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Blunder surgeon looked at kidney X-ray back to front.

Byline: Laura Elston

FORMER North Wales surgeon accused of killing a kidney patient because of a bungled operation may have looked at the man's X-rays back to front, a court heard yesterday.

Consultant urologist John Gethin Roberts, 60, is accused alongside surgeon Mahesh Chard Goel, 40, of manslaughter after the surgical error which happened at Prince Philip Hospital, Llanelli, in January 2000.

Retired pipe lagger Graham Reeves, 69, died in March 2000 five weeks after his healthy left kidney was removed instead of his diseased right kidney.

Roberts, of Pastoral Way, Tycoch, Swansea, and Goel, of Burnley General Hospital, both deny manslaughter.

Leighton Davies QC, prosecuting, told the jury at Cardiff Crown Court that Roberts said in a statement to police that he could have looked at the Xrays the wrong way round prior to the operation.

He said: ``What Mr Roberts went on to say is this: `I can only assume that when I put the X-ray films up to look at them I inadvertently put up the right kidney on the left side'.

``He appears to be claiming that he put on the X-ray films back to front.''

Mr Davies added the X-ray error would have been picked up if Roberts had checked Mr Reeves's notes and consent form and that Roberts also told police that he did not recall seeing any labels on the X-rays. ``What he was relying on was inadequate X-ray evidence in order to ascertain the side and he was dreadfully wrong in his conclusion,'' said Mr Davies.

The court heard that Roberts, who worked at Ysbyty Gwynedd, Bangor, for many years, could have looked at more than 20 other X-rays relating to Mr Reeves.

The surgeon described in another statement as part of the hospital's internal investigation how his ``heart sank'' when he heard Mr Reeves was not passing urine after the operation.

``Mr Roberts said: `I became concerned lest we had removed the incorrect kidney. I went to the ITU to see Mr Reeves'.

```I came to the conclusion that I could not understand why I had previously decided that a left nephrectomy was correct when a second view made it obvious that the nephrectomy should have been right-sided'.''

Mr Davies said that if Roberts and Goel had done their job properly the ``conflict'' between the correct information on the consent form and notes and incorrect information on an operating list would have been noticed.

He said the mistake could have been picked up by the ``simple and elementary step'' of checking medical notes and that ``to attempt to blame others is, the prosecution, say fatuous''.

The court also heard that Goel, who carried out the surgery, admitted in a police interview that he did not cross-check Mr Reeves' notes with the operation list.

Mr Davies said: ``He admitted that prior to carrying out the operation he did not check the medical notes. He said by the time he came to the theatre Mr Reeves had already been positioned for a left nephrectomy.

``He said `I assumed the cross checks had been done by my boss'. He accepted that he should have cross-checked as well.''

Mr Davies added that Goel revealed that he did not speak to Mr Reeves before the operation during a ward round because the pensioner was sleeping and was a high risk patient.

Mr Davies said: ``When he was asked whether he had looked at the X-rays of Mr Reeves in the theatre he said he looked at them but only from a far distance.''

Questioned during the police interview as to why he did not get closer to the images, Goel declined to answer, Mr Davies said.

The court also heard that Goel had incorrectly written an L for left nephrectomy in the department's operation diary by Mr Reeves' name but that he took this information from an incorrect TCI admission slip written by another doctor.

Mr Davies asked junior doctor Robert Ley, who held a preadmission clinic for Mr Reeves and obtained his consent form: ``Would you expect Mr Roberts and Mr Goel to look at the notes before the operation?''

Dr Ley replied: ``I can't speak for other people but personally I would have done.''

The case continues.


ACCUSED: Surgeon John Gethin Roberts
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Publication:Daily Post (Liverpool, England)
Date:Jun 14, 2002
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