The High Court has dismissed an action by a woman against the Rotunda Hospital in Dublin over hysterectomy surgery performed on her.
Margaret O’Dea (55), a mother of three, of Doctor Mannix Road, Salthill, Galway, sued the hospital for negligence over her surgery in October 2013. The hospital denied the claims.
Ms O’Dea claimed she suffered a bladder injury, a vesico-vaginal fistula, from the surgery and that it was the result of an unrecognised intraoperative trauma to her bladder.
She claimed the damage to the bladder was secondary to placing a suture through the bladder wall while closing the vaginal stump.
It was also alleged that the defendant failed to properly supervise her care post-operatively.
She suffered incontinence afterwards, had to have a follow up operation to deal with it and still feels that her bladder does not empty fully and she has a slow urinary output.
The Rotunda disputed negligence in respect of the performance and follow-up care of the hysterectomy. It particularly disputed there was an unrecognised trauma and the allegation in relation to a suture carried out during the surgery. It denied any delay in treating or diagnosing her post-operative symptoms.
Dismissing the case on Friday, Mr Justice Michael Hanna found no objective evidence to indicate the presence or otherwise of injury indicative of intraoperative insult to her bladder.
No scientific certainty
Since there can be no scientific certainty as to the cause of this fistula he therefore had to rely on the “varying and contrasting professional opinions as to what occurred”.
Considerable importance must be attached to the impression that the various professional witnesses made upon him, he said.
He found one of Ms O’Dea’s experts, retired NHS of Britain consultant obstetrician and gynaecologist, Mr Richard Porter, “the least persuasive of the expert witnesses”.
He found the extent to which he amended his views from those first expressed in his initial report up to and including the trial to be “unimpressive”.
He found gynaecologist and obstetrician, Dr Ronan Gleeson, who carried out the surgery in the Rotunda, to be an impressive and forthright witness.
He was satisfied that when confronted with Ms O’Dea’s problems during a check-up that he did not hesitate to “put his hands up” to the possibility that an error on his part could have caused her problems.
However, the judge was satisfied the suturing by Dr Gleeson during the operation did not catch or otherwise damage either the surface of the bladder or the ureter.
“I am satisfied, on the balance of probabilities, that there was no penetration or tear, partial or otherwise, of the bladder surface specifically at the midline and at the site where the fistula appeared”, he said.
From the evidence available, it seemed to the judge the most likely cause of the fistula was the development of a haematoma which became infected and which interfaced with the surface of her bladder.
He accepted expert evidence on behalf of the hospital, that as a result of the previous caesarean section surgery, the integrity of the bladder surface was compromised.
“This, in turn, led to the development of the unfortunate but unavoidable outcome suffered by the plaintiff”, he said.
He was not persuaded on the balance of probabilities that the fistula, which she undoubtedly suffered, was caused or contributed to by any negligent act by the defendants, their servants or agents.