Summary
The Collections
The Heart Collection
14. The heart collection was
started in 1948 by Dr John Hay, subsequently Professor of Child
Health, and became clearly established in the period 1948–1954
and since then has continued to grow. It resides at the Institute
of Child Health (ICH) at Alder Hey. In October 1999 the heart record
books released to the Inquiry referred to 2,128 hearts. It is regarded
as one of the leading two collections in the country and one of
the most extensive in the world. It has been used by many specialists,
both national and international. In 1978 it attracted funding from
the National Heart Research Fund and subsequently the Greenwood
Trust, the British Heart Foundation and the Endowment Fund of the
Royal Liverpool Children's Hospital. The University of Liverpool
is responsible for management of the ICH. The premises are actually
at the Alder Hey site where clinicians have direct access for education,
research and surgical purposes. Overall, on all the evidence, we
concluded that the ultimate responsibility for the collection was
joint, between the University and Alder Hey.
The Fetal Collection
15. The fetal collection at
the ICH was recorded in February 2000 as containing 1,564 stillbirths
or pre-viable fetus including 52 late premature or term fetus, although
none since 1973. The store of primarily intact fetal tissue started
in 1955 with identification details from 1975 and ceased in 1992.
The collection was again started by Dr Hay. In 1986 the new ICH
building was opened and included a room specifically designed for
the fetal store. At one stage the collection contained a total of
3,575 fetus but in the three years before transferring to the new
ICH building, a substantial number were incinerated. In replying
to the Chief Medical Officer's census in February 2000, the University
accepted that it bore responsibility for the fetal collection in
the ICH.
The Fetal Collection at Myrtle Street
16. Following Professor van
Velzen's arrival in 1988, fetus began to be referred to his Unit
of Fetal and Infant Pathology by the Unit 3 management group including
Mill Road Hospital, which closed in 1992, Liverpool Maternity Hospital,
which closed in 1995, and the Women's Hospital in Catherine Street,
which closed in 1995. The three hospitals were subsequently incorporated
into the Liverpool Women's Hospital NHS Trust which was established
in 1992. This was essentially a diagnostic regional service for
fetal abnormalities and approximately 100 fetus per year were received.
The service did not exist prior to Professor van Velzen's appointment.
Due to Professor van Velzen's failure to attend to the fetal pathology
service, a backlog built up and was never resolved. In December
1999, 445 fetus were retained at Myrtle Street dating back to 1989–1991.
Of the 445 fetus, 198 were intact. In February 2000, a further 30
fetus were identified. There seems little doubt that the majority
of fetus at Myrtle Street came through the NHS diagnostic route
and the remainder were transferred by the ICH. Limited research
has been carried out upon this fetal collection. Alder Hey must
accept broad responsibility for the Myrtle Street fetal collection.
However, its uses included research activity by the University,
who must accept some responsibility for its existence.
The Collection of Children’s Body Parts at
the Institute of Child Health
17. The store contains a number
of children's heads and intact bodies dating back to dental cleft
palate research in the 1960s. Some material was disposed of by proper
funeral arrangements and much was disposed of at the time of the
move from the Dental Hospital. The material transferred to the ICH
did form the basis for research until 1973/74. A number of hospitals
supplied bodies, once consent had been provided, for research purposes.
The store now consists of 22 body parts from 15 children. There
are 13 post natal heads/parts of heads from children from a few
days old to 11 years of age dating back to the 1960s and 22 heads
from late premature/term fetus. There are two containers with a
whole body of a child in one and the separated head in the other.
Perhaps the most disturbing specimen is that of the head of a boy
aged 11 years. The most recent specimen was obtained in 1973. There
was extensive publication in relation to the work undertaken in
respect of cleft palate malformation. There is no doubt that responsibility
for this collection lies with the University, given the nature and
purposes of the collection.
The Eye Tissue Collection at the Royal Liverpool
University Hospital
18. The University notified
the Inquiry of the fetal eye collection on 24 March 2000. It took
some time for us to obtain facilities to view the collection. We
established that the store contains 188 eyes and 2 optic nerves
from 109 specimens. The majority consists of both left and right
eyes but there are some specimens where only one eye is present.
A number of the eyes were removed from children at post mortem examination
at Alder Hey. The majority were obtained from fetus but we highlighted
12 cases where eyes had been taken from identified neonates and
children. The youngest child had lived for only an hour, the oldest
for 21 months. The specimens were taken from fetus as long ago as
1988. A total of 79 of the 109 specimens had been used in research.
The other specimens in the collection remain intact, stored in fixative.
There are 100 analysed eyes and 88 unanalysed eyes. All the eyes
have been retained and are stored in a double locked room in the
Royal Liverpool University Hospital. The eye collection is clearly
a store for which the University has ultimate overall responsibility.
Animal Material at the ICH/Myrtle Street
19. Within the heart collection
but separate from it are a small number of animal hearts retained
essentially for comparative work. There are a small number of hearts
from pigs, lambs, rats and chicks. There are some hearts from very
rare species of animals including a red kangaroo, a gibbon and a
giant tortoise, given to the ICH for comparative studies. These
hearts are kept on a completely separate shelf from human hearts
and are clearly identified. There is no suggestion that the animal
hearts have been stored in the same containers as human hearts.
Some animal material was also stored at Myrtle Street in the basement.
In particular, there was research on lamb and piglet hearts in relation
to cot death. This material was stored separate from human material
and there is no question of animal material having been held in
the same container as human tissue or organs.
Cerebellum Collection
20. In August 2000 we discovered
the existence of a cerebellum collection. The cerebella had been
taken from brains already held at Myrtle Street, where they had
accumulated during the van Velzen years. Alder Hey revealed that
147 families were affected and in particular, 58 sets of parents
who had already had second funerals were told that there were cerebella
yet to be buried. The University held back the existence of the
collection in late 1999, probably in order to complete research.
It retained the collection despite public knowledge of return of
organs for second funerals and the inevitability of third funerals.
