Background: While Dr Michael Neary was struck off the medical register this week, key questions remain over how such a scale of alleged negligence was allowed to go unchallenged for almost 20 years.
The Drogheda-based obstetrician is facing 65 legal actions following claims that he performed unnecessary Caesarean hysterectomies, but dozens more cases are expected to follow. The women's wombs were removed following childbirth at Our Lady of Lourdes Hospital, in a procedure normally used only in an emergency, where the mother's life is at risk from haemorrhaging.
Two North Eastern Health Board midwives were the first to question Dr Neary's activities at official level, in October 1998, sparking a series of investigations which revealed he had carried out an alarmingly high number of Caesarean hysterectomies.
In November 1998, Dr Neary's solicitor produced reports by three obstetricians which found that his management of nine cases, selected by him, was "without fault and acceptable".
These findings didn't allay the concerns of health board officials, however. When the same cases were reviewed by a Manchester-based obstetrician a month later, the UK consultant said he had "major concerns" over Dr Neary's conduct.
With alarm bells ringing and a litany of complaints being made, the Medical Council applied to have his name removed from the medical register. Around this time a report confirmed that there was an an abnormal level of Caesarean hysterectomies at the hospital.
Despite the initial flurry of activity, the council took around four years to hear the allegations against Dr Neary - which totalled around 35 by that stage - and to come to its conclusion to strike him off the register for removing the wombs of 10 patients.
Frustrated by the delays, one woman, Ms Alison Gough, took a High Court case against Dr Neary, claiming that he unnecessarily removed her womb after she gave birth by Caesarean section to her first child in 1992.
Dr Neary was found guilty of misconduct in November 2002. The main findings were upheld by the Supreme Court in June this year, paving the way for dozens more High Court cases. Former patients of the doctor are now demanding a public inquiry to find out how this was allowed to take place, and to ensure the mistakes are not repeated.
