A CARDIOLOGIST was ‘overstretched’ when he carried out experimental heart surgery on patients, a misconduct hearing was told today.

Dr Joe Motwani, is also said to have conducted two clinical trials at Derriford Hospital in a ‘careless, inadequate and unethical manner’.

In both trials, it was found that patient consent forms had been post-dated once treatment had already started, the General Medical Council has heard.

The cardiologist was treating patients with percutaneous coronary intervention (PCI) – a controversial alternative to open heart surgery which involves accessing blocked arteries by inserting a wire into the wrist.

But the surgeon was including patients in his trial who were not well enough to give consent, it is said.

Expert witness Terence Stacey, director of the Central Office for Research Ethics Committee, said Motwani should have got ‘specific approval’ to include emergency cases in his research trials.

Mr Stacey said although official guidance offers a ‘smorgasbord’ of ways that researchers can get consent ‘it isn’t giving the investigator a pick and mix choice’.

He added that only when an ethics committee has approved a research plan including the way consent was obtained that it became ‘sacrosanct’.

Andrew Hurst, for the GMC, said some of Motwani’s heart patients had been admitted as emergency cases – and were not told of the procedure they were due to undergo.

Mr Stacey said an ethics committees would understand the need for the trial, and said patients had been known to be entered onto a trial while unable to give consent.

But he explained: “The moment they are able to understand what has been going on, you must discuss what has happened.”

They would then be able to consent as to whether or not they wished to continue with the medical trial or not, the panel heard.

He told the hearing: “I think Dr Motwani found that he got a lot of acute patients.

“That is the point where he should have gone back to the ethics committee and said I am having problems.”

Mr Stacey said if the doctor had asked to change the consent procedures “they would have undoubtedly said yes”.

During the hearing he also agreed that Motwani was overstretched at the time of the trials.

Ian Stern, for Motwani, said: “From what you have seen Dr Motwani was overstretched.”

Mr Stacey replied: “I think he was overstretched. The idea is a good one, it seems very ambitious. I would have thought he needed some support to do that research.”

He added: “The question I would ask is in the situation, is it right to continue to do the research?”

Motwani, of Deerleap, Down Road, Tavistock, also faces claims that he acted out of ambition and not in the best interests of patients who her performed PCI on. He denies misconduct. The hearing continues.

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