Inquiry told how child was given wrong operation

Tue, Sep 18, 2012, 01:00

A MOTHER whose 2½-year-old had an unnecessary tongue-tie operation at a Dublin hospital told a Medical Council fitness-to-practise inquiry yesterday her daughter was “constantly drooling” and “her tongue was hanging out of her mouth” after the procedure.

“Siobhán”, the mother of Baby X, from Co Meath, said she corrected hospital staff when they told her before the procedure went ahead that a tongue-tie operation was to be carried out.

The child was under the care of Prof Martin Corbally, who was a paediatric surgeon at Our Lady’s Children’s Hospital in Crumlin, but is now working in Bahrain and yesterday followed proceedings via video link.

The consultant had previously faced allegations of professional misconduct when a patient in his care had the wrong kidney removed despite pre-surgery concerns raised by the parents. That case concluded when an inquiry agreed to accept undertakings from Prof Corbally and a junior doctor to whom he had delegated the operation about their future medical performance.

In yesterday’s case Prof Corbally faced four allegations of poor professional performance in relation to his treatment of Baby X, including that he incorrectly described the procedure needed by the child on her notes and delegated the procedure to a junior without adequate communication.

JP McDowell, solicitor for the Medical Council, said on examination, in February 2010, Prof Corbally found the child’s upper labial frenulum, a fold of skin attaching the upper lip to the gum, was too tight, causing a gap in her front teeth and needed to be excised – an operation called an upper labial frenulectomy. In his notes he described the procedure as an excision of the “upper lingual frenulum”. This was inputted into the hospital computer as a tongue-tie procedure – a lingual frenulectomy – to release the fold of skin holding the tongue to the floor of the mouth. The computer had only “one code” for all three possible types of frenulectomies, Mr McDowell said.

When Baby X attended the hospital’s day ward on April 30th, the nurse and the admitting doctor examined her and spoke to her parents, who explained the procedure she actually needed.

Prof Corbally delegated the operation to a fourth-year registrar, Farhan Tareen, telling him to “release the tongue tie”.

The surgeon carried out a lingual frenulectomy. The mistake was discovered when the child was in recovery and she was readmitted to theatre, where Prof Corbally then carried out the correct operation. He apologised to the parents about the mistake, Mr McDowell said.

The parents afterwards made a formal complaint to the Medical Council.

Giving evidence yesterday, the girl’s mother said she returned to Dr Corbally on May 18th because of the pain her daughter was in. She was also “constantly drooling” and “her tongue was hanging out”. But she said her daughter was now fine. She told the inquiry on the day of her daughter’s operation that the admitting doctor referred to her “tongue-tie” procedure and she told the doctor it was not the procedure her daughter was to have. The doctor said “we still call it that”. The mother asked the doctor “are you sure?” and was told yes.

Under cross-examination by Eileen Barrington SC, for Prof Corbally, the child’s mother agreed that her daughter was seen promptly when a follow-up was requested and said she was glad the hospital computer system had since been amended.

Ms Barrington said Prof Corbally had to describe the procedure in the way he did in order for it to be “caught” by the hospital’s computer system. It did not amount to poor professional misconduct, she said.