Medical Council inquiry: main findings

Dr Michael Neary found guilty of professional misconduct in relation to his treatment of 10 patients whose wombs he removed.

Dr Michael Neary found guilty of professional misconduct in relation to his treatment of 10 patients whose wombs he removed.

Hysterectomies in association with pregnancy were carried out more than 20 times as frequently in Our Lady of Lourdes Hospital, Drogheda, between 1993 and 1998 as in the Coombe Women's Hospital or in the National Maternity Hospital.

Dr Neary carried out one Caesarean hysterectomy for every 20 Caesarean sections he conducted between 1993 and 1998. The rate at the Coombe was one per 600.

The practice in Drogheda, as demonstrated by these figures, fell "very substantially outside the range of what might be accepted. From these figures the committee can only conclude that it is highly probable that the procedures carried out in Drogheda were largely unnecessary".

READ MORE

It found Dr Neary showed a pattern of rapid recourse to Caesarean hysterectomy.

There was a substantial and continuing pattern of discrepancy between his clinical findings and those of pathologists.

Dr Neary had a tendency to exaggerate events - in four cases a blood transfusion was not felt necessary at all despite descriptions being used of the haemorrhage as being "uncontrollable", "copious non-stop" and "continuous".

He overreacted to what he perceived to be copious bleeding.

The notes in a number of cases did not seem to represent what had actually transpired in the operating theatre and tended to exaggerate or overdramatise blood loss and/or the risks to the patient.

The fitness-to-practise committee found he made "profound errors of judg ment with very serious consequences for each of the patients".

There was no mechanism either within the hospital or elsewhere to ensure such errors as occurred might be corrected or that a pattern of adverse or unusual outcomes should be properly monitored.

It also found there was "a curious internal and external culture of isolation and absence of consultation" within Our Lady of Lourdes Hospital.

There appeared to have been little evidence of consultation with colleagues or with practitioners in other disciplines such as pathology in order to preserve and maintain acceptable medical standards.

Dr Neary did not accept that he adopted any wrong procedure in any of the 10 cases. Explaining his rate of hysterectomies he said sterilisation was not permitted at the hospital and blood supplies were often scarce.

He also claimed there were 16 maternal deaths at the hospital between 1964 and 1974.

In addition, he said he effectively worked on a one-in-two rota which was "a very punishing schedule".

At one stage "one of his colleagues suffered from ill-health which restricted his ability to share fully the burdens with Dr Neary".