Summary

At the end of February 1994, the pediatric cardiac surgery program resumed service. While the resulting problems were not yet fully apparent, the program's structure was clearly flawed. Lines of authority were fractured, team members had not had a chance to develop trust or confidence in one another-indeed, difficulty with communication was already emerging as an issue. Other issues that could have been identified at this point, such as Odim's concern with the number of anaesthetists or the limitations of the ICU wards, had not been properly flagged. These problems stemmed from the fact that the Department of Surgery and the Department of Pediatrics had not provided Odim with a strong orientation, while, at the same time, Odim appears to have declined to benefit from the more informal opportunities that had been presented to him.