The Pediatric Cardiac Surgery Inquest Report




On Thursday June 16, Odim met with the Baumann family. He testified that he explained the risks to the family in detail. Deanna Baumann testified that they were told that the operation involved placing a patch over the ASD, a procedure that would take only 15 minutes, although it would take several hours to prepare their son for this repair. She recalled that Odim gave them no indication of any risk, and they were led to believe that Aric would be home within seven to ten days following the operation. Odim testified that he could not recall discussing the slowdown in the program with the Baumanns. He did say that during this period he did inform parents that the program was undergoing a slowdown and reorganization.

During that summer when we were seeing patients in clinic, it was quite often patients wanted to know when they would have their surgery. And the families who were being seen in the clinic, sort of, many of them are anxious to get a surgical date. And during those conferences in the office, I did mention to families that the program had slowed down. I did mention to families that that's why we don't have a particular date, or could not promise them when we might be able to do an operation. I did mention to families that the team was having difficulties and problems, and we are trying to sort that out. (Evidence, page 25,199)

However, Deanna Baumann testified that she and her husband were never told anything about any problems in the Pediatric Cardiac Surgery Program.

While this case had first been presented to the CVT conference before the May 17 program slowdown, the operation did not take place until after the Wiseman Committee had started its deliberations. Giddins was asked if this case was taken to the committee since it involved open-heart surgery. He testified: "No, because atrial septal defects were in the general category of being low risk." (Evidence, page 3,862) He testified that he had reached this conclusion because there had already been two ASD cases undertaken after the May 17 slowdown. In his testimony, Giddins said he believed that this was a very low-risk operation, with the fatality rate being between zero and five per cent. This sentiment was also expressed by Odim, who said he believed the operation to be low risk.

However, in a letter that he wrote to Simmonds on August 22, after the child's death, Odim stated:

In light of the torrential left to right shunt, pulmonary hypertension, elevated pulmonary vascular resistance despite oxygen therapy, and relative left-sided hypoplasia, we all knew that Aric would be at a substantially higher surgical risk [underlining added] than the usual ostium primum defect lesion. (Exhibit 2, page BAU 34)

In his testimony, Odim said he still believed Aric to have been a low-risk patient, although the risk was greater than the five per cent risk he would assign to an ASD. He declined, however, to assign a percentage value to the risk. Odim also indicated that he gave the parents the following information about the risk to Aric:

We were very concerned about the issue of the pulmonary hypertension, the issue of the increased pulmonary vascular resistance, and cautioned mom and dad that the post-operative course could be very difficult if the child were to have what we call pulmonary hypertensive crisis, remain intubated for a long time, need additional types of drugs to help with the pulmonary bed. (Evidence, page 25,179)

Swartz had a different view of the risk involved in the case, although she agreed to proceed with the case when it was discussed at the pre-operative conference. She testified:

I thought this was a high risk case, just the very fact that he had pulmonary hypertension. I wondered why we were going ahead with it. I might even, you know, I can't remember, I can't remember exactly if I talked to Dr. McNeill. (Evidence, page 15,892)

From the testimony presented to this Inquest, it would appear that Aric Baumann's lesion might justify calling this a low-risk case, as indicated by Odim and Giddins. However, the seriousness of his pulmonary hypertension and increased pulmonary vascular resistance suggest that the risks associated with this case were much higher. While he might not be a high-risk patient, at the very least he was on the high-end of the low-risk rating.

There is a significant difference in the testimony of Deanna Baumann and Odim as to the amount of information that was provided to the Baumanns about both the particular level of risk in the case and the state of the overall program. On this point, Deanna Baumann's evidence is to be preferred.



Current Home - Table of Contents - Chapter 7 - Consent
Next Admission to the hospital
Previous The decision to operate
Section 1 Chapter 1 - Introduction to the Issues
  Chapter 2 - Pediatric Cardiac Issues
  Chapter 3 - The Diagnosis of Pediatric Heart Defects and their Surgical Treatment
  Chapter 4 - The Health Sciences Centre
Section 2 Chapter 5 - Pediatric Cardiac Surgery in Winnipeg 1950-1993
  Chapter 6 - The Restart of Pediatric Cardiac Surgery in 1994
January 1, 1994 to May 17, 1994
  Chapter 7 - The Slowdown; May 17 to September 1994
  Chapter 8 - Events Leading to the Suspension of the Program
September 7, 1994 to December 23, 1994
  Chapter 9 - 1995 - The Aftermath of the Shutdown
January to March, 1995
Section 3 Chapter 10 - Findings and Recommendations
Appendix 1 - Glossary of terms used in this report
Appendix 2 - Parties to the Proceedings and counsel
Appendix 3 - List of witnesses and dates of testimony
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