A fitness-to-practice inquiry regarding a doctor who performed surgery on a Limerick woman who died three days later has heard gardaí requested to be told of the committee’s findings, but there has been no prosecution.
Dr Ashish Uday Lal, while a consultant surgeon at University Hospital Limerick (UHL), operated on May 8th, 2018, to remove a benign tumour from the abdomen of 18-year-old Jessica Sheedy, who died three days later following a significant bleed.
Dr Lal, who made full admissions as to fact, was found guilty on Tuesday of professional misconduct and poor professional performance.
Neasa Bird, for the chief executive of the Medical Council, told the fitness-to-practice panel that while her client did not agree that conditions would be an appropriate sanction these should be the minimum sanction recommended by the committee.
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Ms Bird said if the committee were to recommend the imposition of conditions regarding Dr Lal’s registration then these would need to be “far reaching and significant” and an extensive plan would have to be put in place for his return to surgical practice.
This should include steps to address the deficiencies identified in his practice regarding Ms Sheedy, she said.
Ms Bird said Dr Lal’s return to work should not encompass a return to abdominal surgery.
She said the chief executive was requested by An Garda Síochána to be told about the findings of the committee and of any report by the committee.
Ms Bird told the hearing there was no prosecution brought by the DPP concerning Dr Lal’s conduct regarding Ms Sheedy.
She said this after Simon Mills, SC for Dr Lal, made his submissions as to what sanction the medic should face.
Mr Mills said that while there were a chronological series of failures, these related to the care of a single patient, Ms Sheedy.
Mr Mills said this should be treated differently to a single serious failing made regarding a range of patients or where there were multiple failings made regarding multiple patients.
He told the inquiry that Dr Lal had worked at UHL for five-and-a-half years as a consultant surgeon before the operation on Ms Sheedy.
The inquiry heard how Dr Lal was also the subject of two other complaints to the Medical Council which were deemed not to meet the threshold of seriousness to warrant a formal fitness-to-practice inquiry.
Mr Mills said Dr Lal, following feedback from the legal team for the Medical Council chief executive, was agreeable to 19 conditions being attached to his registration.
These included that Dr Lal would return to general surgery excluding retroperitoneal surgery, which relates to the space behind the abdominal or peritoneal cavity, and any surgery involving benign tumours.
Furthermore Dr Lal would identify a supervising consultant of general surgery who would supervise his general abdominal practice and help to devise a professional development plan.
Mr Mills said references supplied by three surgeons with whom Dr Lal has worked with in New Zealand were the “most accurate snapshot” regarding what type of surgeon in the round he was.
The inquiry heard how Dr Lal had worked as a surgeon in New Zealand for about nine months across four periods in 2021, 2023 and 2024.
The inquiry heard how Dr Lal’s registration in New Zealand became the subject of a number of conditions as a result of a complaint made concerning damage that occurred to the common bile duct of a patient on whom he operated in 2021.
Ms Bird told the inquiry the complaint did not proceed to a formal fitness-to-practice inquiry, but there were conditions attached as there was a concern that Dr Lal’s practice did not meet the required standards of competence.
She also said the complaint related to an abdominal surgical incident.
Members of Ms Sheedy’s family brought a framed photo of Ms Sheedy, from Caherguillamore, Bruff, Co Limerick, to the hearing and were emotional at times.
The inquiry heard how Dr Lal was the subject of a HSE disciplinary investigation and he has been on administrative leave from his job as a consultant general surgeon, with a speciality in breast surgery, with UHL.
The inquiry heard how the systems analysis report carried out after Ms Sheedy’s death identified issues with clinical governance, which Mr Mills submitted some weight should be attached to.
Patricia Dillon SC, legal assessor, said she disagreed with Mr Mills regarding his submission that the inquiry concerned an isolated case.
She said the events occurred regarding a single patient but over a number of months and involved different types of conduct.
The hearing on Wednesday was the third day of the inquiry, with the committee hearing evidence on Monday regarding the factual allegations against Dr Lal.
The fitness-to-practise committee found on Tuesday that each of the 13 factual allegations proven amounted to “a serious failing”. The committee retired on Wednesday to consider its recommendation about any sanction.
It will forward its recommendation to the Medical Council, which will make a decision to be forwarded to the High Court for confirmation.
