Brain op patients at Birmingham NHS trust suffered unnecessarily - report

Keith Bastable had deep brain stimulation surgery in Birmingham and suffered side effects including slurred speech

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.

There were unacceptable delays responding to patient concerns, the independent review also said.

UHB said it was "deeply sorry" and improvements were being made.

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

A spokesperson for UHB said they were "deeply sorry" and vital improvements had been made.

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 areas of the brain and sending electrical pulses to alter activity.

Electrodes have to be put in the correct place or within 1-2mm, otherwise 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.

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

Never switched on

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.

They were removed and new ones recently 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.

The procedure involves implanting electrodes into areas of the brain and sending electrical pulses to them

"You've got something wrong, it's a major operation and you just have the feeling of being abandoned and it's terrible," he said.

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

It found 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.

Mr Bastable said he was deeply indebted to this nurse for the help she had given him.

The BBC understands 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.

Solicitor Michael Portman-Hann said some of his clients were "in a really bad way" after their surgery

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 BBC has contacted Ms White for a comment.

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."

Solicitor Michael Portman-Hann represents four patients and said some of his clients, who have dystonia, were badly affected by their procedures.

"Their speech is affected, their motor skills are affected, they are wholly dependent on others and they are in a really bad way," he added.

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

A spokesperson for UHB 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 a review of about another 90 patients was continuing, UHB said.