Clinicians and managers at the BMI Edgbaston Hospital, where McMinn carried out the majority of his operations, actively took part in the collection of bones and – even after alarms were raised – the hospital did not immediately act to stop the tissue being taken away, according to a leaked internal report seen by The Independent.
For more than two decades, Derek McMinn harvested the bones of his patients, according to a leaked report – but it was not until last year that anyone challenged the renowned surgeon. The full scale of his alleged collection was apparently kept from the care regulator until just days ago, and thousands of those who went under his knife for hip and knee treatment still have no idea that their joints may have been collected in a pot in the operating theatre, and stored in the 67-year-old’s office or home.
An investigation found operating theatre staff at the private hospital left dozens of pots containing joints removed from patients femurs during hip surgery in a storage area, in some cases for months. According to the report, there had been warnings about their responsibilities under the Human Tissue Act when an earlier audit between 2010 and 2015 identified the storage of femoral heads, the joints removed in the procedure.
The internal report said there was no evidence McMinn had carried out any research or had been approved for any research work – required by the Human Tissue Authority to legally store samples. It said one member of staff told investigators the samples were being collected for research on McMinn’s retirement.
“She stated that it was known that there was no live research and that he intended to carry out research when he retired ‘to keep his mind active’. She explained that this was ‘common knowledge’ within the hospital.”
Despite thousands of patients potentially being involved, including some NHS patients, BMI Healthcare’s parent company Circle Health, which took over in June, told The Independent that none had been informed because it adjudged no significant harm to have taken place, meaning there was no “regulatory requirement” to contact them.
However, after being asked by The Independent to justify this, the company said: “In the interests of openness and transparency, we are revisiting this with additional external advice and expect to take further action.”
Although the Care Quality Commission knew about claims that a small number of bones being kept by McMinn, it is understood that the regulator received a copy of the BMI Healthcare investigation report only last Friday, after The Independent had made initial inquiries about the case. That report suggests a minimum of 5,224 samples had been taken by McMinn.
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The regulator confirmed to The Independent it had not been aware of the extent of McMinn’s supposed actions.
Professor Ted Baker, the CQC’s chief inspector of hospitals, said: “While we understand that BMI’s internal investigation incurred delays, it is disappointing that it has taken so long for the findings to be shared with us. We will be reviewing the reports in full to understand the findings and how BMI are responding to them, to determine whether there is a need for CQC to take any further action.”
Similarly, the General Medical Council has confirmed it also did not have copies of reports completed by BMI Healthcare, though it had been informed by the company about its findings concerning McMinn. Despite these concerns, McMinn remains registered to practise with the medical watchdog with no restrictions.
The GMC said: “We can’t provide detail on evidence we have received while investigations are ongoing. However, we are aware of the concerns and have asked BMI Healthcare to provide us with their investigation reports and any evidence that may raise concerns about a doctor’s fitness to practise.”
McMinn also operated on patients at Spire Healthcare’s Little Aston Hospital in Birmingham but, while BMI Healthcare claimed it had alerted Spire that its patients may have been involved, Spire told The Independent it had not received any communication about Derek McMinn.
An insider at BMI Healthcare accused the company of “covering up”, adding: “Quite senior staff at the hospital went along with it and just handed the pots over to his staff when they came to collect them.”
It added that the collection of bones had not been documented by operating theatre staff: “No logs or records were maintained by theatres in respect of the samples collected, stored and handed to Mr McMinn’s team. Therefore, there is no evidence available locally to establish how many samples were collected and given to Mr McMinn within the department or hospital. The theatre manager said they were placed in the room and then forgotten by theatre staff until they were collected by Mr McMinn or his team.”
On the issue of consent the report said the theatre manager “had not seen, at any time, any written evidence of consent and had never witnessed oral consent being obtained. She stated that she had assumed it was always completed in clinic by Mr McMinn and she had not sought to clarify this at any time.”
A routine audit identified 20 pots containing human bones in March last year which triggered concerns to senior managers. The report said: “At the time of discovery, samples were collected in theatre by BMI staff. BMI staff then placed the tissue in pots and filled the pots with formalin. The pots were ordered by and supplied by BMI.
“Theatre staff then placed the pots in cardboard boxes in a store room in the theatre suite. These boxes would then be collected by McMinn Centre staff and taken off site every three to four months when they were full.”
After concerns were raised the hospital wrote to McMinn telling him that the bones had to be removed from the site on the day of the surgery as the hospital did not have a licence from the Human Tissue Authority. At no point in this correspondence did the hospital instruct McMinn to stop nor did it ask questions about consent.
This happened only weeks later, when the CQC learned of the issue and asked the hospital to confirm it was authorised to store human tissue and McMinn had consent from patients. The Human Tissue Authority was informed after the CQC raised concerns last year.
In a statement the HTA said: “Following an investigation after concerns were raised at the BMI The Edgbaston Hospital, we made a referral to the police. We cannot comment further on the police investigation.”
The Independent understands the HTA has seen the internal report and has spoken to staff at the Edgbaston Hospital. West Mercia Police said: “We are currently investigating an allegation of breach of statutory licensing requirements under the Human Tissue Act 2004 following a referral from the Human Tissue Authority. Our investigation relates to a private premises in Worcestershire. We are working with the relevant authorities as part of our ongoing investigation.”
