An 11th- hour intervention by the Department of Health failed to stop Bristol heart surgeons carrying out a fatal operation on an 18-month- old boy.
The General Medical Council's professional conduct committee heard last week that Peter Doyle, senior medical officer at the DoH, called United Bristol Healthcare trust medical director James Wisheart and 'expressed concern' about the decision to operate on Joshua Loveday.
Joshua, from Gloucester, was the last of nine out of 13 children to die at the Bristol Royal Infirmary after 'switch' operations performed there by surgeon Janardan Dhasmana between July 1992 and January 1995.
The hearing also heard a meeting of surgeons and anaesthetists had met to discuss the operation on the evening before it was carried out on 12 January 1995.
Mr Wisheart admitted under cross-examination it was 'highly likely' Mr Dhasmana would have agreed to postpone the operation if he had told him to do so.
He also agreed that anaesthetists, including 'whistleblower' Stephen Bolsin, had expressed strong views that the operation should not go ahead.
But Mr Wisheart said Mr Dhasmana had agreed at the meeting that he should operate.
He said he had also taken the concerns of consultant cardiologist Robert Martin into account. He said the operation could not be delayed for long.
Mr Wisheart is accused of giving his approval for the operation on Joshua despite concerns expressed by colleagues, when it was not in the patient's best interests and without taking any adequate steps to have him referred elsewhere for surgery.
Mr Wisheart is charged with continuing to perform AVSD (hole in the heart) operations despite the concerns of others.
Mr Dhasmana faces similar charges relating to his 'switch' operations (involving the heart's two main blood vessels).
John Roylance, former UBH chief executive, is accused of failing to take action to stop the two surgeons operating on babies after concerns were expressed about mortality and morbidity at the hospital.
All three deny serious professional misconduct.