Surgeon 'ordered to stop work after turning his back on bleeding patient'

A surgeon accused of botching operations that left five women dead and seven more injured was told to stop work after an 86-year-old patient lost huge amounts of blood during cancer surgery, the General Medical Council was told yesterday.

The second day of the hearing against Steven Walker, a consultant general surgeon at the Victoria Hospital in Blackpool, was told the patient, a woman who had angina, suffered two heart attacks during the operation in December 1998 and died three months later.

After the operation, the 16 anaesthetists at the hospital withdrew their support for Mr Walker. Dr Peter Hayes, the medical director who had appointed Mr Walker in April 1995, said: "I was told that it was a unanimous decision. I thought we had to investigate it and, in a sense, we had been investigating it already. But this brought it to a head."

Mr Walker had earlier been ordered to stop doing liver or breast reconstruction surgery. Four days after the anaesthetists withdrew their support, Dr Hayes met Mr Walker and his notes of that meeting were read out to the hearing. In the notes, Dr Hayes said staff had been "dismayed by what appeared to be a cavalier approach". They had raised concerns about blood loss and an "unwillingness to communicate with anaesthetists".

The notes said Mr Walker had explained that he had tried to do "innovative things to move the surgery forward" but admitted he had been "somewhat dismissive in his eagerness to put Blackpool on the map".

Dr Helen Matheson, a consultant anaesthetist, told the GMC how Mr Walker turned his back on a heavily bleeding patient to supervise photography of the liver he had just removed. The 70-year-old woman, referred to as DM, had already lost at least four litres of blood during the operation on 18 December 1995. She said the bleeding was so bad that staff had difficulty transfusing enough to replace it. Eventually the patient needed 17 litres.

Dr Matheson went on: "I was astonished. At the time the patient was still bleeding and, in my experience as an anaesthetist, it is unusual for a surgeon to turn his back on a patient. The liver was out of the body, it was placed on green towels on a trolley for a good view. He supervised the angles he wanted the liver sample to be taken from. The bleeding actually was quite severe and eventually it took all three of us to try and keep up."

Earlier, she described her concerns about Mr Walker's approach to surgery, saying he often turned up late for operations and his patients regularly bled heavily. She said that she was most troubled by his attempts at removing cancer of the rectum, known as perineal resection.

"It was the blood loss. The bleeding used to start and, with Mr Walker, it was a rare occasion when it did not bleed heavily. There was a minimum blood loss of eight units [half a litre]. I had two cases where he lost 30 units, which is a lot of blood. I suspected he had gone too deep into the patient and damaged the veins, which are very difficult to stop bleeding."

Dr Matheson said that she eventually refused to work with Mr Walker in April 1997. She had tried to withdraw a year earlier, saying in a letter that long operations tired her. Asked what she meant, she told the hearing: "You cannot write a letter to a surgeon and tell him he is incompetent."

Mr Walker was suspended on full pay after an inquest into the death of Margaret Wilson, 62, on 8 January 1999. He is charged with serious professional misconduct in relation to his treatment of 12 patients. He denies the charge.

The hearing continues.