Charity Blamed In Children's Deaths -- Critics Say Operation Smile Practices Assembly-Line Medicine

NORFOLK, Va. - Operation Smile, a charity that sends surgeons around the world to fix the cleft palates and lips of poor children, is under fire for allegedly shoddy medical practices and 16 patient deaths.

The charity, based in Norfolk, has raised millions of dollars and provided free surgery to 53,000 children in 19 countries since 1982.

Critics in the United States and such places as China and Kenya have accused the organization of assembly-line medicine. The New York Times yesterday quoted a Chinese report as saying the surgeons "prioritized numbers treated at the cost of quality and safety."

Operation Smile's co-founder, plastic surgeon William Magee Jr., denied the allegations. He said Tuesday that a lawyer has been hired to review the charity's operations and will report by January.

Last year four children died during or after surgery, The Times said. Charity officials acknowledged losing 12 other patients since 1982. Deaths from cleft-palate or lip surgery are rare in the developed world. Anonymous e-mails of complaint, made public Tuesday, were sent in September and this month to Operation Smile's board members, staff members and corporate sponsors.

One of the e-mails, signed by a "concerned Op Smile mission volunteer," said a 2-year-old girl in China died because of substandard anesthesia-monitoring techniques.

Monitoring of anesthesia was increased overseas after the 1998 death, Magee said. The girl, who had a heart condition, suffered

cardiac arrest while anesthetized.