catheterisation, and none had stopped him from going ahead.

The courts have accepted that Dr H, 46, had intended to help the child, Charlotte Floor, who had been born with a severe heart abnormality. In 2001 he operated at Utrecht’s Wilhelmina Children’s Hospital to place a stent. Expert witnesses have said that such an extremely risky operation was then "scarcely known" in a child aged under 12 months. They accepted that it might be necessary in extreme circumstances, but it was made clear that Charlotte did not present an emergency. Also, the hospital’s most experienced paediatric cardiologist was not present at the operation because of a personal row (BMJ 2002;325:1381).

Dr H discovered that the sheath to be used in placing the stent into the heart was too long and cut it using a lancet and the underside of a metal beaker. On removing the sheath, he noticed there was a rough edge where it had been cut. Charlotte died through a chain of events, but one of the most important was damage to an artery during surgery.

The appeal court accepted that the work circumstances were "to put it mildly not optimal." It also said that placing a heart stent in a child under 12 months had been described in the medical literature (and therefore was not unheard of) and that cases of surgeons cutting stents to make them fit "apparently does happen."

However, it rejected defence arguments that no direct link existed between the girl’s death and the operation. Complications from Dr H’s operating procedure were an essential factor.

The court reconsidered his ban on practising medicine, saying that Dr H had had an "unblemished record of service and a good reputation as a paediatric cardiologist."

Dr H has not worked as a doctor since his arrest in August 2002. He is now out of prison and says he has no intention of returning to paediatrics, when the six year ban on him returning to the speciality is lifted. He would be prevented from doing so, in any case, because of his conviction. But he has said he is considering working in other areas of medicine.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1261225/

Even with his reduced Sentence I don"t think any Hospital would employ him and if he worked as a GP no
mother would want him to examine her child.

Do you wanna know what lead to his arrest?

His arrest came after a court---applying a law on the disclosure of government information---allowed publication of a confidential report .

http://www.bmj.com/cgi/content/extract/325/7377/1381/c

Schnuffel wrote:Do you wanna know what lead to his arrest?

His arrest came after a court---applying a law on the disclosure of government information---allowed publication of a confidential report .

http://www.bmj.com/cgi/content/extract/325/7377/1381/c

So the Government was prepared to keep it under wraps from the public?

Panda wrote:

Schnuffel wrote:Do you wanna know what lead to his arrest?

His arrest came after a court---applying a law on the disclosure of government information---allowed publication of a confidential report .

http://www.bmj.com/cgi/content/extract/325/7377/1381/c

So the Government was prepared to keep it under wraps from the public?

It appears so. The law that applies to the disclosure of government information in the UK is the Freedom Of Information Act.

Panda wrote:

Schnuffel wrote:Do you wanna know what lead to his arrest?

His arrest came after a court---applying a law on the disclosure of government information---allowed publication of a confidential report .

http://www.bmj.com/cgi/content/extract/325/7377/1381/c

So the Government was prepared to keep it under wraps from the public?

Whenever I read that a Health Authority has paid out without accepting liability, I think....doctor has been shipped off to another hospital/area: we know he/she is incompetent, but the BMA will protect this person.

Anybody see "Panorama" last night, the same thing goes on in schools with incompetent teachers. Even if you get struck off the register, you can still teach in private schools! If you can get BBC iPlayer and you missed it, it's well worth a look.

AnnaEsse wrote:

Panda wrote:

Schnuffel wrote:Do you wanna know what lead to his arrest?

His arrest came after a court---applying a law on the disclosure of government information---allowed publication of a confidential report .

http://www.bmj.com/cgi/content/extract/325/7377/1381/c

So the Government was prepared to keep it under wraps from the public?

Whenever I read that a Health Authority has paid out without accepting liability, I think....doctor has been shipped off to another hospital/area: we know he/she is incompetent, but the BMA will protect this person.

Indeed Anna, the BMA will protect such a person!

I often wonder if it was a government decision to protect the Tapasniks from going to trial due to a couple of them having something nasty in their backgrounds yet being allowed to continue to practice as Specialists in our hospitals? I mean could you imagine the fall out from such a thing!

pennylane wrote:

AnnaEsse wrote:

Panda wrote:

Schnuffel wrote:Do you wanna know what lead to his arrest?

His arrest came after a court---applying a law on the disclosure of government information---allowed publication of a confidential report .

http://www.bmj.com/cgi/content/extract/325/7377/1381/c

So the Government was prepared to keep it under wraps from the public?

Whenever I read that a Health Authority has paid out without accepting liability, I think....doctor has been shipped off to another hospital/area: we know he/she is incompetent, but the BMA will protect this person.

Indeed Anna, the BMA will protect such a person!

I often wonder if it was a government decision to protect the Tapasniks from going to trial due to a couple of them having something nasty in their backgrounds yet being allowed to continue to practice as Specialists in our hospitals? I mean could you imagine the fall out from such a thing!

Indeed pennylane. I cant help wondering though about the quote below & how the UK Government would react to such a case of 'public alarm' caused by a British doctor(s). Perhaps Clarence Mitchell could enlighten us?

The court said the "bizarre combination" of the two cases had created public alarm. "Patients and their parents," it noted, "put trust in doctors and their profession."

Let him come to the uk, after all, we accept ANYBODY here NO MATTER what they have done.

What is the MaCanns connections to the Netherlands, did one or the two of them not work there?

They once live in amsterdam