Hospital boss defends under-fire surgeon amid calls for his suspension
- Credit: Archant
The boss of the surgeon accused of ‘mutilating’ gallbladder patients has backed her colleague amid calls for him to be suspended from work, telling this newspaper she would trust him to operate on her own children.
Professor Erika Denton, medical director of the Norfolk and Norwich University Hospitals Trust, said the two cases reported this week appeared to be tragic but unconnected incidents, and the quality and safety of the surgeon’s work was not in doubt.
It comes amid calls for the suspension of Mr Camilo Valero, 43, who is under investigation by the General Medical Council after three events in five days last January each warranted a ‘root cause analysis’ review.
Paul Tooth, 64, said he had been left ‘mutilated’, and needs tubes out of his abdomen and up his nose to recycling bile, and Lucy Wilson, 33, is now incontinent and in chronic pain after Mr Valero wrongly removed their bile ducts and parts of their livers, rather than just taking out their gallbladders.
Mr Valero has not been suspended and continues to operate at NNUH. He conducts laparoscopic biliary surgery - the specific procedure which led to Mr Tooth and Mrs Wilson’s injuries - under supervision but otherwise operates unsupervised.
The Trust has apologised and admitted liability, and says it has improved its systems, introducing a rule that two surgeons must always be present for any gallbladder surgery which is anticipated to be especially complicated.
Prof Denton told this newspaper: "These two incidents were extremely difficult surgeries each with their own specific complications. We are deeply, sincerely and profoundly sorry for the life-changing injuries Paul Tooth and Lucy Wilson suffered.
"The surgeon is no longer performing this kind of surgery on his own, but after two reviews none of the other aspects of his clinical practice are in any doubt at all.
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"He is an abdominal general surgeon, and he's very good at it. I would have no hesitation letting him operate on my own children."
But both Mr Tooth and Mrs Wilson have called for Mr Valero to be immediately suspended from work pending the outcome of the GMC investigation.
Mrs Wilson added: “How is he still operating?”
Alex Stewart of patients’ welfare group Healthwatch Norfolk said: “This set all sorts of alarm bells ringing regarding patient care quality and safety.
“We’ve written to the chief executive asking a whole series of questions, and we have taken it up with NHS Improvement."
We can also reveal that Mr Valero was reported to his boss six months before the surgeries for misprescribing drugs and having a confrontation with his patient.
Mr Tooth spent six months unsuccessfully trying to get a different surgeon for his operation - and even texted a friend on the morning of his surgery about his fear of going under the knife of a man he described as ‘incompetent’.
In June 2019 Mr Tooth, a retired RAF engineer from mid Norfolk, went into the NNUH for an exploratory procedure. As directed by his GP he had paused taking ticagrelor, his blood thinning medication, six days earlier because it is too dangerous to undergo general anaesthetic while on the medication.
But when Mr Valero visited Mr Tooth’s ward on the day before the procedure he prescribed ticagrelor again.
Mr Tooth said: “I was lying there with sepsis, high temperature, very ill, but I told the nurse ‘I can’t take these’.
“She went off and got him and he stood at the end of my bed and said ‘I understand you don’t want to take your tablets?’
“I said, no, I’m not meant to.
“He said, ‘Are you a doctor?’. He was standing at the end of my bed, pointing his finger, and he said louder ‘are you a doctor?’
“I said no, and he said it again - ‘Are you a doctor?’.
“So I tried to tell him what it said on the packet, and he said “Do you want to self-medicate?’, and he did that three times, jabbing his finger every time.”
After the altercation Mr Tooth took the medication, but the following day was told he could not have the procedure because he had taken them. He then had to stay in hospital an additional week.
Mr Tooth’s son wrote the Trust’s CEO about the incident, and Mr Tooth tried repeatedly over the following six months to change surgeon but was told he could not do so without going to the back of the waiting list.
On the morning of the surgery which was to decimate his quality of life, he wrote to a friend: “Last year I spent 4 weeks an an inpatient at the N&N hospital, 7 days of it were due to the incompetence of the consultant, who unfortunately is today’s surgeon!!”
He went on: “To say I have little confidence in today’s procedure is an understatement.
“Fingers crossed I get through this unscathed.”
He did not. He woke up a few hours later in agony he described as “25 out of 10”, and now has to pump his own bile back into his body for six hours every day through a tube up his nose.
Mr Valero had not just removed the gallbladder as he should have done, he had removed the crucial bile duct linking the liver to the intestines, and part of Mr Tooth’s liver as well.
Ten months after the surgery, and shortly after Mr Tooth contacted the GMC, both patients received a lengthy and personal letter of apology from Mr Valero.
A key paragraph reads: “I know that as a Surgeon, I perhaps give the impression sometimes that I am distant and uncaring. However when carrying out surgery it is crucial to remain objective and keep my emotions in check. This is a skill that surgeons have to learn to be able to do their job. But I want you to know that I will never forget your name. I have replayed that surgery in my head numerous times. I know that this does not make up for my mistake, but I want you to know that I have learnt from my mistake, as I do not take your suffering lightly.”
It goes on: “You may think that doctors just forget and move on, but we don’t. We are human underneath it all and I do this job for the sole purpose of reducing pain and saving lives, not to take lives or cause more pain. I wake up every morning accepting the responsibility of having to work at 100% because I do not get to have a bad day without there being consequences for my patients. I am so sorry that I let you down.”
Apart from an additional paragraph in Paul Tooth’s letter, which apologises for the incident in June 2019, the two letters are identical.
Mrs Wilson, a former NHS prescription clerk, said: “Now we know why the hospital wouldn’t let us get in touch with each other don’t we. Pressing copy and paste isn’t remorse.”
The Trust said that confidentiality meant its internal reports and the review carried out by the Royal College of Surgeons could not be made public due to patient confidentiality and ongoing litigation.
Expert legal sources told this paper there would be no breach of confidentiality as long as specific identifiable personal details were not included in reports.