A DOCTOR’S treatment of a young woman when she became gravely ill following breast augmentation surgery at a cosmetic surgery clinic in Co Wicklow was branded “absolutely reckless in the extreme” yesterday at a Medical Council fitness to practise inquiry.
The inquiry heard Kate Murray (25) developed a severe infection after the operation at Cosmedico in Kilmacanogue on March 15th, 2008, but despite returning to the clinic several times and complaining of being in serious pain, the infection was not diagnosed until she was taken by ambulance from her home in south Dublin to St Vincent’s hospital on April 3rd.
At that stage she was seriously ill with sepsis and “a step away from” developing necrotising fasciitis, commonly known as flesh-eating disease, which is a life-threatening condition. She had to spend four weeks in hospital and underwent nine procedures under general anaesthetic, including skin grafting.
Her breast surgery was carried out by Dr Marco Loiacono (35), who faced several allegations of professional misconduct arising out of his failure to provide her with proper post-operative care, including failing to take or review blood test results or to refer her to hospital.
The fitness to practise committee found him guilty of professional misconduct and recommended he be struck off. It also recommended steps be taken to ensure cosmetic surgery clinics attain proper standards of pre- and post-operative care.
Dr Loiacono, who no longer works for Cosmedico and who did not turn up for yesterday’s hearing, was also found guilty of professional misconduct last year over his treatment of a 33-year-old Swords woman who attended him for a breast augmentation operation at a different private clinic in 2006. He failed to arrange for adequate post-operative treatment for her, too, when he became aware her left breast had become infected.
Dr Peter Meagher, a consultant plastic surgeon at St Vincent’s hospital and an expert who reviewed Ms Murray’s treatment for the Medical Council, said she was left horribly physically and mentally scarred.
“I think it’s absolutely appalling what’s happened her,” he said. “It’s going to be incredibly difficult to reconstruct this girl,” he added.
Furthermore, he said, he would have very real concerns about any patient having an operation such as hers performed in a facility such as Cosmedico which could not admit patients when they suffered post-operative complications.
He said Ms Murray at one stage wasn’t seen for six days by Dr Loiacono, even though she was in pain, which was inexplicable. “You can’t undertake surgery such as this and then treat the patient remotely by telephone through a nurse,” he said.
He described Dr Loiacono’s treatment of Ms Murray, including the decision to send her home rather than keep her under observation, as reckless in the extreme. The paucity of detail in the doctor’s notes in relation to his operation to eventually remove the implants on March 31st was also “terrifying”.
While medical notes suggested Dr Loiacono believed Ms Murray may have had an allergic reaction rather than an infection, Dr Meagher said he had never come across an allergic reaction to breast implants. He said any experienced surgeon could have seen “from 100 paces” she had an infection.
Ms Murray told the inquiry if she had the surgery before a certain date she could get it for €5,800. Otherwise it would be €6,200. She went for the cheaper option. Pain set in three days after the operation and she broke down as she recalled Dr Loiacono didn’t seem to understand the level of pain she was in. On March 26th, he told her the implants were fine and advised against her going to hospital in case she’d pick up an infection.
Ailish Kelly, managing director of Cosmedico, said she wasn’t familiar with any financial incentives offered to clients. She said surgeons got 30 per cent of the amount clients were charged and this covered pre- and post-operative care. Aftercare for clients was hugely important, she added, but in this case she felt “to some extent” Ms Murray “was let down by her clinician”.
Another plastic surgeon who used to work in the clinic told the inquiry the Medical Council should look at standards in clinics like this.
“They are run by people whose whole motive is profit,” Dr Keith Robertson said. He added that at one stage, when he saw Ms Murray when Dr Loiacono wasn’t there, abnormal blood tests results were locked in an office to which clinical staff had no access.
Ms Murray is now taking a claim for damages against Dr Loiacono.