Foreign doctors under fire as woman dies after hip op

Britain's procedure for vetting foreign doctors has come under fire yet again after a woman died following a routine operation by a German surgeon. Ninety-four-year-old Ena Dickinson ended up losing half the blood in her body during a hip replacement when Werner Kolb severed her artery in a series of horrific blunders.

During the operation at Grantham Hospital in Lincolnshire in August 2008 Kolb, 51, also cut through the wrong muscle, slicing into a 'danger zone' known as the femoral triangle. Flustered, he then severed the artery and used an inappropriate power saw to remove a large piece of hip bone. An inquest into the death of Mrs Dickinson, a former nurse, heard how Kolb then became so "upset" and "agitated" that he began speaking German.

Another surgeon, Odathurai Paramasivan, was forced to step in to save Mrs Dickinson's life by stemming the bleeding. Although she survived the operation she was left bed-bound and weakened, and subsequently caught pneumonia. She died eight weeks later, on October 26 2008.

Expert witness Professor Angus Wallace told Sleaford Coroner's Court in Lincolnshire that it was the worst case of negligence he had come across. An orthopaedic surgeon for 25 years, Professor Wallace also told the court that Kolb's errors were likely to have caused her death. "Mr Kolb was out of his depth and unable to deal with the situation. I believe that the operation brought forward her death."

Meanwhile Odathurai Paramasivan told Coroner Stuart Fisher that Mrs Dickinson had been a few minutes from dying before he stepped in to save her. She had lost more than two litres of blood, he added. "The operation relied on basic anatomical knowledge, even at a junior level. I was horrified by what I saw," he said.

Normally based at Bethesda Hospital in Stuttgart, Kolb was three weeks into a six-week placement at Grantham Hospital as holiday cover for another surgeon. It has since emerged that Kolb had mainly spent the past four years lecturing. He had only performed a relatively small number of hip operations throughout his career, the inquest heard.

Astonishingly, Kolb was allowed to continue to work in the UK for eight months after Mrs Dickinson's operation. Although he had been sacked by United Lincolnshire Hospitals Trust the following day, the trust failed to report him to the General Medical Council (GMC). It was only when Professor Wallace was commissioned by the coroner to examine the evidence in June 2009 that the GMC was notified and Kolb was suspended.

Kolb did not attend the inquest and told the Daily Mail yesterday that he did not consider himself responsible for Mrs Dickinson's death. He said: "I can clearly recall that after the procedure she was in a good condition. She was old and there would always be a risk for a patient of her age but I repeat, the procedure was carried out properly and I say my work had nothing to do with her death."

The case has highlighted the issue of using foreign doctors to cover staff shortages. EU laws allow European medical staff to automatically work in Britain without being tested in line with NHS standards.

Last month another German locum, Daniel Ubani, was found to have unlawfully killed a 70-year-old man by giving him 10 times the proper dose of diamorphine, a painkiller. The inquest in early February found that inherent "weaknesses" in the vetting procedures meant that Ubani was allowed to treat patients despite the fact he had failed an English language test and had no experience of working in the NHS. ·