A GYNAECOLOGIST and consultant obstetrician broke down in tears as she described the “major and dramatic” deterioration of a patient in her care who later died.
Linda Royal (50), Forest Green, Kingswood Heights, Tallaght, Dublin, died from the complications of septicaemia six days after she underwent a hysterectomy at Mount Carmel Hospital.
She died at St James’s Hospital on September 29th, 2008.
Dublin City Coroner’s Court heard yesterday that the mother-of-three had been sweating profusely and vomiting in the days following the procedure, and had complained of pain.
However, Dr Mona Joyce, a consultant obstetrician and gynaecologist at Mount Carmel, said the patient displayed a collection of symptoms which were not abnormal. “Two isolated episodes of vomiting do not a seriously ill patient make,” Dr Joyce said.
She said she had had “no cause for concern” that the patient would develop a serious condition on examining Mrs Joyce on September 26th, 2008.
Solicitor for the family Damien Tansey noted that Mrs Royal had developed “crampy” abdominal pain later that day.
Dr Joyce said on Saturday 27th she believed Mrs Royal to be constipated and to have wind, something which she had come across in post-operative patients.
The doctor said Mrs Royal was not confined to her bed on the Saturday afternoon, and was not critically ill at that time.
She said she first became aware that Mrs Royal was showing signs of septicaemia on the morning of Sunday September 28th. Within a few hours Mrs Royal had undergone a “dramatic deterioration” in her clinical condition.
“At this point I was suspecting sepsis,” Dr Joyce said, adding that she rang St James’s Hospital and requested Mrs Royal be transferred immediately. She also arranged for an in-house anaesthetist and a high-dependency unit nurse to accompany Mrs Royal by ambulance to the hospital.
Mr Tansey said that, at this point, Dr Joyce had “pulled out all the stops”, but added: “What I have to put to you is that if you had pulled out all the stops on the 26th, we wouldn’t be here today.”
He added the inquest would hear evidence that a specialist in St James’s supported this in a conversation with Mrs Royal’s family.
Dr Joyce said this was “hearsay”, adding there was no way she could have predicted such a tragic outcome. She said she was “very sorry” that Mrs Royal had developed a rare sepsis from a bacterial organism, but that she had no clinical grounds to transfer Mrs Royal out on the 26th.
“If I’d known Mrs Royal was developing such a rare and complicated condition I would not have sat idly by . . . I am a caring doctor,” an upset Dr Joyce said.
Nursing administrator Mary Flynn said Mrs Royal’s condition was first brought to her attention on September 27th, 2008, when a nurse, Marie McCloskey, said she had concerns about the patient.