Wednesday, February 28, 2007

The Plight of the Whistleblower in the UK Illustrated: The Case of the Missing Brain Tissue

We recently discussed the plight of health care whistle-blowers in the US.

From the Guardian (UK), yet another story of the fate that awaits health care whistleblowers in the UK,

Allegations that patients at a Liverpool hospital had parts of their brains removed for medical research during neurosurgery without consenting to the procedure, can be revealed today.

The University of Liverpool is accused of covering up the procedures, alleged to have resulted in at least 12 patients having brain parts removed. Its medical school, which was embroiled in the Alder Hey organ retention scandal, is facing claims that it tried to silence a senior hospital whistleblower who raised the alarm about alleged misconduct by a leading brain surgeon.

Until 2005, the university employed Professor Peter Warnke, who was chair of neurosurgery and operated at the Walton Centre hospital. In 2002, allegations surfaced that Warnke had been taking tissue from the brains of living and dead patients at the Walton Centre without obtaining consent.

Warnke is alleged to have taken samples of brain tissue during surgery, freezing them in liquid nitrogen, marking them with a black dot and sending them to Genpat 77, a private biotechnology company in Germany. The samples were used to test a new treatment for brain diseases involving an antibody called TIRC 7. Warnke was a joint owner of the patent taken out on TIRC 7, along with the founder of Genpat 77. Warnke has always vigorously contested claims of wrongdoing. The Observer has established that, at around the same period, Warnke attempted to obtain tonsils that had been removed from patients at the Aintree Hospital in Liverpool for use in associated research. Elizabeth Preston, the hospital's medical director, said: 'I can confirm that Professor Warnke did ask for tonsils, but a nurse questioned whether he had ethical consent. He was refused and as far as I am aware he never had access to any tissues from Aintree.'

Both the nurse and a surgical colleague of Warnke's raised questions about his conduct with Dr Marco Rossi, who then chaired the regional ethics committee set up to improve research standards after the Alder Hey scandal, where hundreds of children's organs were retained without parents' consent. Rossi, who was a consultant neuropathologist at the Walton Centre, claims that when he began investigating the allegations against Warnke he suffered threats from senior staff at the university's medical school. He claims that the level of intimidation made him ill and he was unable to continue his work.

Rossi is suing the Walton Centre, the University of Liverpool and the strategic regional health authority for breach of contract. He argues that as a senior employee and whistleblower they should have protected him, and claims that senior medical school staff were more concerned in covering up a potential scandal. He alleges that he was subjected to a campaign of bullying and harassment in an attempt to get him to withdraw his accusations. In court, the university has argued that Rossi's allegations about Warnke were irrelevant and should not be heard.

Last week, a judge rejected this and ordered the university to hand over its dossier on the affair, including an internal investigation into Warnke's conduct. The court has heard that Rossi alleges that dozens of ethical consent forms used by Warnke for his research were either incomplete or inaccurate.

Although Rossi left in 2002, no action was taken against Warnke until April 2005, hours after Rossi launched his legal action. Warnke was suspended and later resigned. In November 2006 he was appointed chief of neurosurgery at the Beth Israel hospital in Boston, part of Harvard Medical School.

The British law firm Weightmans, which is acting for Warnke, issued a statement to The Observer rejecting Rossi's claims. It said the allegations against Warnke were 'brought by a disgruntled former employee and a colleague of our client'.

Also see the BBC coverage here.

As in the recent US case which we discussed, note that it was the person who came to the aid of the original whistle-blowers who allegedly found himself in even hotter water than they did.

It seems that many types of health care organizations in many countries lack a mechanism to give whistle-blowers a fair hearing, investigate their complaints, and protect them from the wrath of those they accuse, and from institutional leadership which fears those who would rock the boat, even if it is in an effort to alter course away from the iceberg.


Anonymous said...

And now we have this guy over here, really bolsters my faith in our medical system.

Steve Lucas

Anonymous said...

Obviously I can't judge the specifics of this case from the reports, but as a pathologist I can say the issue of to whom surgically or autopsied removed tissue "belongs" is a longstanding thorn. Our hospital's surgical and autopsy consent forms had boilerplate language giving possession of these tissues to the hospital. It had its usefulness in case one wished to refer back to the tissue if a retrospective problem arose, and sometimes we would use certain tumor tissue as controls for certain special stains, for instance.
The issue of giving the tissue to other companies for research also arose at our institution and was a thorny one. Removed tonsils are no good to anyone, but researchers liked them to study their large numbers of lymphocytes. Should the patients be compensated when the tissue would otherwise be incinerated? I do not presume to judge, I am just providing another perspective.
However, as I mentioned above, these possibilities were mentioned in the preoperative consent forms and therefore consent was given if the forms were signed. Maybe that did not occur in the UK case.

Anonymous said...

freemasons in the nhs protect the consultants.
medical protection society and medical defence union protect the name of medicine , cover up bad practice.

law firms collude with mps and mdu, contaminate the statement of those who it is charged to defend. law firms win win...the circle goes on.... but patient harm is covered up.....clinicians go on harming...register masonic drs, lawyers, judges,

Anonymous said...

Anonymous above is right- that is the sickening truth - the secret and deliberately-deceptive collusion between the medical boards, the Medical Protection Society/ Medical Defence Union, corrupt expert witnesses and law firms, who, because of tort medical malpractice liability reform, no longer actually represent injured plaintiffs but follow a system that just profiteers out of them. The police who should be laying criminal charges in intentional battery cases are fobbing patients off to the medical boards, just for them to 'minimise or limit' the case. This means the patient is deceptively planted with falsified records and manipulated xrays so that dishonourable judges can complete the sham and find the doctors not guilty. The patient is left with all the costs and no compensation. Freemasons? It can't be a coincidence that Tony MASON is the head of the Medical Protection Society!!