I felt 'ambushed' by patient after surgery, says gynaecologist
A consultant gynaecologist has defended his care of four hysterectomy patients and claimed he was "ambushed" at a post-operative meeting.
Mr Peter Van Geene is facing a number of allegations in relation to four women on whom he performed hysterectomies between 2009 and 2011 at Aut Even Hospital in Kilkenny.
Three of the women suffered post-operative blood loss and required blood transfusions.
Helen Cruise (62), who was the only patient to waive her right to anonymity, has claimed that Mr Van Geene obtained her consent only when she was in the operating theatre.
She needed emergency surgery after the hysterectomy to stop the bleed. Ms Cruise claimed her gynaecologist blamed the bleed on her coughing because she was a smoker. The claims are disputed by Mr Van Geene.
At the Medical Council hearing in Dublin yesterday, Mr Van Geene insisted that he obtained consent for Ms Cruise's operation before she entered the operating theatre.
He said that he usually reviews the consent forms with patients in his outpatient clinic before the day of their surgeries.
However, on the day of her operation, Ms Cruise was brought from the ward directly to the theatre suite and Mr Van Geene decided to get her consent in the theatre suite.
"She was seen by me outside the operating theatre," Mr Van Geene told the inquiry. "She could not have got into the theatre without consenting."
He added that both his anaesthetist, Dr Prasad Penugonda and his nurse would have checked to ensure that Ms Cruise had given consent before hand.
After a second operation to stop internal abdominal bleeding, the gynaecologist met with Ms Cruise. She and a nurse present at the time both claimed that Mr Van Geene was quite rude during this conversation.
Mr Van Geene told the inquiry that he had explained to Ms Cruise that the post-operative bleed was caused by a "coughing episode".
"She took particular umbrage with this," Mr Van Geene said.
Mr Van Geene said she was very upset and seemed to be convinced that the bleed had started during surgery.
"Everything seemed to be my fault," Mr Van Geene. "She got very upset. I was upset too. As the meeting went on, she got progressively more irate with me."
Mr Van Geene decided it would be best to end the meeting and to meet the next day at Aut Even. On the way out, he told the ward nurse that he felt like he had been "ambushed".
"I didn't mean to be rude," the consultant said. "I was stunned, though."
Mr Van Geene also discussed the care he provided to patients A, B and C.
During cross-examination, Neasa Bird, the legal representative for the CEO of the Medical Council in this inquiry, asked Mr Van Geene whether he paused to consider whether he was doing anything wrong, after three of his patients had suffered major post-operative bleeds within 18 months.
Mr Van Geene said he did want to find out why these women had suffered from post-operative bleeding.
"If a patient has a complaint, it's upsetting," he added.