Surgeon accused of manslaughter over death of two patients

A surgeon has gone on trial charged with the manslaughter of two women who died during abdominal operations.

A surgeon has gone on trial charged with the manslaughter of two women who died during abdominal operations.

One of Steven Walker's patients had her bowel perforated during an exploratory procedure that should never have been done: the other died after severe bleeding following an operation, the Old Bailey was told yesterday.

After the deaths, the operations register disappeared from theatre two at the hospital and was found some time later in the loft of the doctor's home, the court was told.

Mr Walker, 47, a former consultant at the Royal Victoria Hospital, Blackpool, denies the manslaughter of Jean Robinson, 66, and Dorothy McPhee, 71, in 1995. He also denies stealing the operations register from the hospital and perverting the course of justice by taking it.

He had worked as a surgeon for 12 years before being appointed a consultant in Blackpool, specialising in abdominal operations, in April 1995. Six months later, he performed a colonoscopy, in which a flexible telescope is used to examine the colon, on Mrs Robinson, who suffered from bowel disease.

She had been referred to Mr Walker to decide whether a benign polyp - a non-cancerous growth - in her colon should be removed. But during the colonoscopy Mrs Robinson's bowel was perforated and she had to have an emergency operation. She had been told that she would be able to go home the same day, but she never left intensive care and required further surgery before her death three weeks later in November 1995.

"The procedure should never, in all the circumstances, have taken place," said Rebecca Poulet, QC, for the prosecution.

The following month Ms McPhee bled to death after an operation to remove a cancerous tumour on her liver.

A year earlier, she had had a similar operation by another surgeon which had proved successful. But when Mr Walker operated Ms McPhee suffered "massive and catastrophic blood loss" and died shortly afterwards. Ms Poulet said: "It was an operation that should never have taken place in Mr Walker's hands."

Describing the regulatory environment in the NHS at the time, Ms Poulet said: "The consultant was left to make his own decisions regarding the management of his patients and was not questioned to any great extent by his colleagues.

"That was the tradition at the time. There was no structured procedure for overseeing a new general surgeon."

Mr Walker was suspended in January 1999 and appeared before a disciplinary hearing of the General Medical Council in October 2001. After the hearing, the Lancashire coroner, who had certified both deaths as natural causes at the time, referred the matter to the police.

In February 2002, the police found the operations register during a search of the loft at Mr Walker's home, the court heard. The register was supposed to remain in the theatre and should have been available to senior members of the hospital trust as a record of Mr Walker's operations after his suspension. It should "certainly never" have left hospital property, Ms Poulet said.

She told the jury: "Mr Walker caused the death of these two patients by his grossly negligent treatment of them. His standard of care fell so far short of what should be expected of a reasonably competent consultant general surgeon of Mr Walker's level of training and experience. The patient is entitled to expect that all doctors should recognise the limit to their professional competence."

The case continues.