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Brain-dead operated on illegally

Doctor performed most of the surgeries on homeless patients
Oct 10,2019
A neurosurgeon at the National Medical Center is suspected of conducting unauthorized brain surgeries, which may have led to the deaths of dozens of patients, a lawmaker said Tuesday during an inspection of the state-run hospital.

“Tens of deaths after brain surgeries are attributed to one particular doctor,” said Rep. Kim Soon-rye of the Liberty Korea Party on Tuesday during the National Assembly’s inspection of the National Medical Center.

According to the data collected by her office, problems were discovered with 38 patients who were operated on by a neurosurgeon of the medical center between 2015 and 2018. According to the lawmaker, 28 patients died within three days of the operations.

“Most of the patients were homeless people, and 22 of them were actually brain-dead or near brain-dead at the time of the surgeries,” an aide to Rep. Kim said. “Consent forms showed that 10 surgeries were authorized by using patients’ thumbprints, suspected to have been collected while they were unconscious. And the doctor did not order postoperative CT (computed tomography) scans on 17 patients.”

Performing the surgeries using the patients’ thumbprints as consent is against the law, a professor of neurosurgery at a national university hospital said. “There can be some exceptions, but the principle is that we need the patient’s signature,” he said.

“If a patient is brain-dead for sure, performing a surgery is meaningless,” said the professor. “It is a routine procedure to order a postoperative CT scan of the brain after the surgery, but he didn’t. That means the patient was irrecoverable.”

According to the lawmaker, the doctor performed surgeries on five different patients that each took less than one hour. The average time span for brain surgery is about five to six hours.

Kim’s office said the doctor spent one to two hours each on 12 patients and two to three hours on four others.

On an emergency patient who arrived at the hospital in August 2016, the doctor performed a late night surgery and used a new bypass technique. Four minutes after the operation, he posted a photo of the patient’s open skull on his social network account. According to Kim’s office, the patient died 34 hours after the surgery.

“The doctor appeared to have practiced his surgical skills on patients,” said an official well-informed about the affairs of the National Medical Center. “Other doctors tried to stop him, but he went ahead and performed surgeries in some cases. Because many of his patients did not have families or were poor, no one really raised an issue.”

Insisting that there was no ethical breach for his surgical operations, the doctor said 38 cases out of hundreds were picked out and scrutinized. “But it was my fault that I posted the photo of a patient’s brain without consent,” he said.

The doctor defended his actions. “We have many urgent care patients, so we have no luxury to see who is brain-dead or not,” he said. “We had to perform surgery first. Treatments won’t be different whether the patient is homeless or has a family or not.”

“When the patient’s family is not contacted despite urgent conditions, we just have to perform the surgery using their thumbprint on a consent form,” he said. “And the surgery time is naturally short, because we have to rush when a patient is critical.”

The case was revealed when a whistle-blower made a report to the Anti-corruption & Civil Rights Commission in August this year and the commission informed the Ministry of Health and Welfare of the case last month.

Rep. Kim argued that Chung Ki-hyun, president and CEO of the National Medical Center, had been aware of the scandalous practice of the doctor. “A doctors’ organization informed Chung about the case in May, but he dismissed it as slander against the doctor,” Kim said. “And the neurosurgeon is still actively practicing medicine at the hospital.”

The whistle-blower then filed a petition to the prosecution to investigate Chung early this month for suspected dereliction of duty.

At the National Assembly inspection on Tuesday, Chung said the ministry, a direct supervisor of the hospital, did not order any investigation. “Because we have limits to conduct our own internal probe, we asked for outside expert help,” he said.

“An investigation must take place to thoroughly probe whether the patients actually required open-skull brain surgeries and if the doctor performed proper surgeries and offered proper care to the patients after the operations,” said Professor Kim So-yoon, director of Medical Law and Ethics Division of the Yonsei University’s College of Medicine.

BY JEONG JONG-HUN [ser.myoja@joongang.co.kr]