The Bristol heart scandal occurred in England during the 1990s. At the Bristol Royal Infirmary, babies died at high rates after cardiac surgery. An inquiry found "staff shortages, a lack of leadership, [a] ... unit ... 'simply not up to the task' ... 'an old boy's culture' among doctors, a lax approach to safety, secrecy about doctors' performance and a lack of monitoring by management".[1] The scandal resulted in cardiac surgeons leading efforts to publish more data on the performance of doctors and hospitals.[1][2]