Alder Hey organs scandal

The Alder Hey organs scandal involved the unauthorised removal, retention, and disposal of human tissue, including children’s organs during a period from 1988 to 1995. During this period organs were retained resulting in more than 2,000 pots containing body parts from around 850 infants. These were later uncovered at Alder Hey Children's Hospital, Liverpool, during a public inquiry into the organ retention scandal.

History
Alder Hey was considered a world-class hospital until revelations about organ stripping were brought to light during a public inquiry in 1999. Until then the general public was unaware of the activities of Alder Hey and other hospitals within the National Health Service (NHS) in regards to their practices of organ retention.

The public remained generally unaware of the practice of organ retention until the events surrounding the death of 11 month old Samantha Rickard who died in infancy while undergoing open-heart surgery in 1992 at Bristol Royal Infirmary (BRI).

A few years later Helen Rickard, her mother, had learned of the allegations of excessive mortality rates for children's heart surgery at the BRI. In 1996 Helen demanded a copy of her medical records from the hospital and found a letter from the pathologist who performed the postmortem to her surgeon, stating that he had retained Samantha's heart. Once confronted with this evidence, the hospital promptly returned her heart. By this time 5 years had passed since Samantha had died. Helen quit working to find out exactly what had happened to her daughter and she set up a support group with other parents and ran a freephone helpline to cater to the thousands of families affected as well.

At this time a Bristol Heart Children Action Group was set up. The group embarked on discussions with the hospital to find out how much human material had been kept from children who had died after cardiac surgery. In February 1999, the Action Group members called a press conference so that the public should know about the retained hearts. In the meantime serious doubts about the quality of pediatric cardiac surgery at Bristol led to the formation of a Public Inquiry, chaired by Ian Kennedy. In September 1999 a medical witness to the Inquiry drew attention to the large number of hearts held at the Alder Hey Children's Hospital in Liverpool.

As the details of Alder Hey's organ retention began to come to light the public learned that the program went back decades. An investigation was opened in December of 1999. However in Liverpool it was not just Alder Hey that was affected. Walton Hospital stored the organs of 700 patients which did not come to light until December 1999. This information seems to have been forgotten by those involved in the Alder Hey scandal and the media.

In January 2001 the official Alder Hey report (also known as the Redfern Report) was published. This led to large scale public outcry against the National Health Services when it was revealed that Dutch pathologist Dick van Velzen systematically ordered the "unethical and illegal stripping of every organ from every child who had had a postmortem" during his time at the hospital. This was ordered even for the children of parents who specifically stated that they did not want a full post-mortem. The report also revealed that over 104,000 organs, body parts and entire bodies of fetuses and still-born babies were stored in 210 NHS facilities. Additionally 480,600 samples of tissue taken from dead patients were also being held. Later that year the General Medical Council (GMC) ruled that Dutch pathologist Dick van Velzen should be temporarily banned from practicing medicine in the UK.

Furthermore, it emerged that Birmingham Children's Hospital and Alder Hey Children's Hospital in Liverpool had also given thymus glands, removed during heart surgery from live children, to a pharmaceutical company for research in return for financial donations. Alder Hey also stored 1,500 foetuses that were miscarried, stillborn or aborted without consent

Early 2003 saw the Alder Hey claims by families of victims being settled for an out-of-court settlement of £5million, a sum equivalent to about £5000 for each child.

In January of 2004 more than 2,000 families filed suit against the NHS with the High Court for removing the body parts of dead patients, including children, without consent.

Starting on August 5th, 2004 the bodies of 50 nameless babies stored for medical research at Liverpool hospitals were buried at Allerton cemetery. Alder Hey accounted for 7 of the unnamed while the rest came from other hospitals. More funerals followed on the Thursday of each week for several months to come. Over 1,000 unidentified bodies, most of them fetuses less than 28 weeks old, were buried during this time.

By December of 2004 the Crown Prosecution Service (CPS) decided that there should be no prosecution of Dick Van Velzen for criminal offences. The reason given for this decision was that there could be no guarantee that organs which remained in the containers were those originally taken at post mortem examination. This caused a problem for the prosecution, who were required to prove beyond a reasonable doubt that the organs were indeed illegitimately obtained. The police attempted to find a solution to this problem, but were unable to do so.

The families of the victims involved in the Alder Hey scandal were appalled that Van Velzen would not have to face criminal charges. They also criticized the CPS for making this decision.

On Monday June 20, 2005 the GMC ruled that Dutch pathologist Dick van Velzen would be permanently banned from practicing medicine in the UK.

Effects upon science
Following the revelations of the Alder Hey scandal various individuals within the UK scientific community began to worry publicly about the effects of the scandal upon organ donation rates. Many public figures openly expressed concern for the potential harm that could be done to scientific research as well.

Time has proven these conclusions to be incorrect. Donation rates have remained consistent with virtually no change despite the amount of attention given to the Alder Hey scandal by the media.

Primary conclusions of the Redfern report

 * Professor Dick van Velzen ordered unethical and illegal retention of all children's organs when he took up post in 1988 and falsified records and postmortem reports. He failed to catalogue organs and took away medical records when he left


 * Alder Hey and Liverpool University knew there were risks in appointing Professor Van Velzen but failed to supervise him


 * They failed to monitor his work or follow up complaints and missed numerous chances to discipline him. Close scrutiny of his work would have revealed unethical organ retention, but it never happened

Recommendations of Redfern report and chief medical officer

 * Independent commission to oversee cataloguing and return of 105,000 organs retained by hospitals in England


 * New law on informed consent


 * Review of coroner's system


 * Trusts to employ bereavement counselors


 * Review by the education secretary of arrangements for joint hospital/university posts

Alder Hey scandal timeline
April 1988 - Section committee at Alder Hey appoints Dick van Velzen as chair of fetal and infant pathology.

September 1988 - Dick van Velzen assumes his post as chair at Alder Hey.

1992 - Samantha Rickard dies while undergoing open-heart surgery at the Bristol Royal Infirmary.

December 1994 - Dick van Velzen is restricted to fetal and perinatal work only. On hearing this he takes an unauthorized leave from Alder Hey.

February 1995 - Dick van Velzen is ordered to stop any research project without proper ethical approval

December 1995 - Dick van Velzen leaves Alder Hey and begins work at IWK Grace Hospital in Nova Scotia

1996 - Helen Rickard demands a copy of her medical records from the BRI and finds a letter stating Samantha’s heart had been retained

1998 - Dick van Velzen head of pathology at Halifax's IWK Hospital is fired.

February 1999 - the Action Group members call a press conference to inform the public about the retained hearts at BRI.

September 1999 - A medical witness at the BRI inquiry draws attention to the large number of hearts held at the Alder Hey Children's Hospital in Liverpool.

December of 1999 - An investigation is opened resulting in the Redfern report.

September 2000 - A worker at a storage facility in Halifax, Nova Scotia, finds the organs of an 8 year old girl in a plastic bag.

2001 - GMC rules that Dutch pathologist Dick van Velzen should be temporarily banned from practicing medicine in the UK.

January 30, 2001 - Redfern report released.

February 4, 2001 - Prosecutors in Halifax, Nova Scotia, indicate that they are prepared to ask for the extradition of Prof Dick van Velzen relating to the discovery of children's organs in heat-sealed bags at a rented warehouse.

July 2001 – Van Velzen is convicted of improperly storing body parts removed from a child in the Halifax case. He was given a 12 months of probation and ordered to pay $2,000 (Canadian) to charity.

Early 2003 - Alder Hey claims settled with families of the victims for an out-of-court settlement of £5million.

January 2004 - 2,000+ families file suit against the NHS with the High Court for removing the body parts of dead patients without consent.

August 5, 2004 - Start of unidentified body burials at Allerton cemetery.

December 5, 2004 - The Crown Prosecution Service decides there should be no prosecution of Prof Dick Van Velzen for criminal offences.

June 20, 2005 - General Medical Council rules that Dutch pathologist Dick van Velzen should be banned from practicing medicine permanently in the UK.