A verdict of death by medical misadventure was recorded yesterday at the inquest of a man who died three days after undergoing a procedure to remedy facial blushing. Christine Newman reports.
The Dublin City Coroner, Dr Brian Farrell conducted the inquest into the death of Mr Alan Synnott (44), of Brennanstown Road, Cabinteely, Dublin who died on March 30th, 2003.
Dr Farrell said evidence had been given by Mr Synnott's widow, Mrs Eleanor Synnott, Prof Austin Leahy, the vascular surgeon who performed the operation, and Prof Elaine Kay who carried out the autopsy.
He said on March 27th, 2003, Mr Synnott was admitted to the Bons Secours Hospital, Dublin, to undergo the procedure to remedy facial blushing.
The procedure involved making an incision and collapsing the right lung in order to reach the site to burn off nerve endings from the sympathetic nervous system.
Prof Leahy had said in evidence he tried several times to pass a tube into the area under the neck and in the chest cavity. At least three attempts were made but they were unsuccessful. There was some bleeding and an abrasion of the lung.
He then changed the angle of entry upwards to avoid damage to the surface of the lung. During the procedure the subclavian artery and a vein were lacerated. This led to massive, heavy bleeding.
An operation started and colleagues assisted including a thoracic surgeon who was called in. It was confirmed that there was a laceration of the artery and a vein. The vessels were repaired and sutures were put in place.
After the extensive haemorrhage, efforts were made, including blood transfusions, to stabilise Mr Synnott.
The operation continued for several hours and the bleeding was stopped. Mr Synnott was transferred to Beaumont Hospital, Dublin, the next day. He appeared to be initially stable, but died on March 30th, 2003 after a stroke.
Dr Farrell said he thought the haemorrhage emanated from the site of the initial procedure. The autopsy confirmed laceration to both vessels which were repaired.
He said Prof Kay told the inquest that infarction, which is the death of tissue and obstruction of the blood supply, occurred when there was reduction in the blood supply to the right side of the brain stem.
Dr Farrell said there was also a congenital anomaly which was that the right artery was of a smaller size than normal. That area was particularly vulnerable as a result.
The coroner said he accepted that the cause of death was due to infarction of the brain stem which was supplied by the artery.
The haemorrhage was the primary cause of events, but because of the congenital condition, the area was particularly vulnerable when blood pressure dropped. He would bring in a verdict of death by medical misadventure.