No need to remove patients' wombs, expert tells inquiry
AN expert witness at the inquiry into allegations against a gynaecologist has claimed two of the surgeon's patients did not need to have their wombs removed and that other procedures would have been more appropriate.
Rotunda Hospital clinical director Peter McKenna said it was also his view that the pattern of patients suffering post-operative bleeding following surgeries carried out by Peter Van Geene in the Aut Even Hospital in Kilkenny amounts to "poor professional performance".
He said he was also concerned by the surgeon's inability to be "introspective", and said that to "spread the blame" to his patients for surgical complications was "inexplicable".
The tribunal heard evidence from Dr McKenna, the former master of the Rotunda Hospital, on the fifth day of the Medical Council's fitness-to-practise inquiry.
The allegations are by four patients of Mr Van Geene who underwent hysterectomies carried out by him at the private hospital between 2009 and 2011.
"Looking at the pattern of outcomes and alleged exchanges with patients, I would have concern about the poor professional performance of the individual," Dr McKenna told the inquiry.
Later he said: "When you have poor outcomes such as these and they are very poor outcomes, you would have to question the ability of the person to pick the right patient for the procedure and the ability of the person to do that operation."
Dr McKenna addressed the allegations in respect of each of the four patients who gave evidence this week.
In relation to Patient A, the inquiry heard she had presented with post-menopausal bleeding and had complained of suffering from stress.
Mr Van Geene agreed to perform the hysterectomy in April 2009. Dr McKenna said he "did not see what could be achieved" by performing the procedure.
"That's like saying if you have indigestion because of stress, remove your stomach," he said. "It's nonsense."
"I cannot understand the rationale in treating this patient at all. To me it doesn't it make a whole lot of sense," he added. "To me I feel the patient had the wrong operation."
Similarly in the case of another patient, Helen Cruise who waiver her anonymity, he said he could not understand why a hysterectomy was carried out as she was suffering with incontinence. "I do not see how a vaginal hysterectomy can fix a urinary problem," he said and added "It was no wonder Ms Cruise isn't feeling any better".
Ms Cruise subsequently required six units of blood during a laparotomy when she suffered haemorrhaging, an amount he described as "massive".
Ms Cruise had also alleged Mr Van Geene had shouted at her at a meeting after her operation and said her postoperative bleeding was because she had coughed and caused ligatures to come out.
"If you have caused a complication, you don't have a leg to stand on," Dr McKenna said, adding he would expect someone working under him to inform the patient of the problem, apologise, accept responsibility and not "walk away from it".
In relation to the allegation that he had thrown Ms Cruise's womb into a bucket, he said he understood "how something like that could be said and it could be misinterpreted".
In relation to Patient C who also needed six units of blood after her operation, he said no one in his hospital could recall a patient getting that much blood in 10 years. He did also state some of the allegations, if as 'stand alone' problems, would not in his view amount to poor professional performance.
Mr Van Geene is expected to dispute the findings when he gives evidence. The inquiry continues on Monday.