A verdict of medical misadventure has been returned in the case of a 66-year-old mother of three who died following a routine procedure to remove a gall stone.
The verdict was returned at the inquest into the death of Patricia Bishop, from Slievebloom Road, Drimnagh, in Dublin 12.
Mrs Bishop loved sea swimming and was fit and healthy when she was admitted for the procedure at St James’s Hospital on September 22nd, 2016.
She planned to travel to Wexford to go swimming the following day but instead of being discharged home as expected she became critically unwell and was transferred from recovery to intensive care.
She developed sepsis due to a perforation of bowel tissues during the procedure and died eight days later.
Dublin Coroner’s Court heard that her doctor had “never before seen a case of sepsis like this”.
Finbar McCarthy, consultant gastroenterologist/physician at St James’s Hospital, said he hoped never to see a case like it again.
He was removing the stone from the woman’s gallbladder ahead of a planned removal of the gallbladder. He said Mrs Bishop experienced some discomfort after the procedure but felt at the time this was normal.
“When I examined her the following morning at 8am her heart rate and blood pressure were normal and she had no fever. These are the early-warning signs for sepsis,” Dr McCarthy said.
Deterioration
Three hours later her condition deteriorated so rapidly that she was transferred to intensive care.
The woman's husband, Tom Bishop, said she was not well hours after the procedure and was having trouble breathing but he was told to go home.
“The next day I went into see her but by 11am they were taking her into intensive care and that was the end of my wife. I was told to bring in the family,” Mr Bishop said from the public gallery.
Dr McCarthy described the bowel as a barrier system to prevent harmful bacteria entering the body. A breach of this barrier such a perforation can allow dangerous bacteria enter the system and “create havoc”, he said.
“She wasn’t matching up with what you would expect to see in somebody in her condition,” he said of her initial post-procedure condition.
As a result the woman developed an overwhelming form of sepsis that led to multi-organ failure.
“There was a period where things were being held together but then it was like a dam broke. I have never seen anybody get so sick so quickly,” Dr McCarthy said.
A postmortem report by pathologist Dr Kate Dineen gave the cause of death as multi-organ failure due to sepsis due to a complication of endoscopic retrograde cholangiopancreatography (ERCP) to remove a gallstone.
Coroner Dr Myra Cullinane returned a verdict of medical misadventure and offered condolences to the family.