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Medical Tribunal Starts for Doctor Who Left Patients with 'Life-Changing' Injuries

Editor's note: The headline has been changed to reflect this was a medical tribunal, not a trial.

A surgeon performed two botched gallbladder operations that left patients with life-changing injuries, a medical tribunal heard. Dr Camilo Valero has admitted a number of failings relating to the patients' care after they underwent procedures at Norfolk and Norwich University Hospital in January 2020.

He is further accused of failing provide good clinical care to a third patient in March 2021 by "inappropriately" discharging him from hospital without adequate assessment.

A Medical Practitioners Tribunal Service (MPTS) hearing in Manchester heard how Dr Valero, who qualified at the Universidad Industrial de Santander in Columbia in 2002, carried out a laparoscopic cholecystectomy on two patients, referred to as Patient A and Patient C.

Patient Left with 'Life-Changing Injuries'

Scans had revealed Patient A, who was 32 at the time, had gall stones and cholestasis so the decision was taken that she needed surgery to remove her gallbladder.

But Bob Sastry, for the GMC, told the tribunal that she was left with "life-changing injuries" after Dr Valero mistakenly severed her bile duct during the gallbladder procedure. 

Dr Valero failed to "adequately dissect the lower third of the gallbladder from the liver bed" and "misinterpreted the anatomy", he said. Patient A suffered a "high volume" bile leak, which went unidentified, said Mr Sastry, and the "full extent" of the damage was "not ascertained in a timely fashion" by the surgeon. Dr Valero also "inappropriately" applied a clip to control the bile, without ascertaining where it as coming from.

The procedure left Patient A sick, in constant pain, and drifting in and out of consciousness but it's alleged Dr Valero failed to carry out further investigations, which included a tubogram and/or a return to theatre. The patient was later transferred to Addenbrooke’s Hospital, in Cambridge, for corrective surgery that took 10.5 hours, the tribunal heard, but she has continued to suffer health complications.

Patient A, who attended the tribunal, was told by Charles Foster, counsel for the doctor, that he wished to apologise and had "got in wrong" with her surgery.

"He recognises that you had a terrible time and is very sorry for that," Mr Foster said.

A tearful Patient A then had to be helped out of the tribunal room.

Doctor Admits Injuries were 'Entirely Avoidable'

Patient C, a 63-year-old man, also suffered injuries after "similar failings" when Dr Valero performed gallbladder surgery him, the tribunal heard.

The patient had previously attended the hospital in June 2019 after suffering a perforated gallbladder and on that occasion, Dr Valero had shouted at him in an aggressive tone during a disagreement about the medication he was taking.

"Are you a doctor?" he repeatedly asked the patient while allegedly jabbing his hand at him.

When Patient C attempted to explain why he should not take the medication, Dr Valero is alleged to have aggressively told him, "Do you want to self-medicate?" before storming off.

Patient C felt Doctor Valero’s behaviour as "totally unprofessional", said Mr Sastry.

Dr Valero admits botching the patient's gallbladder operation, with the injuries he suffered described as "entirely avoidable" and due to a "misinterpretation of the anatomy".

He also failed to "adequately perform a critical view of safety", consider other options - including converting to an open operation to enable safe dissection - and seek the assistance of another experienced consultant surgeon.

Patient C, who served with the armed forces, also underwent further surgery at Addenbrooke's Hospital but the "problem could not be fixed" and he will need reconstructive surgery and a liver transplant in the future, Mr Sastry said.

The patient, the tribunal heard, believed that Dr Valero's operation "completely changed his life". His weight dropped from 18 or 19 stone to 13 stone, and he is no longer able to ride his motorbike, mow the lawn, or "eat like he used to".

Doctor Faces Eight Charges in Total

Patient D, who has cerebral palsy, epilepsy, and learning difficulties and needs a full-time carer, was allegedly discharged by Dr Valero in March 2021 despite evidence of a distended small bowel and obstruction.

Dr Valero recommended discharging the patient with laxative treatment while his bowels remained closed, but the patient later became unwell and vomited faecal matter, the tribunal heard, and eventually needed surgery.

He allegedly failed to adequately assess and document Patient D's mental and physical capacity, made an "inappropriate" decision to discharge him, and failed to take into account a CT scan which suggested a small bowel obstruction.

It is also alleged he was "rude and unprofessional" and "unsympathetic" towards the patient's sister when she raised concerns he was being discharged too early.

Dr Valero, who faces eight charges in total, can no longer perform gallbladder surgery unsupervised after restrictions were placed on his practice at an interim orders tribunal in 2021.

In legal cases brought by Patient A and C, Norwich University Hospitals NHS Foundation Trust (NNUHFT) has admitted liability for the errors and standard of care provided to them.

A Trust spokesperson said: "We can confirm that the Trust has admitted liability in relation to the cases of Mr Tooth and Mrs Wilson."

"We can also confirm that interim conditions are in place, which are in line with the supervision arrangements already in place following our own internal investigation and recommendations from a Royal College of Surgeons review."