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University of Iowa transplant surgeon sanctioned for 2017 operating-room death [1]
['Clark Kauffman', 'More From Author', '- July']
Date: 2022-07-28
A University of Iowa transplant surgeon has been sanctioned by state licensing authorities after being accused of being under the influence of drugs while operating on a patient who died during the procedure.
The patient death occurred in 2017 when Dr. Alan Hemming was the director of the Center for Hepatobiliary Disease and Transplantation at the University of California in San Diego. Currently, Hemming is a clinical professor of surgery at the University of Iowa.
According to California state records, in September 2017, one of Hemming’s colleagues at UC spoke to him about two livers that were available for a transplant patient who had end-stage liver disease. The worker noticed Hemming had a hard time following what she was saying and that he was unable to differentiate between the two available livers. A day later, Hemming was notified of surgery that was planned for the patient the next morning at 6 a.m.
Hemming didn’t appear at the hospital for the surgery, which eventually proceeded with another doctor in his place. A UC employee was able to reach Hemming by phone at 9 a.m., at which point Hemming allegedly yelled that the procedure should not go forward.
At 9:45 a.m. that day, Hemming allegedly appeared in the operating room, by which time his colleagues had almost completed the removal of the patient’s old liver. He did not have a surgical hat on and was instructed to go get one. He then scrubbed in and took over as the lead surgeon.
At one point in the procedure, Hemming allegedly stopped and begam swaying back and forth. When asked if he all right, he allegedly replied that he was tired and that interns kept calling him during the night. He then proceeded with the operation and allegedly cut the patient’s hepatic vein, which runs from the liver to the heart, causing the patient to bleed profusely. A colleague tried to intervene and help stop the bleeding but Hemming allegedly refused to let her assist.
An anesthesiologist then stepped in and began giving the patient multiple units of blood. Hemming was unable to stitch the vein closed and the surgical team had a hard time placing the new liver in the patient due to the bleeding.
Wandering, asking where the operating room is
Hemming continued to try to stitch shut the cut vein, according to California state records, but the stitches became tangled and he allegedly wound up sewing some veins closed while sewing other things to the back wall of the surgical opening. When a colleague repeatedly tried to explain the errors, Hemming reportedly appeared unable to comprehend what she was saying.
According to the California state records, Hemming then unclamped another vein, causing more bleeding, and for 20 minutes the patient coded – a term that is generally used to describe someone in cardiac arrest. Then, when a colleague’s glove got caught on a clamp, Hemming allegedly opted not to cut the glove or put on another clamp. Instead, he reportedly released the clamp, causing the patient to bleed out from the heart and die.
In the immediate aftermath of the surgery, Hemming allegedly blamed one his operating-room colleagues for the death, then began wandering around while asking where the operating room was.
During a subsequent investigation, Hemming reportedly attributed his conduct to the Ambien – a sedative hypnotic that is also a Schedule IV narcotic – he took the night before.
Several months later, he was removed as UC’s head of the transplant program. At the time, neither the school nor Hemming commented publicly on the reason for the change.
In 2019, Hemming moved to Iowa and, according to California licensing authorities, took a position as the University of Iowa’s surgical director of the liver transplant program.
Last October, the California licensing board filed charges against Hemming over the 2017 operation. The board charged him with gross negligence, alleging he had operated on a patient while in an altered state and then failed to speak to the patient’s family immediately after the procedure. He also was charged with using a controlled substance to the extent that it impaired his ability to practice medicine, and with repeated negligent acts.
Two weeks after filing those charges, the board acknowledged that Hemming’s move to Iowa meant that the imposition of probation was not feasible. Hemming agreed to surrender his license to practice medicine in California where, he told the board, he had no intention of returning.
The Iowa Board of Medicine recently voted to fine Hemming $5,000 and issue him a warning, stating that if he again engages in the conduct alleged by the California board he could face further disciplinary action.
In addition, the board has placed Hemming’s Iowa license on probation for five years during which time he will participate in a monitoring program.
Hemming did not return Iowa Capital Dispatch’s call seeking comment on Thursday.
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