2017年5月2日，英國(guó)醫(yī)學(xué)會(huì)（BMA）官方期刊《英國(guó)醫(yī)學(xué)雜志》發(fā)表新聞報(bào)道：英國(guó)乳腺外科醫(yī)生被指控二十項(xiàng)非法傷害和蓄意傷害罪名！

　　乳腺外科流氓醫(yī)生：伊恩·帕特森，對(duì)1000多位女性進(jìn)行了失誤或不必要的手術(shù)，被宣判犯有17項(xiàng)蓄意嚴(yán)重人身傷害和3項(xiàng)非法傷害罪名。

　　帕特森，59歲，主要在西米德蘭茲（英格蘭中西部）索利赫爾醫(yī)院工作，被諾丁漢刑事法庭宣布有罪，并將于5月底判決，蓄意傷害的最高刑期為終身監(jiān)禁。

　　上述指控僅涉及他的10位私人患者，其中包括1位男性。起訴人稱(chēng)：公道的外科醫(yī)生認(rèn)為所涉乳房手術(shù)均不合理。帕特森向患者們和全科醫(yī)生們對(duì)活檢結(jié)果進(jìn)行誤導(dǎo)，對(duì)家族史危言聳聽(tīng)，并聲稱(chēng)乳房切除術(shù)對(duì)防止癌癥進(jìn)展至關(guān)重要。

　　不過(guò)，盡管上述刑事案件主要是對(duì)健康者進(jìn)行不必要的手術(shù)，但是針對(duì)他的幾百例民事訴訟大多數(shù)都涉及他對(duì)真正癌癥的乳房切除術(shù)不充分。

　　帕特森擅長(zhǎng)“保留乳溝”的乳房手術(shù)（與徹底的乳房切除術(shù)相比，復(fù)發(fā)率較高）并于2007年英格蘭中心醫(yī)?；鸶鶕?jù)調(diào)查告知其停止該手術(shù)后仍繼續(xù)進(jìn)行。結(jié)果，超過(guò)1100位患者被召回進(jìn)行復(fù)查和治療。

　　為此，醫(yī)保基金已經(jīng)支付將近1800萬(wàn)英鎊（折合2100萬(wàn)歐元或2300萬(wàn)美元）以解決帕特森造成的256筆公立醫(yī)院患者醫(yī)保索賠。他工作過(guò)的斯派爾醫(yī)療（英國(guó)第二大私立醫(yī)院集團(tuán)）面臨著數(shù)百筆索賠，但是賠償尚不確定，因?yàn)樗⑽幢凰古蔂柟陀?，而且醫(yī)療維權(quán)聯(lián)盟（英國(guó)最大的醫(yī)生維權(quán)組織）在他的商業(yè)保險(xiǎn)范圍超出后拒絕承擔(dān)他的賠償責(zé)任。

　　起訴人朱利安·克里斯多夫御用大律師（又稱(chēng)資深大律師，直譯女王顧問(wèn)、皇室或王室法律顧問(wèn)）表示：帕特森的動(dòng)機(jī)亦是“不可理喻”，無(wú)論“保持他忙碌、成功、炙手可熱、事業(yè)如日中天的外科醫(yī)生形象”，還是“通過(guò)額外的手術(shù)和隨訪(fǎng)咨詢(xún)……賺取額外的費(fèi)用”，或者因?yàn)榕撂厣壬?span style="color: rgb(216, 79, 169);">以幫助別人為快樂(lè)之本”。

　　患者稱(chēng)他有完美的床邊功夫（為患者提供服務(wù)的態(tài)度）和感染能力（感動(dòng)并說(shuō)服患者的能力）。2013年，其中一位患者接受英國(guó)醫(yī)療衛(wèi)生委員會(huì)前主任委員伊恩·肯尼迪為撰寫(xiě)調(diào)查報(bào)告而進(jìn)行的面談時(shí)稱(chēng)：“盡管他是一位顧問(wèn)（英國(guó)醫(yī)生高級(jí)職稱(chēng)），但他總是站在你的立場(chǎng)說(shuō)話(huà)”。

　　但是，十多年來(lái)，同事們一直對(duì)帕特森存在很大質(zhì)疑，直至2012年，英國(guó)醫(yī)學(xué)總會(huì)終于注銷(xiāo)了他的行醫(yī)資格。此前，他是4次調(diào)查和通報(bào)的對(duì)象。

　　2008年，受醫(yī)保基金之命調(diào)查帕特森的外科醫(yī)生馬丁·李將其技術(shù)堪比“旋風(fēng)”，其手術(shù)如同輕松進(jìn)入劇院……而且只想盡快完成手術(shù)。

　　其他工作人員稱(chēng)帕特森“傲慢自大”、“咄咄逼人”、“獨(dú)斷專(zhuān)行”、“橫行霸道”。一位外科醫(yī)生告訴肯尼迪：這意味著帕特森經(jīng)常孤立工作，正符合他的目的。

　　肯尼迪總結(jié)道，帕特森之所以能夠長(zhǎng)期如此，是因?yàn)橛⒏裉m中心醫(yī)?；鸱钚小氨Ｃ芎桶荨保前鸦颊叻旁谑孜?，并且由于其他臨床醫(yī)生沒(méi)有及時(shí)引起英國(guó)醫(yī)學(xué)總會(huì)的重視。

　　西米德蘭茲（英格蘭中西部）總警司馬克·佩恩對(duì)此評(píng)論道：帕特森是一個(gè)有恃無(wú)恐的流氓惡霸，扮演著上帝，玩弄著人命，因此而過(guò)著奢華的生活。

BMJ. 2017 May 2;357:j2134.

Breast surgeon is convicted of 20 counts of unlawful wounding and wounding with intent.

Dyer C.

The BMJ.

The rogue breast surgeon Ian Paterson, believed to have carried out negligent or unnecessary surgery on more than 1000 women, has been convicted of 17 counts of wounding with intent to cause grievous bodily harm and three counts of unlawful wounding.

Paterson, 59, who worked mainly at Solihull Hospital in the West Midlands, sobbed quietly as the verdicts were announced at Nottingham Crown Court and faces sentencing at the end of May. The maximum sentence for wounding with intent is life imprisonment.

The charges related to just 10 of his private patients, including one man. All underwent breast surgery that, prosecutors said, "no reasonable surgeon at the time would have considered justified." Paterson misrepresented biopsy results to patients and GPs, played on fears raised by family histories, and claimed that mastectomies were essential to prevent the development of cancer.

But though the criminal case focused on unnecessary surgeries performed on healthy patients, most of the hundreds of civil claims against him involve insufficiently thorough mastectomies for real cancer.

Paterson specialised in "cleavage sparing" breast surgery, associated with a much higher recurrence rate than full mastectomies, and continued to practise this technique after he was told to stop, following an investigation at Heart of England NHS Trust in 2007. Eventually over 1100 of his patients would be called back for further tests and treatment.

The trust has since paid out nearly ￡18m (€21m; $23m) in damages and costs to settle 256 claims involving Paterson's NHS work. Spire Healthcare, which owns the private hospitals where he worked, faces hundreds of claims, but compensation is uncertain because he was not employed by Spire and because the Medical Defence Union has refused to cover him for claims lodged after his commercial insurance coverage lapsed.[1]

Paterson's motives remain "obscure," said prosecutor Julian Christopher QC at his trial, "whether to maintain his image as a busy successful surgeon in great demand and at the top of his game, whether to earn extra by doing extra operations and follow-up consultations ... or because Mr Paterson enjoyed the responsibility that came with helping people."

Patients said that he had the perfect bedside manner and radiated competence. "Even though he was a consultant, he spoke on your level," said one, interviewed for a 2013 report compiled by Ian Kennedy, former chair of the Healthcare Commission.

But colleagues had been raising grave doubts about Paterson for more than 10 years when the General Medical Council finally suspended him in 2012. By then he had been the subject of four investigations and reports.

Martin Lee, a surgeon asked by the trust to observe Paterson during surgery in 2008, compared his technique to a "whirlwind." Lee added, "He would breeze into the theatre ... and just try to get on as quickly as possible."

Other staff described Paterson as "arrogant," "aggressive," "autocratic," and "a bully." This had meant that he often worked in isolation, which suited his purposes, one surgeon told Kennedy.

Paterson was able to keep working, Kennedy concluded, because the Heart of England Trust focused on "secrecy and containment," rather than putting patients first, and because fellow clinicians failed to bring their concerns to the GMC.[2]

Chief Superintendent Mark Payne called Paterson a "controlling bully, who played God with people's lives so he could live a luxurious lifestyle."

References

1. Dyer C. Legal action against rogue surgeon is suspended after MDU withdraws funding. BMJ. 2014;357:g7437. DOI: 10.1136/bmj.g7437 PMID: 25477502

2. Dyer C. Rogue surgeon was allowed to continue operating for years because patients' interests were not put first, report says. BMJ. 2013;357:f7648. DOI: 10.1136/bmj.f7648 PMID: 24361857

PMID: 28465329

DOI: 10.1136/bmj.j2134