Hospital equipment is updated after tragedy

First published in News

NEW staple guns are being used by surgeons after the death of a retired school teacher on the operating table.

The automatic staple guns are being used by cardio- thoracic surgeons at the John Radcliffe Hospital following Sheila Ebbage’s death.

Oxfordshire coroner Darren Salter gave a verdict of accidental death by cardiac arrest at Oxfordshire Coroner’s Court last month.

The 69-year-old, of Folly View Road, Faringdon, died while undergoing an operation on a chest tumour at the hospital on January 22.

Consultant cardiothoracic surgeon Edward Black had to staple Mrs Ebbage’s pulmonary artery, which pumps blood from the heart to the lungs, with a staple gun.

However the staples were one millimetre out of place, the inquest heard.

Following the surgery an investigation was launched by Oxford University Hospitals NHS Trust, headed by clinical lead for cardiothoracic surgery Rana Sayeed.

He said: “It is a rare but recognised complication of lung surgery.

“If there is any movement when you are firing a staple that movement is magnified, but when there is a motor there is much less movement.These motorised staple guns are new and we had been thinking about getting them.

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“But this incident provided a stimulus to move to the automatic staple guns.”

They have been brought in to replace manual guns in cardiothoracic surgery.

Professor Edward Baker, medical director of Oxford University Hospitals NHS Trust said: “The trust very much regrets the tragic events leading to Mrs Ebbage’s sad death.

“The trust has invested in new equipment for use in our cardiothoracic theatres .”

Of the 400 to 500 thoracic surgical cases a year at the John Radcliffe Hospital, 80 to 100 need stapling.

Mr Black gave evidence at the inquest and answered questions raised by Mrs Ebbage’s family.

Mr Black, who has worked at the John Radcliffe for four years, is one of two thoracic surgeons at the hospital – and one of only 60 in the whole country.

TECHNOLOGICAL ADVANCES

The manual and automatic staple guns each cost around £300, with cartridges for the automatic gun costing an extra £150-250.

Both are disposable and are only used during one operation.

The automatic staple guns are smoother because they are operated by a button rather than squeezed by a surgeon’s hand.

They also do an automatic pinch test on blood vessels in surgery rather than the surgeon pinching them with their fingers.

A pinch test cuts off the blood flow to see how the patient copes – if they cannot, their blood pressure will spike.

After the test, the gun then fires the staples in the exact place the test was done.

Before the new guns were introduced, the doctor had to do a manual pinch test with their fingers, then take their hand out of the body to pick up the staple gun and then go into the body again to fire the staples.

The doctor might therefore not staple in exactly the same place as they conducted the pinch test.

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