Seven families have instructed solicitors to investigate the care provided to loved ones who died after undergoing heart valve operations at Castle Hill Hospital.
Hudgell Solicitors say all families “tell a similar story of risks and outcomes of surgery not being fully explained” and “a lack of transparency” from Hull University Teaching Hospitals NHS Trust. All patients died after undergoing Transcatheter Aortic Valve Implantation (TAVI) procedures, a minimally invasive heart procedure used to treat narrowed heart valves, at Castle Hill.
Among those being represented are the family of Barbara Fields, 76, who had a TAVI procedure and suffered a stroke, ten minutes after waking from the operation. She died three days later.
Despite concerns first being raised by a clinical director at the Trust five years ago, families say they only learned of the investigations into “poor” TAVI procedures at the hospital through recent media reports, and after a police investigation was launched. The legal firm has revealed the cases it is investigating date back to 2019, the year that TAVI procedures were introduced at the hospital, to August last year, on patients aged 75 to 87.
The death of a patient in August 2024 was five months after the Trust had been presented with the findings of a 2023 Royal College of Physicians (RCP) review into 11 deaths following TAVI procedures, identifying poor levels of care in six cases, one of which was described as “very poor”. The RCP also said there had been a “lack of experience” in the first few years of the department’s operation, after launch in 2019, a time when the death rate was three times the national average, with “issues raised over the process for contacting the coroner’s office”.
‘Time for full transparency and proper accountability’
Neil Hudgell, executive chairman of Hudgell Solicitors, said: “The time has come for full transparency and proper accountability. We are now putting the next steps in motion towards achieving that by requesting full medical records of the patients whose families have come to us seeking answers around their treatment at Castle Hill Hospital and their subsequent deaths, and putting the Trust on notice of intended legal action.
“Over recent weeks we have met and spoken at length with seven families who all tell a similar story of the risks and outcomes of surgery not being fully explained to them, and then a lack of transparency and clarity after their loved ones had passed. They are quite simply furious with the Trust and they want answers.
“Patients suffered bleeding and cardiac arrests during procedures. We have significant concerns about the information given to patients and their families about the risks involved to allow them to make fully informed decisions, and also the details they were provided after they had died.
“There are serious concerns over the accuracy of death certificates, and why some failed to disclose the procedure as a contributing factor. The Coroner was not routinely informed of the deaths either, which is another matter which needs significant investigation.”
‘Red flag’ concerns of clinical director dismissed in 2020
Mr Hudgell represented Dr Thanjavur Bragadeesh, a former clinical director of the cardiac unit, at an employment tribunal against Hull University Teaching Hospitals NHS Trust in 2023. Dr Bragadeesh had been demoted after raising concerns over the death of a patient in 2020 who suffered a significant tear in her femoral artery, a major blood vessel, and died, following a TAVI procedure. His claims of detriment were dismissed and most were ruled out of time.
A separate review in 2021 found the care provided in the very case Dr Bragadeesh had raised concerns over to have been “poor” due to the use of an “inappropriate access site” during the procedure. Mr Hudgell said: “While there was an investigation by the Royal College of Physicians in 2023, it is clear there now needs to be a fully independent review, alongside the ongoing police investigation, into all aspects of the work of the TAVI team, from the care provided to its recording of deaths and its communications with the Coroner.
(Image: Hudgell Solicitors)
“It is clear that reports to date have been based on an incomplete picture, often in the face of missing and withheld key documents. We are happy to cooperate and offer the information we have gathered over the past five years to any ongoing investigation.
“This is a matter which should have been made more public knowledge much earlier, possibly back in 2020 when Dr Bragadeesh first took his concerns to his employers, but certainly at the latest in 2023 when the Royal College of Physicians highlighted poor care in six of 11 cases. That report was not shared outside of the Trust until recent media interest.
“It cannot be right that the Trust has in effect been left to mark its own homework. Dr Bragadeesh deserves credit for putting his head above the parapet and speaking out, and continuing to campaign for complete transparency.
“Instead of listening to him in the interests of patient safety, the Trust either failed to take heed of the red flag he was waving, or simply showed wilful ignorance. The families are extremely grateful for what he has done in ensuring this hugely important matter has not been able to be brushed under the carpet, which the Trust has clearly sought to do.
“Even now, they seek to minimise responsibility by saying these are historic issues and that lessons have been learned. Given the lack of candour to date on the Trust’s part, the families want to satisfy themselves that lessons have indeed been learned, and that patients are safe in the hands of this team.”
NHS Humber Health Partnership said TAVI (Transcatheter Aortic Valve Implantation) is a heart valve treatment undertaken on the oldest and frailest patients with heart valve disease, in whom a team of specialists have recommended keyhole surgery rather than open-heart surgery. The procedure has many benefits for these patients, but like any major procedure on such patients, it is also recognised to carry a significant risk.
All TAVI services across the NHS from the date they each started have undertaken steps to reduce these recognised risks for patients with huge success locally and nationally; however, risks will always remain for these patients who are by definition not fit enough for conventional open-heart surgery, it said. A spokesperson for NHS Humber Health Partnership said: “We have previously written to families who have lost a loved one following TAVI treatment with an invitation to meet and discuss the specific circumstances of their case with us.
“TAVI treatment is undertaken on our oldest and most frail patients with heart valve disease and the recognised risks are discussed with every patient prior to the procedure being carried out. We cannot and would not comment on a specific individual case; however, it is not uncommon for a death certificate to be amended following a discussion with the coroner’s officer or, in more recent times, with the medical examiners’ office before or as they are being issued.”
A spokesperson for Humberside Police told Hull Live last month: “An investigation is in the very early stages in relation to deaths following Transcatheter Aortic Valve Implantation (TAVI) surgery at Castle Hill Hospital. Enquiries are being carried out and at this time, we can confirm no arrests have been made.” The situation has not changed.
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