Medical misadventure verdict on man who died after hernia

A verdict of medical misadventure has been returned at the inquest into the death of a 68-year-old man who died two days after being discharged from hospital following a hernia operation.

John Comerford, a father of two from Castlecomer in Co Kilkenny, had the procedure carried out at St Luke's Hospital in Kilkenny on March 18th of 2011 and was discharged the next morning.

He came into the emergency department on the night of March 20th, an inquest heard today, with a swollen tongue, groin and abdomen, low blood pressure and in a “very unwell” condition, and died early on March 21st in the hospital’s intensive care unit.

The coroner’s court in Kilkenny heard Mr Comerford’s bowel was perforated as a result of the hernia operation on March 18th. He was suffering from septic shock when he returned to the hospital’s emergency unit and had underlying heart disease.

Consultant surgeon Ian Wilson said that, when Mr Comerford was brought to the operating theatre on the night he was readmitted, after he had a CT scan, the sutures from his hernia operation were opened and there was “some leakage”. The wound was washed out during surgery and he was brought to the intensive care unit where he went into cardiac arrest. He died later.

Under cross-examination from Raymond Bradley, solicitor for the Comerford family, Mr Wilson said that, knowing what subsequently happened, his interpretation was there was a “partial injury” caused to the wall of the bowel during the initial hernia surgery on March 18th.

This injury then became a perforation between the time the patient was discharged from hospital and the time he was re-admitted the following night. At the time of his discharge, there was no evidence of any “significant leakage” from the bowel or internal bleeding, Mr Wilson said.

Pathologist Dr Fergus McSweeney said cause of death was multi-organ failure, with evidence of a bowel perforation and intra-abdominal haemorrhage following the repair of an incision hernia, with heart disease a contributory factor.

The coroner, Tim Kiely, referred to the evidence of the hernia surgery, "which everybody accepts caused the bowel perforation". He returned a finding of medical misadventure but stressed this was not a finding of fault with any party involved.

After the inquest, Mr Comerford's daughter, Karen Brown, said the family were relieved to have some "clarity" about what happened but were "devastated" about the loss of her father. Her mother, Pamela Comerford, is taking a civil action against the hospital.

She described her father as “a fit man” and said he and his family expected his hernia operation to be “a simple, straightforward thing” on March 18th of 2011. “Two days later we lost him.”