Hospital slated over transplant deaths

St George's Hospital faces strong criticism

The deaths of a series of transplant patients have led to damning criticisms of a London hospital.

The Commission for Health Improvement (CHI) was called in to investigate heart and lung transplants at St George's Hospital, in Tooting.

It concluded that many patients had been picked for transplant operations even though their physical condition should have ruled them out.

And it published comments from staff who spoke of "unbearable squalor", animal faeces in corridors, cockroaches and rodents seen in the unit and rat traps in operating theatres.

The hospital had an 80% death rate amongst heart and lung transplant patients during the ten months of the investigation - five times the national average.

Units aim for an 80% survival rate a year after transplant.

But 10 patients out of 14 died in just 10 months at St George's.

The commission's report, published on Wednesday, detailed other failings at the hospital including "unclear criteria for transplant" and poor record keeping.

The wrong patients were given the wrong operations

Peter Homa, CHI

There were also too few post mortems carried out, a lack of surgical leadership, and a failure to tell hospital bosses of the problems as they arose.

Peter Homa, chief executive of CHI, said: "The wrong patients were given the wrong operations by a team whose leadership had broken down and failed to follow their own rules about which patients should receive heart transplants."

CHI has said there should be clear national standards for such centres including for assessment for transplants.

Transplant record

The hospital started doing heart transplants in 1986. By 1998 the transplant programme was so successful that at one point it went 12 months without a single death.

But eight patients out of the 11 who underwent heart transplants at the hospital between December 1999 and September 2000 died within 30 days of surgery.

In the same period two lung transplant patients out of a total of three also died.

The hospital suspended the transplant programme and Health Secretary Alan Milburn ordered CHI to investigate.

CHI said six who had died had medical conditions which meant they were "too high risk" for their transplants.

Two would not have been accepted at other units. Both died.

Three others who died had kidney problems which, under St George's own criteria, meant they were unsuitable for a heart transplant.

Mr Homa said many people shared responsibility for the failings.

Family reaction

Alton Rose, 57, underwent a heart transplant at St George's in February 2000 after waiting for more than a year.

What is hugely disappointing is that we have now discovered that five or six people had died in a row previously to my father's operation

Jason Rose

The initial transplant operation was successful, but he contracted MRSA following surgery, and died after two further operations to clean up wounds.

Before the operation, his son Jason was told his father had a 90% chance of surviving the operation.

He told the BBC the family felt they should have known the hospital's record prior to the operation - and if they had, they may not have gone ahead. "What is hugely disappointing is that we have now discovered that five or six people had died in a row previously to my father's operation.

St George's has one of the smallest heart and lung transplant units in the country and performs no more than a dozen heart transplants a year.

The unit is due to close as part of a Department of Health plan to concentrate heart and lung transplants at four or five centres of excellence.

A report into such services will be published at the end of September.

Professor Paul Jones, medical director of St George's, said: "The CHI investigation has recognised the difficulty in distinguishing between a run of poor outcomes which may occur by chance and those that indicate there may be an underlying problem with the clinical service.

"There are no easy solutions."