Patient Recall Over Possible Unnecessary Heart Procedures
More than 160 patients with advanced heart conditions are to be recalled by the Belfast Health Trust following a review that indicated some may have undergone a procedure unnecessarily.
The recall affects only those patients who were fitted with a Cardiac Resynchronization Therapy (CRT) device, a more complex device than a standard pacemaker, between 2007 and 2023.
In an official statement, the trust emphasized that CRT devices are safe and that patients treated by cardiologist Dr Ernest Lau do not need to take any immediate action.
A complaint from a patient in 2023 led the trust to notify the Royal College of Physicians (RCP), which requested a review of cases dating back to 2007.
The Belfast Trust confirmed that Dr Lau remains an employee but has not seen patients in the past three years while the review is ongoing.
The trust added that it could not provide further details regarding human resources matters.
In recent weeks, letters were sent to 25 patients, with an additional 35 patients contacted this week to inform them of the situation.
A spokesperson for the trust confirmed to NI that the recall could impact up to 163 patients and that they are initially contacting smaller groups.
The trust stated that between 2023 and 2024, concerns were identified regarding decisions to implant very specific and specialist devices for several patients under Dr Lau's care. At that time, the trust requested the RCP to conduct an expert and independent review of multiple cases.
According to the trust, the RCP agreed with some concerns about Dr Lau's decision-making and recommended further investigation.
Although concerns about the cardiologist were raised by colleagues in 2020, no action was taken until a patient complaint was made three years later.
The trust said that due to patient confidentiality, it could not discuss details about the welfare of the patient who made the complaint.
It remains unclear why patients have only recently been notified.
The trust is also reviewing records of deceased patients. No link has been identified at this stage, but this may change as the review progresses.
A spokesperson emphasized that only patients fitted with a CRT device between 2007 and 2023 are affected by the recall.
What are Cardiac Resynchronization Therapy Devices?
CRT devices, also called biventricular pacemakers, are designed for patients with specific advanced heart conditions where the heart's lower chambers (ventricles) do not contract synchronously.
While functioning similarly to a standard pacemaker to treat slow heart rhythms, a CRT-P device also delivers small electrical impulses to both the left and right ventricles to help them contract simultaneously, improving the heart's pumping efficiency.
Although thousands of people in Northern Ireland have standard pacemakers, CRT devices are less commonly used.
Findings of the Review
The review of cases from 2007 to 2023 identified 684 individuals who had been fitted with a CRT device.
The RCP established criteria to determine which patients should be recalled, a standard practice.
Of the 684 patients identified, 163 met the criteria for review, though this number could increase.
The cases have been divided into smaller groups, allowing cardiologists to conduct reviews alongside their regular duties.
Based on the review, affected patients are either invited to attend a face-to-face consultation or informed that while a consultation is not mandatory, one will be arranged if requested.
The trust stated it has begun writing to each patient, offering the opportunity to meet a consultant cardiologist to discuss the review results.
The focus remains solely on patients who had a CRT device implanted by Dr Lau.
Several patients have already been seen by a specialist consultant cardiologist involved in the review at a dedicated clinic, with more appointments scheduled in the coming weeks. Notifications are sent by letter.
A relative of one patient reported that receiving the letter caused significant distress.
Sources told NI that some consultants expressed frustration over the length of time the trust takes to review a consultant's work.
One medical professional described the review process as unnecessarily lengthy, causing distress among patients and frustration among doctors in the affected department.
The trust encourages anyone with concerns to contact them directly.
