The Alfred Hospital has launched an internal inquiry into allegations by five of its doctors that a top surgeon may have placed Victorian patients at risk.
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Confidential hospital documents obtained by Fairfax Media reveal that the five doctors met with one of the hospital's top medical staff, Professor Jeffrey Rosenfeld, on July 4 to raise concerns about the "recent surgical outcomes" of the surgeon who is the subject of the inquiry.
Fairfax has chosen not to name the top surgeon, whom the Alfred Hospital has confirmed has "agreed to reduced duties with oversight" while the investigation continues.
A letter detailing the July 4 meeting states that the five doctors raised two cases in which patients had died and warned that many other patients may have been affected.
"In the interests of patient safety, we felt that these poor outcomes represent a worrying trend," the doctors told Mr Rosenfeld.
"In general, we have the impression that [the surgeon's] complication rate may be outside of the range of what would be expected – and verifying whether this is true or unsubstantiated is needed."
As a result of the complaint, Mr Rosenfeld launched an inquiry overseen by the Alfred's surgery director, Bill Johnson.
Mr Rosenfeld also wrote to the five complainants to acknowledge that they were "placing the welfare of Alfred patients at the forefront".
The revelations raise questions about the hospital's internal review processes and whether they failed to pick up the top surgeon's allegedly questionable practices prior to the five doctors making their complaints.
They also raise questions about the independence and impartiality of the internal review process, with a letter from the five complainants revealing that the top surgeon sought to approach them about their complaint.
"It has since transpired that [the surgeon] has become aware that these concerns were raised by the registrars and he has on separate occasions since 16/7/14 attempted to discuss the matter with us individually."
The inquiry involves reviewing several cases handled by the top surgeon, including those in which patients have died.
"This review is a complex process which takes time and involves support from several senior clinicians in the hospital," an Alfred hospital spokesman said.
"The ability for staff at all levels to raise concerns and ask questions about clinical practice is an important part of our clinical governance process. As this case demonstrates, these concerns are taken seriously and investigated."
The complaint by the five doctors comes six years after the Victorian Ombudsman criticised the Alfred's failure to detect and act on what the Ombudsman described in a parliamentary report as harmful and unnecessary surgery performed by its former trauma surgery director, Thomas Kossmann. Mr Kossmann has always denied the Ombudsman's findings, which also included a recommendation that the Alfred reform the way it oversees its surgeons' operations.
Doctors aware of the recent complaints about the top surgeon said it was "very significant" that five doctors had felt strongly enough to put their complaints in writing.
However, some of the doctors also stressed that because the surgeon's speciality is complex, highly subjective and often involves operations on very ill patients, it would be difficult for any of the complainants to definitively state that the surgeon had made any serious and avoidable mistakes.
The Alfred's spokesman said: "We expect the review to be completed in December. If there are any findings to consider, the surgeon will have the opportunity to respond to these findings."
