I did not have the support I asked for, locum surgeon tells baby inquest

A locum surgeon told an inquest he felt "sorry" for the family of a two-day-old baby who died following an operation but said he has not been supported by colleagues after the procedure.

Baby Paul Mitchelhill died in his mother's arms following abdominal surgery at the Great North Children's Hospital in Newcastle in October 2013, an inquest heard.

Locum Emmanuel Towuaghanste - known as Mr Towu - defended his decision to operate immediately on the baby who was born with a defect known as an exomphalos major, rather than wait to find out more.

The inquest in the Civic Centre has heard that other surgeons would have elected to treat the defect more conservatively to start with and only operated when the baby was older.

Mr Towu, 62, said he had last carried out the procedure 10 years before.

Paul underwent the 7pm surgery as part of his stomach, intestine and liver were protruding through a 7cm gap in his abdomen.

The baby developed a fatal condition Abdominal Compartment Syndrome (ACS) as a complication of the operation and died the next day.

As Paul's condition deteriorated overnight, Mr Towu claimed he repeatedly tried to call a more senior surgeon.

In the hours after the operation, he told the inquest there was an "unfriendly atmosphere" with other staff on the intensive care unit.

He told the inquest: "I was super worried, I was very anxious about what was going on.

"I got the impression there was so much undercurrent that was not being passed on to me directly."

And the locum felt his instruction to give the baby blood products was not followed by Intensive Care Unit staff after the operation.

The inquest has heard other staff were concerned about tightness of Paul's abdomen and a lack of circulation to his limbs.

One was said to have told him: "You don't appear to understand just how sick this baby is."

Mr Towu, who was working at two hospitals that night, saw his 2.7kg patient again at 5.10am and realised he had got worse.

He told coroner Karen Dilks: "I regret to say I didn't do something earlier.

"I have to say again I should have done something earlier and I am sorry about that.

"I am sorry for the parents, sorry for the entire team.

"I didn't have the support I asked for, I would have benefited from."

He said there could have still been a "successful outcome" if that happened.

Paul was opened up a second time, and Mr Towu said he found evidence of bleeding in his abdomen.

A more senior surgeon later took over and told Mr Towu he should go home.

The inquest has heard a pathologist said Paul died from multiple organ failure due to ACS, precipitated by the operation.

Mr Towu disagreed, blaming the ACS and bleeding to the abdomen, secondary to "disseminated intravascular coagulation" because Paul was not given blood products to replenish what he lost.

The surgeon, who graduated from the University of Benin in 1978 and had trained widely around the world, admitted he had not kept a record of all his operations since losing his log-book in 2000.

Mrs Dilks said Northumbria Police had tried to check his claims he had carried out the same procedure at other centres in the UK, but that detectives had been unable to verify them.

He said it was "almost impossible" for surgeons to check with hospitals what operations they had carried out themselves.

Mrs Dilks said the Royal College of Surgeons found it was good practice for members to keep records to demonstrate their experience.

The inquest continues.

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