Woman died from septicaemia less than one week after hysterectomy

A WOMAN died from the complications of septicaemia a week after an elective hysterectomy at a private Dublin hospital, an inquest…

A WOMAN died from the complications of septicaemia a week after an elective hysterectomy at a private Dublin hospital, an inquest has heard.

Linda Royal (50), Forest Green, Kingswood Heights, Tallaght, Dublin, was seriously ill when she was rushed from Mount Carmel Hospital to St James’s Hospital on September 28th, 2008, six days after a surgical procedure to remove her womb at Mount Carmel Hospital.

She died at St James’s the following day.

Pathologist Dr Máirín McMenamin and consultant obstetrician and gynaecologist Dr Mona Joyce, who performed the hysterectomy, both broke down in tears in the witness box at Dublin City Coroner’s Court yesterday on the first day of an inquest into the death of Ms Royal, a mother of three.

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Louis Royal told the inquest that following his wife’s transfer to St James’s, he was told by a doctor there that there was nothing he could do for her as the damage was too extensive.

The doctor told him that if “they’d got Linda a day or two before that we wouldn’t be having this conversation”.

Dr Joyce told the inquest that the procedure on September 22nd was very straightforward. Up to September 27th she had no cause for concern about Ms Royal. Having seen her that evening, she had no cause for concern other than post-operative constipation for which she prescribed a laxative.

The doctor, who saw Ms Royal every day, did not suspect any major post-operative complication.

When Dr Joyce was called to see Ms Royal on the morning of September 28th, she was concerned by her “sudden” and “dramatic deterioration”.

She considered she might have a bowel perforation and organised an urgent transfer to St James’s to an intensive care bed. It was the second time she had seen her that morning, having been called to see her at 5.30am.

Questioned by solicitor for the family Damien Tansey as to whether episodes of low blood pressure and a fast heart rate on September 26th were the beginning of a process that led to septic shock, Dr Joyce said it might be.

Mr Tansey said: “The advice I’ve received suggests very strongly that had the treatment for Mrs Royal been appropriate and adequate in Mount Carmel, that on the 26th she would have been transferred to St James’s or some other hospital and had that happened, we wouldn’t be here today.”

Dr Joyce said that looking back, she really felt she had no grounds to transfer Ms Royal on the Friday or Saturday evening.

A postmortem found Ms Royal died of multi-organ failure due to septicaemia as a consequence of an elective vaginal hysterectomy for uterine prolapsed and pelvic floor repair. There was no evidence of a perforation at autopsy.

The septicaemia was caused by an organism called morganella morganii, a virulent bacteria.

“This was tragic circumstances, – an unexpected death in an otherwise healthy woman,” said pathologist Dr McMenamin.

The inquest continues today.