Trust apologises over 'unnecessary' heart procedures

A health trust has apologised after it emerged that more than 160 patients with advanced heart conditions may have undergone an unnecessary procedure.

The patients were fitted with a Cardiac Resynchronization Therapy (CRT) device - a small implant that treats heart rhythm and pumping issues - between 2007 and 2023.

A complaint by a patient in 2023 prompted the Belfast Health Trust to notify the Royal College of Physicians (RCP), which asked for a review of the cases. The patients have now been recalled.

The trust said patients treated by cardiologist Dr Ernest Lau do not need to take immediate action. Its medical director apologised for any distress.

Chris Hagan from the trust said recalling patients was not ideal he but he wanted to reassure those affected that the device was safe and they should not be unduly worried.

"I'd like to apologise on behalf of Belfast Trust to anyone who has been impacted by this," he said.

"We would never bring back patients for review unless we really thought it was necessary.

"We need to work out if anything more needs to be done with that device but I want to reassure them that they don't need to worry about it at the minute."

Hagan added that the ongoing review of patient records was thorough and those who need to be seen will be contacted by letter.

He confirmed that Lau remained a paid employee but was not seeing patients and has not done so since 2023.

A spokesperson for the trust confirmed to BBC News NI that the recall could affect up to 163 patients and it was initially contacting smaller groups.

In the past few weeks, letters were sent to 25 patients, however an additional 35 people have been contacted this week advising them of the development.

The trust said between 2023 and 2024 it had identified some concerns regarding decisions to implant very specific and specialist devices for a number of patients under the care of Lau and at that stage asked the RCP to "carry out an expert and independent review of several cases".

The RCP, according to the trust, "subsequently agreed with some of the concerns around Lau's decision making and it recommended further investigation.

While concerns about the cardiologist were raised by colleagues in 2020, action was not taken until a complaint was made by a patient some three years later.

The trust said due to patient confidentiality they could not discuss any details about the welfare of the patient who brought the complaint.

It is not clear why patients have only been recently notified.

It is understood the trust is also looking back over deceased patient records.

At this stage no link has been identified, however, that could change as the review continues.

CRT devices, also known as biventricular pacemakers, are designed for patients with specific, advanced heart conditions where the heart's lower chambers (ventricles) do not contract in a synchronised manner.

While functioning like a normal pacemaker to treat slow heart rhythms, a CRT-P device also delivers small electrical impulses to the left and right ventricles to help them contract at the same time, so your heart pumps more efficiently.

While thousands of people in Northern Ireland are fitted with standard pacemakers, CRT devices are less common.

A review of cases between 2007 and 2023 identified 684 people having been fitted with a CRT device.

In what is normal practice, the RCP set criteria for which patients should be recalled.

Of the 684 people identified, based on the criteria, 163 required review.

The trust said that number could increase.

Those cases have been further broken down to smaller groups, which the trust said was allowing cardiologists to carry out the reviews while continuing with their normal work.

Based on the case review those affected are either being invited to attend for a face-to-face consultation or advised that while a consultation is not necessary if they wish to have one appointment, it will be facilitated.

In a statement, the trust said it had begun the process of writing to each person, offering them the opportunity to meet a consultant cardiologist to go through the results of the review process.

It added it was only focusing on patients who had a CRT device inserted by Lau.

A number of patients have already been seen by a specialist consultant cardiologist involved in the review process at a dedicated clinic and more will be seen in the coming weeks.

They will be notified by letter.

A relation of one of those patients said the letter had caused a lot of distress.

Sources told BBC News NI some consultants were angry about the length of time it takes the trust to review a consultant's work.

One medic said that the review process is unnecessarily lengthy and causes distress among patients and frustration between doctors in the affected department.

The Trust has an advice line on 028 9615 0100 which is open from 09:00 - 20:00 on Friday 15 May and 10:00 -14:00 on Saturday and Sunday 17 May.