Varicose vein death: Mum could not be admitted to hospital as doctor was away
CONSULTANTS at a private hospital must ensure adequate cover in their absence after a patient died nine days after surgery to remove varicose veins.
Karen McCabe (46) of Bewley Drive, Lucan, Co Dublin underwent radiofrequency oblation, a procedure to remove varicose veins at the Bons Secours Hospital in Dublin on August 6 2014.
Her vascular surgeon, Professor Austin Leahy went on a break to his Co Kerry holiday home two days later. On August 15, Ms McCabe died due to a blood clot in the lung believed to have originated in the lower leg.
An inquest into her death heard that she presented at Beaumont Hospital on August 14 and died the following morning. She had contacted the Bons Secours Hospital three days before her death complaining of pain in her knee and difficulty walking.
A resumed inquest at Dublin Coroner’s Court heard from Bons Secours Senior House Officer (SHO) Dr Kingsley Opputeh wanted to admit the patient and carry out a scan on August 13, but only Prof Leahy could authorise Ms McCabe’s admittance to the Bons Secours. Prof Leahy had left specific instructions that he should be contacted via text message if he was needed but network coverage in the area was unreliable, the court heard.
He noticed a missed call from a general Bons Secours number and did not reply because it was not a specific number, the court heard.
Bons Secours Hospital Manager Mike Tonery confirmed it was hospital procedure that consultants must take responsibility for admitting patients but said ‘never again’ would an SHO be prevented from admitting a patient because a consultant was not available. He said he had personally with the hospital’s consultants to ensure adequate cover be organised where appropriate.
“Never again will it happen that a patient won’t be able to be admitted without a consultant,” he said. Mr Tonery said under new measures introduced in the wake of Ms McCabe’s death, the SHO’s first option was to contact the primary consultant, followed by the second consultant and failing that could refer patients to a recently opened medical assessment unit within the hospital that operates within office hours.
“Out of hours, all other options exhausted, they should refer to Accident and Emergency at Beaumont,” Mr Tonery said, adding that transport could be provided.
Barrister for the McCabe family, David Holland said if Dr Oputteh had been able to admit the patient, a scan could have been carried out and treatment such as clexane, a medication to treat Deep Vein Thrombosis in the legs, could have been administered.
“Had Dr Oputteh been able to put his plan into effect an ultrasound would have been performed either that night or the following morning,” Mr Holland said.
“...That fact of (Dr Oputteh’s) inability to put the plan into effect was at least part of the causative sequence that lead to Karen McCabe’s death,” he said. Ms McCabe was given clexane at Beaumont Hospital, where she presented the day before her death.
Coroner Dr Brian Farrell returned a verdict of medical misadventure and endorsed the new arrangements made at the Bons Secours in relation to attendance of patients at the hospital.
A statement from Karen McCabe's family was read by their solicitor Kathrina Bray after the inquest.
“After 18 long and difficult months the family are comforted by the fact the coroner has returned a verdict of death by medical misadventure and that the coroner has identified a number of risk factors that lead to the unfortunate and untimely death of the late Karen McCabe.
"The family is comforted by the fact that learnings have occurred in the Bons Secours hospital and that new cover arrangements when consultants are unavailable have been put in place.
"Unfortunately for Karen’s family nothing can bring her back.”