Surgeon's finger was 'oozing' with blood

But 83-year-old Blodwen Jenkins died of hepatitis B 14 weeks after Mr Ingley carried out the hip replacement operation at Ysbyty Gwynedd in Bangor in July last year.

Mr Ingley denied a charge of serious professional misconduct when he appeared in front of the GMC yesterday.

He took up the job as a registrar specialising in orthopaedics at the hospital last July despite knowing he was infected with hepatitis B.

He admitted cutting his finger during the operation but denied it was bleeding heavily.

He also denied taking inadequate precautions to protect patients and colleagues.

The hospital was aware he carried the virus, which is transmitted through blood, but allowed him to carry on working because he was considered to be a low risk carrier.

Staff Nurse Elaine Gregory, from Anglesey, who assisted in the operation on the elderly patient, told how Mr Ingley had cut one of the fingers on his left hand when he made the incision.

''It was bleeding quite heavily,'' she said. ''You could see the blood. I would say it was oozing. I vaguely remember swabs being used and another pair of gloves was put on the top of the ones he was wearing.''

Mrs Gregory, who was not aware at the time that Mr Ingley had hepatitis B, said she was concerned about the amount of blood and also the fact that the surgeon said his finger was numb. But he insisted on carrying on, saying it was in the patient's best interests because the incision had been made.

Mrs Gregory, who said she was standing so close to the surgeon that she was ''almost touching him'', added: ''As the operation progressed, you could see it (the blood) coming up the glove to the palm. That was how it appeared.''

She said that after the operation one of the other nurses was concerned that an accident report form should have been filled in about the cut.

The hospital said that none was filled in at the time.

Dr Lindon Miles, who worked in the hospital's occupational medicine department at the time, said that one of Mr Ingley's previous employers wrote to the hospital just before Mr Ingley was taken on, telling them that he had hepatitis B but that he had been allowed to carry on operating.

Dr Miles said he phoned Mr Ingley, who agreed to undergo further tests, which showed he was still a low risk carrier.

The two men spoke on the telephone before Mr Ingley took up his job at the Ysbyty hospital, when Dr Miles impressed upon him that he had to carry on taking ''extraordinary procedures'' in order to stop transmission.

Mr Ingley said he had undergone counselling after discovering he had the virus, and Dr Miles said he was satisfied he knew what he should do to be able to work safely. He then issued a certificate saying that the surgeon was fit for duty.

Sister Gwynneth Langham was in the theatre for the start of Mrs Jenkins' operation but left after it got under way.

She told the hearing she was sitting in a coffee room at the hospital when someone came out of the theatre to say that Mr Ingley had cut himself during the operation and was complaining of numbness to his finger.

She went into the theatre and asked Mr Ingley if she should call in another surgeon who could complete the surgery if he could not manage it. He agreed with this.

''I noticed there was blood under his gloved hand and the area of blood was increasing which made me think the cut was reasonably deep to still be bleeding at that stage.''

It was agreed that Mr Ingley would carry on but in the meantime she phoned his boss George Attara at home and he arrived at the hospital 20 minutes later.

By that stage the operation was almost complete and Mr Ingley finished it off.

Afterwards she cleaned and dressed Mr Ingley's wound.

Mr Attara, a consultant orthopaedic surgeon at the hospital, said he offered to complete the operation but Mr Ingley said it was not necessary.

He said he did not know Mr Ingley was a hepatitis B carrier at the time. If he had known he said he would have got in touch with a medical team to ask for advice.

The hearing continues.