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Saturday 3 December 2016

Blood loss 'exceptional in one case, let alone three,' medical inquiry hears

Peter Van Geene
Peter Van Geene

The amount of blood lost by three patients after undergoing hysterectomies by the same surgeon was "exceptional", an expert witness told a fitness to practise inquiry.

Dr Peter McKenna said the chances of the three women suffering such high levels of blood loss after operations by the same doctor was less than 1pc, and said in the case of two patients, they "ought to have been told" the procedure would do nothing to help them.

Dr McKenna, the former master at the Rotunda Hospital, was giving evidence on the sixth day of the inquiry into allegations made by four former patients of gynaecologist Peter Van Geene.

The allegations relate to hysterectomy procedures he performed between 2009 and 2011 in the Aut Even private hospital in Kilkenny.

Dr McKenna said the "one unifying feature in all the complaints" was that each of the women had undergone surgeries and that Mr Van Geene should have stopped performing the operation.

"Either you're not choosing your patients correctly, and if you are, you're not executing the procedures properly," he said.

Patients

Two patients required six units of blood after their operations and another received four. Dr McKenna said these were "very, very substantial episodes of blood loss which warrant explanation".

"That degree of blood loss would be exceptional in one case, let alone three, and I would be unhappy if this was what I had left in my wake. I think the system in most of the maternity hospitals would certainly pick up on this pattern at an earlier stage."

In the case of patient Helen Cruise, who has waived her anonymity, he said the "principal complaint" she presented with was urinary incontinence and a "hysterectomy was not designed to correct that".

He said he had "lots of complaints" with the treatment plan drawn up by Helen Cruise's physician, Dr Ray O'Sullivan, a consultant in St Luke's Hospital.

When asked if it was not a reasonable plan to draw as the patient was in discomfort, he said: "I don't think it's reasonable at all because that's not what the woman came in worried about."

It is alleged Mr Van Geene failed to assess Ms Cruise pre-operatively or to explain the risks of the operation.

Dr McKenna said the patient should have been told by Mr Van Geene: "The procedure I'm going to do won't make you feel any better. Is that okay?"

He added there was no justification for performing major surgery when this couldn't solve the problem. He said unless this was explained to the patient, her consent to undergo the hysterectomy was "invalid".

The inquiry will resume in September when it will hear from expert witness Dr Peter Boylan.

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