AN expert consultant surgeon told an inquiry probing the treatment of a mother-of-13 who died that she had been booked in for a "straightforward" operation which "went wrong".By Louise Hogan
Dr Syed Naqvi, who was a consultant surgeon at the Mid West Regional Hospital in Ennis, has been called before a Medical Council fitness to practise hearing on 11 allegations in relation to the care of Tina Sherlock (39).
Mrs Sherlock was 17 weeks pregnant with her 14th child when she visited the emergency department of the hospital on June 22, 2008, complaining of pain in her right side. Medical staff considered she may be suffering from an inflamed gall bladder – it was not until November, almost five-months later, that she was diagnosed with appendicitis following CT scan results.
She lost the baby girl in July. Mrs Sherlock died from multi-organ failure due to sepsis on December 10, 2008 – this followed three operations at the hospital.
The expert witness for the Medical Council, UK consultant surgeon Anthony Peel, was critical of numerous aspects of the operations.
Mr Peel said the first operation carried out by Mr Naqvi at the hospital on November 22, 2008 “should have been a straightforward procedure” but something “went wrong”. Mr Naqvi operated to remove the ‘mass’ in the appendix shown in the CT scan, and a part of her upper bowel was removed. The inquiry heard there was leaking of bowel contents from the wound following the surgery.
Mr Peel said there were two reasons for the leaking to occure either “poor technique” in the operation or “disease in the bowel itself”, and he pointed out there were no signs of bowel disease.
The expert witness said a CT scan should have carried out to try and identify the problem or source of the leak before two follow-on operations.
The inquiry heard the patient would have had to be transferred for the CT scan of her stomach area to the Mid Western Regional Hospital, Dooradoyle, Limerick as there was no CT scan at the Ennis hospital.
Mr Peel said he believed the failure to arrange the CT scan to identify the problem before the second operation on December 3, 2008, amounted to professional misconduct.
Eileen Barrington, SC for Mr Naqvi, said consultants at Ennis had been complaining about the lack of a CT facility at the hospital for a number of years and it was a “lengthy process” to obtain a CT scan from Limerick.
Ms Barrington said Mrs Sherlock’s symptoms had indicated a “wound infection” and the surgeon was operating on that basis. However, Mr Peel argued the vomiting, pain and level of leaking from the wound may have indicated there was a “more serious problem” and a CT scan should have been obtained.
The inquiry heard that prior to their retirement two of Mr Naqvi’s consultant colleagues had written to the Minister for Health and Medical Council seeking advice about the lack of consultant staff and inadequate facilities.
In September 2009, the A&E at Ennis was closed following a probe by HiQA.
The inquiry heard Mr Naqvi would be defending all the allegations of professional misconduct and/or poor professional performance.
The inquiry continues.
- Louise Hoga
Martina Sherlock, Childers Road, Ennis, died on 10 December, 2008, after three operations.
Ennis consultant surgeon Syed Naqvi is facing 11 allegations of professional misconduct and/ or poor professional performance.
The surgeon, who qualified in Pakistan, has worked in Ireland since 1985.
Ms Sherlock was 17 weeks pregnant when she first attended the Mid-Western Regional Hospital, Ennis, complaining of abdominal pain on her right side.
The inquiry has heard she was wrongly diagnosed with an inflamed gallbladder.
She had a miscarriage on 15 June due to septicaemia, after transfer to the Mid-Western Regional Maternity Hospital, Limerick.
It was not until 18 November following a CT scan organised at the Mid-Western Regional Hospital, Dooradoyle, that appendicitis was diagnosed.
Ms Sherlock underwent three operations under Dr Naqvi at Ennis on 21 November, 3 December and 8 December.
It is alleged that the surgeon performed an inappropriate operation on 8 December, that he failed to arrange CT scans, failed to make provision for a transfusion, failed to ensure Ms Sherlock was adequately resuscitated after the last operation, and failed to arrange for her transfer to Limerick regional in good time.
Senior counsel for Dr Naqvi, Eileen Barrington told the inquiry that doctors at Ennis hospital have written to the Council to say safety was at risk due to the absence of a CT scanner and other equipment.
Doctors had to send patients to Limerick regional for such scans.
Giving expert evidence today for the Medical Council, London surgeon Anthony Peel said what should have been a straightforward procedure on 21 November went wrong.
Mr Peel said that after the first operation on 21 November, Dr Naqvi should have organised a CT scan for Mrs Sherlock.
He said doctors have to battle hard to get what patients need and a CT scan in this case was mandatory.
Following an investigation by the Health Information & Quality Authority in late 2008, the hospital was found to be unsafe for acute emergency care and the Emergency Department was closed.
This is the second day of the inquiry, which is scheduled for three days.
