Mother was 'in shock' after hysterectomy, inquest hears
A mother of three who died following a hysterectomy was "in shock" with multi-organ dysfunction when she arrived at a Dublin hospital, an inquest heard yesterday.
Linda Royal of Forest Green, Kingswood Heights, Tallaght, Dublin 24, was rushed by ambulance from Mount Carmel Hospital to St James's Hospital on September 28, 2008, six days after a procedure to remove her womb at Mount Carmel Hospital.
She died at St James's the following day. Upon arrival at St James's A&E department at around 11.00am, Mrs Royal had inadequate kidney function and deranged liver function with a fast heart rate and low blood pressure, the inquest heard.
Mr Narayanasamy Ravi, consultant surgeon at St James's Hospital, had examined the mother of three and told Dublin City Coroner's Court it was clear that Mrs Royal was extremely sick and she needed to proceed to theatre.
In theatre, Mr Ravi found there was an extensive lack of blood supply (ischemia) to all the organs in Mrs Royal's abdomen, including the stomach, the liver and the small and large bowel.
"What I found there was very bad," he said. "Ischemia of everything within the tummy is very rare." There was no sign of a perforation or any sign of infection, the court heard.
It was at that point the doctor realised "it was more than likely that Mrs Royal would not survive" and it was difficult breaking the news to the family, he said.
Dr Ravi said the ischemia would have happened within hours rather than days.
Following surgery, Mrs Royal was transferred to the intensive care unit where her condition continued to deteriorate.
Dr Ravi agreed with solicitor for the family Damien Tansey that she was beyond repair when she arrived at the hospital, but that was in retrospect. He did not know that at the time, the inquest heard.
Dublin City Coroner's Court heard Mrs Royal had been transferred to the high dependency unit at Mount Carmel Hospital at 5.15 that morning following a deterioration.
By 7.30am her abdomen was distended and rigid and she was jaundiced, restless and uncomfortable due to pain.
"She wanted to be moving because of the pain," said nurse Ruth Kidney, who was looking after her.
A decision was made to transfer her to St James's Hospital when she suffered an acute deterioration at 8.50am.
"Her condition was deteriorating at such a level I made a decision to contact Dr (Mona) Joyce (the consultant who had examined her earlier) immediately. One minute she was warmly talking about her family and son ... .," said nurse Kidney. "Her abdomen went from being a soft abdomen ... to a rigid abdomen."
Nurse Kidney said she didn't believe there was a delay in carrying out the steps.
Coroner Dr Brian Farrell adjourned the inquest for mention to a date in October.