The Pediatric Cardiac Surgery Inquest Report




Giddins testified that, during the spring of 1994, he felt that the parents' understanding of their daughter's heart problem was continuing to grow as a result of regular discussions with him and Odim. He also said he could not recall any discussion with the family about having the procedure performed outside Manitoba.

On June 6, 1994, Odim met with Ben Capili, Sarah Tena and Sarah's mother, Teresida Tena. At the end of the meeting, the family gave verbal consent to surgery.

Odim was asked what he recalled telling Marietess's parents about risk.

Again I separated out the risks, as I usually do, into the risks of cardiopulmonary bypass, and the risks of Fontan operations, issues of prolonged chest tube drainage from the lung, issues of perhaps it not working, and that circulation not being tolerable. But we felt with the data we had in terms of the ventricular function and the AV valve function that if the pulmonary vascular resistance was reasonable that there was every good chance that it should work and told her that given 100 children like her, anywhere from 7 to 10 would have a problem with the operation. (Evidence, pages 25,436-25,437)

Ben Capili, Sarah Tena and Teresida Tena all testified. Because Ben Capili had to absent himself from part of the June 6 meeting to take care of Marietess, he was not present for some of the conversation with Odim. All three testified that Odim gave them no information as to the slowdown in the program. They were not told that only low-risk procedures were being performed in Winnipeg during the summer of 1994.

Sarah Tena recalled that at this meeting, Odim drew a diagram of Marietess's heart. Marietess's condition, she concluded, was more complex than she had earlier understood. She testified that Odim told her that he wanted to do a Fontan procedure. This would result in Marietess being left with a three-chambered heart that was fully functional. She recalled that she had asked twice about the risk to her child from the procedure, and was told by Odim that Marietess had a 97 per cent chance of success. She was told, however, that Marietess might be in the three per cent risk category for morbidity or mortality.

In her testimony, Sarah's mother, Teresida Tena, also confirmed that Odim gave this risk percentage at the meeting. Teresida Tena suggested that the operation take place in Toronto, since a friend's son had undergone surgery there and had done well. She testified that Odim had assured them that they were capable of doing the procedure in Winnipeg. Sarah Tena accepted that as fact, particularly since Marietess had been so well treated previously by Duncan.

When the meeting ended, the family was told that an operation would be scheduled, although they were not given an indication as to when surgery might take place. Sarah Tena thought it would take place during the summer.

Giddins testified that the success rate for operations of this type was 90 per cent, placing it on the high end of the moderate risk scale. He noted that the decision to set a date for Marietess's surgery took place in August. At the time that the operation was scheduled, the Winnipeg team was only handling low and medium-risk cases, with the decision to move to high-risk cases not being made until September. In his testimony, Cornel stated that he thought the risk of complications for this procedure was about seven to eight per cent.

The family was informed of the date for surgery in a letter dated August 30. They were told that Marietess would undergo her operation on September 13, 1994. Sarah Tena testified that the family thought that this was very short notice, but they did not raise any objections.



Current Home - Table of Contents - Chapter 8 - Consent
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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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