Heart op banker died after vital machine left off for 19 hours
A HIGH-FLYING City boss died at one of Britain’s largest private hospitals after a vital piece of equipment was switched off for 19 hours, an inquest heard.
Robert Entenman, 57, underwent routine heart surgery at the London Bridge Hospital, which describes itself as ‘world-class’, and was recovering well.
But eight days after the procedure aimed at repairing a broken valve in his heart – an operation described as ‘99 per cent safe’ – the father of two went into cardiac arrest.
A humidifier attached to the ventilator, designed to prevent a build-up of mucus in the lungs, became blocked after being switched off for 19 hours, Southwark Coroner’s Court heard yesterday.
Mr Entenman, from Chislehurst,
‘Most likely cause of the arrest’
south-east London, had been helped by a ventilator since his surgery on May 15 last year, and the humidifier was being used to moisten the gases and stop secretions building up in the tube.
Intensive care consultant Dr Duncan Wyncoll told the inquest that he believed the pipe to Mr Entenman’s airway had become congested because the humidifier had been switched off. He said he saw a blockage of almost two inches in the endotracheal airway tube when it was replaced.
‘At the end of the tube was a thick mucus plug right at the tip of the endotracheal (ET) tube. That told me that was the most likely cause of the arrest,’ he said.
Dr Wyncoll added: ‘I feel the absence of the humidifier for a prolonged period of time had made them (secretions) sticky, leading to the tube blocking.’
Dr Chee Wong, who was on night duty in intensive care at the hospital, said: ‘There was a dark brown solid mucus plug of 5cm in length at the end of the ET tube.’ Asked what happened after the blocked tube was replaced, Dr Wong said: ‘Immediately the chest wall started expanding nicely and the saturation improved.’
American-born Mr Entenman, who was global head of e-commerce for Uni-Credit Bank, who weighed 22 stone and suffered from Type 2 diabetes, had undergone the operation successfully.
Consultant cardiothoracic surgeon Dr Inderpaul Birdi told the inquest that the banker was starting to make a recovery.
After seeing him on May 22, a week after the operation, Dr Birdi said: ‘I was so pleased by what I saw.
‘He was moving his arms and trying to speak to me. He shook my hand. I said to him all was going to be fine and I left.’
But Mr Entenman’s life support machine was turned off on May 30 after tests found that oxygen starvation during the 15-minute
‘Very significant brain injury’
cardiac arrest had left him with ‘very significant brain injury’.
Doctors originally thought there was no brain damage but a CT scan later confirmed it.
Dr Hadi Orman, who also cared for Mr Entenman, said that although the patient was strug- gling to breathe through the ventilator, it was unclear why at the time.
In a report after the banker’s death, Dr Orman said the blockage was ‘the most likely cause’ for ventilation problems, although he told the inquest he did not remember saying that.
Dr Andreas Marnerides said Mr Entenman died ‘because there was not enough oxygen to the brain’. He added: ‘The reason for that was the blockage of the ET tube.’
The Entenman family’s lawyer, Paul McNeil, said he will explore whether a High Court negligence claim can be brought after the coroner has reached his conclusion. The inquest continues.