This report originally appeared on October 8, 2012
A SURGEON banned from operating at one of Melbourne’s top private hospitals due to patient safety concerns is free to continue operating in other hospitals
His averages give clear cause for concern
Cabrini Health stopped general surgeon Adam Skidmore performing colorectal surgery last year – but the ban does not extend to other hospitals.
Mr Skidmore strongly denies any wrongdoing.
Cabrini Health is also seeking to extend the ban on Mr Skidmore to exclude him from performing major upper gastrointestinal (GI) surgery.
That decision has been delayed after Mr Skidmore was granted a Supreme Court injunction to defer the decision until next month.
But despite Cabrini’s move, which the hospital said was made “in the interests of patient safety”, Mr Skidmore is still working unrestricted at the Epworth, Linacre Private, Sandringham and Frankston hospitals.
None of the hospitals or Mr Skidmore would comment when contacted by the Herald Sun while the case was before the court.
But patient advocates say hospitals should be forced to make restrictions public, while Health Services Commissioner Beth Wilson said doctors should be obliged to reveal work bans to all their employers.
Court documents show Cabrini’s executive director of medical services, Associate Professor Simon Woods, told Mr Skidmore on April 5 that a review of his patients at Malvern had raised concerns.
“Unless I can be persuaded otherwise I believe that the appropriate course of action is to limit your clinical privileges to exclude major upper GI surgery,” he said.
Associate Prof Woods cited four patients of particular concern, including a woman who had a gastric band removed and ended up in intensive care and in hospital for 38 days.
“This is a highly unusual outcome for a procedure normally characterised by an overnight stay,” he said.
Mr Skidmore voluntarily suspended all his lists at Cabrini from April 10.
He asked for a review of the decision and complained he had not been afforded procedural fairness or time to defend “these serious allegations”.
Mr Skidmore argued his data appeared skewed because he dealt with his most serious and complex cases at Cabrini as it was the only hospital available to him with an intensive care unit.
“Looking at length of stay alone … is an unhelpful indicator of the performance of the surgeon,” his lawyers wrote to the hospital.
The court file contains the terms of reference for the clinical review which states: “Mr Skidmore’s case work at Malvern continues to be associated with a long length of stay.”
It said that, in 2 1/2 years, 11 of Mr Skidmore’s patients had required tracheostomy or ventilation for more than 96 hours.
“This is only exceeded by two cardiothoracic surgeons,” the document said.
“The next highest in terms of GI surgeons is four patients.”
For surgery on stomach, duodenum and oesophagus cancers it claimed Mr Skidmore’s patients had an average stay seven days longer than the hospital’s busiest surgeon.
A letter to Mr Skidmore before the court said the hospital needed to “put the safety and quality of patient care above all other considerations” and would restrict his practice “in the interests of patient safety”.
The operators of Epworth and Linacre Hospitals confirmed Mr Skidmore is under no restrictions.
Frankston and Sandringham hospitals would not comment on the surgeon’s operating privileges, but Alfred Health – which runs Sandringham – said no major upper gastrointestinal surgery took place there.
Australian Patients Association chief Stephen Mason said a doctor’s track record should be public so patients could make informed decisions about treatment.