Brain operation patients at NHS trust suffered unnecessarily, report

Patients who underwent brain operations at a West Midlands NHS trust suffered unnecessarily because of poor surgical outcomes, a report has found.

More than 150 deep brain stimulation surgery cases at University Hospitals Birmingham (UHB) trust are now being investigated and surgery is suspended.

The independent review also said that there were were unacceptable delays in responding to patient concerns.

The investigation recommended indefinitely suspending the service at the NHS trust until it is safer.

Deep brain stimulation (DBS) for movement disorders is used on patients with conditions including Parkinson's disease and dystonia, where medication is becoming less effective.

The surgery involves implanting electrodes into parts of the brain and sending electrical pulses to alter activity.

The electrodes have to be put in the correct place or within 1-2mm or they can damage a person's speech and balance.

The independent review, carried out by medics from King's College Hospital, was ordered by UHB after a serious incident investigation of a patient who underwent DBS for Parkinson's disease.

Medics examined 22 cases involving 21 patients between 2017 and 2019 and found in only three of these the electrodes were placed in a good position. Five were usable and 13 were ineffective.

One of those 21 people, Keith Bastable, 74, from Brierley Hill, had DBS in May 2019 for his Parkinson's disease and the review found his probes were placed too far away to be acceptable.

Due to the misplacement, one was never switched on and the other probe had to be switched off as he suffered slurred speech and other side effects. The probes were were removed and new ones reinserted in Oxford after he was referred to a hospital trust there.

Mr Bastable said he had felt abandoned in the time it had taken to get resolved. He said: "You've got something wrong, it's a major operation and you just have the feeling of being abandoned and it's terrible.”

The external review stated a specialist nurse "had caused waves within the DBS team" in her desperation to help patients.

The review found that, although it was unwise to refer patients out of the unit without discussing it with the consultant, the lack of support for the nurse was unacceptable and Mr Bastable said he was deeply indebted to this nurse for the help she had given him.

The BBC said that it understood a second Parkinson's patient had electrodes inserted twice by UHB, in 2017 and 2019, with the first causing side effects and the second ones being unusable.

One surgeon, Anwen White, who was involved in the brain surgery for Pakistani schoolgirl Malala Yousafzai in 2012, was responsible for most of the 22 operations.

The review stated Ms White had been trained by a senior neurosurgeon who made similar mistakes and it was not surprising she had difficulties. It recommended she learn from other units.

The report said: "It is fair to draw the conclusion that the problem was with the technique of an individual surgeon. There is evidence from multiple sources of a significant problem in her surgical technique."

The review concluded DBS surgery for movement disorders should be restarted only once several conditions for a safe reopening of the service had been met.

A UHB spokesperson said they were "deeply sorry" at not providing high quality healthcare for patients and vital improvements had been made.

Following the initial review, 40 other patients were contacted and received external second opinions, while UHB said a review of about another 90 patients was continuing.