Tuesday 6 December 2016

Patient should have been told hysterectomy 'not designed to correct' urinary incontinence - fitness to practise inquiry

Sam Griffin

Published 27/07/2015 | 18:38

Helen Cruise during a Medical Council fitness-to-practise inquiry on Consultant obstetrician and gynaecologist Dr Peter Van Geene at Kingram House, Dublin
Photo: Gareth Chaney Collins
Helen Cruise during a Medical Council fitness-to-practise inquiry on Consultant obstetrician and gynaecologist Dr Peter Van Geene at Kingram House, Dublin Photo: Gareth Chaney Collins

A patient of a gynaecologist should have been told the major surgery she would undergo would do nothing to help the problem she presented with, a Medical Council fitness to practise inquiry has heard.

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Expert witness Dr Peter McKenna also said the consent given by patient Helen Cruise, who has alleged serious allegations of poor professional performance against gynaecologist Peter Van Geene, was “invalid”.

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 Mr Van Geene. He is expected to dispute the allegations when he gives evidence.

They relate to hysterectomy procedures he performed between 2009 and 2011 in the Aut Even private Hospital in Kilkenny.

Dr McKenna was cross-examined in respect of each of the women’s care received and complaints.

In the case of Ms Cruise, he said the “principal complaint” she had presented with was urinary incontinence and a “hysterectomy was not designed to correct that”.

Doctor Peter Van Geene
Doctor Peter Van Geene

He said he had lots of complaints with the treatment plan drawn up by 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.”

Ms Cruise was due to have the procedure in St Luke’s but qualified through the National Treatment Purchase Fund, to have the hysterectomy in Aut Even.

It is alleged Mr Van Geene failed to assess that 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 ok?”

He added there was no justification for performing major surgery when the problem could not be solved by major surgery.

He said unless this was explained to the patient, her consent to undergo the hysterectomy was “invalid”.

Under questioning from the inquiry committee, he was asked if is a culture existing amongst  surgeons not to discuss complications during operations with patients afterwards.

“Maybe it is and maybe an explanation is easier than an apology but certainly I have found if you say ‘this is what happened and unfortunately I got it wrong’ very often it throws the things into a different light,” he said.

Dr McKenna also discussed the care given to Patient A who had presented with postmenopausal bleeding and had complained of suffering from stress.

He said he “strongly disagreed” with the decision to proceed with the hysterectomy on the basis that stress was a contributing factor in the patient’s persistent bleeding.

Eugene Gleeson, for Mr Van Geene, said he would be calling expert witness Dr Peter Boylan, former master of the National Maternity Hospital, who will say such an approach would be appropriate where there is persistent postmenopausal bleeding and malignancy has been ruled out.

The inquiry also heard that Mr Van Geene was not told Patient A suffered had serious blood loss until 12 hours after it had begun. Dr McKenna accepted the surgeon should have been informed of this.

The inquiry will resume in September.

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