Hearts taken after 1990 without consent

By ANGELA GREGORY and MARTIN JOHNSTON

Green Lane Hospital has revealed that it took organs without family consent from at least five babies who died with congenital heart defects from 1990 to 2000.

This is despite a Ministry of Health assurance last week that informed consent had been sought for all body parts kept for teaching or research since the 1988 Cartwright report.

Yesterday, the ministry said the assurance was based on information from public hospitals and medical schools. The Green Lane cases were exceptions to the widely-accepted culture of informed consent.

The hospital holds more than 1300 hearts from children, babies and aborted foetuses, and a few from adults, in a research collection dating from 1950. Preserved in individual containers, some of the hearts have other organs attached, such as lungs, kidneys, spleen, liver and abdominal tissue.

Families have been offered the opportunity to take back the organs.

Most of the organs taken without parental permission appear to date from before the Cartwright report, a time when seeking informed consent was not standard practice in hospitals.

Green Lane says that of 35 hearts found by Tuesday to have been taken without consent, five were taken after 1989, 12 in the 1980s, 10 in the 1970s, and eight in the 1960s.

Figures for after Tuesday were unavailable because hospital staff were too busy responding to inquiries on the 0800 heart hotline to compile them.

Green Lane said last week it was sure that in most cases consent to keep body parts would have been sought since the late 1980s.

Yesterday, Auckland District Health Board spokeswoman Brenda Saunders said: "We instituted processes for consent in the 1990s. As we've said all along [since the offer to return hearts was made last week] they haven't been followed to the letter. We have some that have fallen through the cracks."

The chief executive, Graeme Edmond, told Parliament's health select committee on Wednesday that if any organs had been kept since proper consent procedures were implemented in about 1995, the hospital would make inquiries to find out how it happened.

Green Lane's head of children's heart surgery, Dr Kirsten Finucane, yesterday recalled two cases in which hearts had been retained without consent.

One case she attributed to a procedural error between the hospital and pathology department, and the other occurred one Christmas Day.

She had a "crucial" meeting with the pathology department on Wednesday to discuss the fine points of gaining informed consent, "so that we could make sure that this just never happens again".

"I think we can be sure all the loopholes are closed now."

But the potential for human error remained, particularly when patients died unexpectedly in the middle of the night, or when key staff were away and their work was covered by people filling in.

Hospital staff had by yesterday contacted 44 families to tell them of a match to a family member's heart in the collection. For a further 122 families, no match had been found.

Nearly 3000 people had called the hotline, but calls were now declining.

Ian and Wendy Fittall, a Henderson couple told that their dead baby's heart and lungs are in the collection, are yet to decide what to do about it.

Mr Fittall said an option might be to ask the hospital to retain the organs from their baby Lance, who died in 1984 aged 8 months, but to spare them from further use in research and teaching.

Ms Saunders said this was a possibility and she urged Mr Fittall to discuss it with hospital staff.

She said Green Lane would also consider his call to set up a support group of affected families.

Mr Fittall said a support group would help deal with the feelings of isolation which he and possibly others were experiencing.

He said the hospital still had to answer many questions.

A spokesman said Health Minister Annette King was satisfied with how Green Lane was handling the issue. The ministry would review progress later "to see if there are any outstanding issues".