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Urologists cleared of manslaughter now face GMC
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     Two urologists who inadvertently removed a patient抯 only good kidney are facing charges of serious professional misconduct before the General Medical Council, 18 months after being acquitted of manslaughter in the case (BMJ 2002;325:9).

    Consultant urologist John Roberts supervised an operation in which registrar Mahesh Goel removed a healthy left kidney from Graham Reeves, aged 69, leaving only a chronically diseased right kidney. The mistake was discovered two hours later, but by then the good kidney had been immersed in sterilising solution.

    Mr Roberts later attempted to place a tube in the diseased kidney, but Mr Reeves developed septicaemia. His remaining kidney was removed in a third operation, and he was put on dialysis. He died five weeks after the botched operation, in March 2000.

    Questioned by police, Mr Roberts said he might have looked at the x ray picture backwards. He and Dr Goel were charged with manslaughter and appeared at Cardiff Crown Court in June 2002. The case collapsed, however, when a prosecution pathologist, Andrew Davison, said in evidence that myocardial infarctions suffered by Mr Reeves on the day of the operation and the day of his death could have happened even if the correct kidney had been removed. The prosecutor chose to offer no further evidence, and the judge directed the jury to acquit.

    The prosecutor in the manslaughter case, Leighton Davies QC, is now presenting the GMC抯 case against the two doctors. Accusing them of "abject, needless, and inexcusable" negligence, he told the hearing that the case demanded more than just compensation.

    Both doctors deny that their actions amounted to serious professional misconduct. While Mr Roberts is attending the hearing of the professional conduct committee, Dr Goel has left for India because of pressing family reasons, the GMC heard.

    Mr Roberts抯 counsel, Alan Jenkins, said his client would admit all but one of the factual allegations when the charges were read. He also applied for the two doctors?cases to be heard separately, saying Dr Goel sent the GMC an email from India last week that is prejudicial to Mr Roberts抯 defence. But committee chairman Dr Chitra Bharucha said a joint hearing would not be unfair to Mr Roberts.

    Mr Roberts has been suspended on full pay by his employer, Camarthenshire NHS Trust, since the operation. Dr Goel no longer works there.

    The trust has instituted new procedures whereby the operation list must be checked against the consent form. In Mr Reeves抯 case, the consent form and medical notes named the correct kidney, but the hospital admittance slip named the wrong one, and that mistake was transferred to the operating list. In the manslaughter trial the jury heard that a medical student observing the operation had suggested that Dr Goel was removing the incorrect kidney, only to be told she was wrong.(London Owen Dyer)