A leading weight-loss surgeon who also acted as an expert in cases of clinical negligence has been struck off after committing a string of what's been described as "deplorable" mistakes in the care of his patients. Dugal Heath, 59, a Fellow at the Royal College of Surgeons, was criticised by a medical tribunal for his clinical performance relating to six patients who died in two years.
Grieving relatives told IBTimes UK this week of their relief after hearing the Medical Practitioners Tribunal Service's (MPTS) decision to remove Heath from the medical register. The parents of one young mother who passed away said: "It won't bring our daughter back and will never make it easier for our granddaughter, who has lost her mum, but we're glad he was struck off. He won't be able to do it to anyone else."
Heath's errors – described in a MPTS hearing last month as "extraordinary" and doing "irremediable" damage – included subjecting patients to the wrong procedures, accidentally damaging internal organs during surgery and even accusing a patient who starved for months on end of making up her illness.
One individual who went in for a routine gastric bypass came out with a damaged liver, an injured colon and a torn bowel due to Heath's "rough" handling and poor use of medical instruments. The patient died a week later.
Another died having suffered heavy internal bleeding while under Heath's knife, with the patient closed up and left haemorrhaging in the hospital ward. A third effectively starved for months on end after a blockage in her intestine was not found, and she was told by Heath that her symptoms were "psychological".
There is no suggestion that Heath was directly responsible for the deaths of the six patients the MPTS investigated. The tribunal made no ruling linking deaths and errors made, while inquest reports seen by IBTimes UK into two of those who passed away simply stated they died of "complications".
But the knowledge that multiple serious clinical mistakes were made in the run-up to their deaths has left grieving families furious that their loved ones weren't given the care they deserved.
The Whittington NHS Hospital in north London – where Heath was employed as a senior consultant – this week apologised to those affected by Heath's misconduct, saying it was "truly sorry". It now faces a string of potentially costly legal cases, with relatives of Heath's former patients alleging a failure in the duty of care.
At least four civil cases are being taken to the High Court, but legal experts told IBTimes UK they expected far more to sue the hospital. A spokesperson for the Whittington admitted last week that the number of lawsuits "is changing", with the hospital facing the fallout of what could be one of the worst weight-loss surgery disasters in the country.
The MPTS found that Heath had committed a series of errors in the care of all six patients that it investigated. Its decision to strike him off the medical register – which comes into permanent effect at the end of this week, pending any appeal – saw the medical regulator express astonishment that a surgeon so senior could make such grave mistakes.
Heath was reaching the end of what appears to be an unblemished 30-year career as a gastro-intestinal specialist. He gave lectures teaching other doctors how to avoid complications during gastric bypass operations and regularly published papers in leading medical journals. He even worked as a mediator and legal expert in claims of clinical negligence, and was a key adviser to a 2012 study into whether the care given to weight loss patients was safe.
The MPTS report into his conduct said: "The extent of his deficient professional performance is extraordinary given his seniority and experience... they demonstrate patterns of behaviour and poor performance which the Tribunal considered fellow practitioners would find deplorable."
Heath was one of two surgeons to lead the Whittington's new bariatric clinic between 2007 and 2012. His team, which made up the obesity service for north London, had become a last resort for those desperate to lose weight.
During his five years at the hospital, the NHS had seen an explosion in demand for gastric-bypass operations, which sees the size of the stomach cut down to make patients feel full quicker. Between 2006 and 2011, figures from the NHS Information Centre showed there had been a tenfold increased in weight-loss operations, from to 858 to 8,794 procedures.
The operations were meant to turn lives around, and had been pitched to men and women struggling with obesity as a largely safe and effective way of shedding the pounds. But there were concerns over whether surgeons entering the now-lucrative weight-loss industry had enough experience to carry out procedures on medically vulnerable patients.
Concerns about the Whittington's bariatric unit first arose following the death of Kim Blake, a mother-of-one from Camden, north London, who had seen her weight balloon after suffering a back injury at work. The 33-year-old, who was registered blind and became wheelchair-bound, suffered depression and was hoping that surgery would give her a "fresh start". But a gastric bypass carried out by Heath at the Whittington in January 2010 was followed by a painful death a little less than a year later.
In total, Heath was found by the MPTS to have made more than a dozen clinical errors while caring for Blake. Her parents, who now look after Kim's 12-year-old daughter, Chloe, at their home in Camden, north London, fought back tears as they spoke to IBTimes UK of their loss, describing her as "a great daughter".
Heath carried on working at the Whittington for two more years after Kim's death. Over that period, five more patients investigated by the MPTS died following his care.
This included Jane White from Romford, Essex, who slimmed down to 22st after another mother sold the idea of a gastric bypass. Heath operated on the 39-year-old in September 2012. She died eight days later.
Heath's conduct during her care was again found by the MPTS to be seriously deficient in more than a dozen areas. This included discharging her three days after her operation, despite having a dilated intestine and being violently sick.
Other errors by Heath went beyond the bariatric service. This included subjecting an 84-year-old patient with kidney failure to the wrong procedure and failing to look after a colleague's seriously ill patient. Both died.
Heath was sacked from the Whittington in December 2012 when concerns were eventually raised over the mortality rates of his patients. His errors were so serious, four separate medical bodies carried out investigations into his performance. They were unanimously critical.
'A senior surgeon lacking basic skills'
To the shock of his former patients and the grieving families of those who died under his care, Heath did not turn up to the tribunal into his conduct.
IBTimes UK recently visited his semi-detached home in the leafy suburb of Kingston-upon-Thames, where he lives with his wife and two dogs. Neighbours were complimentary of the couple but said they "kept themselves to themselves". With a discarded surgical glove lying in his drive, Heath opened the door wearing his dressing gown. He refused to comment when asked if he had a message for the families of his former patients, instead slamming the door on us.
The MPTS heard evidence that Heath's "communication skills were lacking", adding: "Sometimes, he did not work with his colleagues in the best interests of patients. The tribunal has seen no evidence of remediation or reflection by Dr Heath about the connection between the deaths of all six patients and his actions or omissions." The MPTS heard evidence Heath had "very little insight into his actions... and a tendency to blame others".
While the MPTS tribunal focused on the care given to six patients, IBTimes UK spoke to another patient who has suffered numerous complications since undergoing a gastric bypass by Heath in August 2011.
Winifred Zekaj, 43, from north London, has since been in and out of surgery several times. She is now taking the Whittington to the High Court, alleging a failure in the duty of care. She said: "I have been living in constant pain since my first operation. I can't sleep, I'm on pain medication and I can't eat or drink properly. It's been horrible."
Her case has raised questions over just how many patients at the Whittington may have been subject to botched weight-loss surgeries. The MPTS tribunal heard evidence not only of Heath's incompetence but of "apparent problems in the bariatric service at Whittington NHS Health Trust as a whole".
A spokesperson for the hospital said the Whittington had now brought in changes to training and emergency care provision since problems arose.
A statement from the Whittington said: "We are aware of the decision of the Medical Practitioners Tribunal Service (MPTS) to remove Mr Heath from the General Medical Council's (GMC) list of medical practitioners.
"Mr Heath has been excluded from working at Whittington Health since December 2012 while investigations were carried out into his practice. We informed the GMC about our decision to exclude Mr Heath and have cooperated fully with their investigation.
"The safety of our patients remains our first priority. Since Mr Heath's exclusion we have worked closely with our clinical staff to improve our bariatric service and ensure it delivers the highest standards of patient safety and care. Changes to practice include specialist bariatric training for medical and nursing staff, a 24 hour on site senior doctor presence to assess and provide immediate care in an emergency and escalation plans directly to a consultant for bariatric patients.
"We are truly sorry to the families and patients affected."