A doctor has admitted a man who died following a hip operation should have been transferred to intensive care earlier.
Brendan Swan (77) of Upper Beechwood Avenue, Ranelagh, Dublin 6 died at St Vincent's University Hospital on April 23rd 2009 after being admitted suffering from kidney failure symptoms following an operation on his right hip.
The father of three had the hip operation at Cappagh hospital on April 1st. He suffered a significant renal setback on April 4th and was transferred to Vincent's Hospital on April 5th, where he suffered a heart attack upon admission to the accident and emergency department, an inquest heard.
A postmortem carried out by Dr Tom Crotty, consultant histopathologist at Vincent's Hospital, found Mr Swan had died of damage to the brain and spinal cord (hypoxic ischemic encephalopathy) as a result of the heart attack, which was in turn caused by septic shock.
Mr Swan never regained consciousness following the heart attack and died 18 days later on April 23rd, the inquest heard.
Counsel for the family John Rogers said the medical personnel at Cappagh hospital didn't appreciate how unwell Mr Swan was on the morning of April 5th.
"Had they properly interpreted his condition they would have immediately transferred him to the intensive care unit," he said.
Mr Swan was transferred to ICU at 6.40pm but should have been transferred at 9.30am that morning based on his clinical condition - the fact he was suffering renal problems, Mr Rogers told the inquest.
Ciaran O'Rourke, a consultant orthopaedic surgeon at Vincent's Hospital, said with the benefit of retrospect Mr Swan ought to have been transferred to ICU in the morning.
Requesting a verdict of medical misadventure, counsel for the family said the fact that Mr Swan was not removed to Vincent's Hospital early on April 5th was not ideal.
"There is a clear sequence of events indicating a level of medical misadventure," he said.
Recording a narrative verdict, Dublin City coroner Dr Brian Farrell said he could not give a verdict of medical misadventure without any evidence from Cappagh hospital.
"I haven't heard any evidence from the Cappagh hospital. I'm relying on a comment, an admission by Mr O'Rourke. That's an opinion - given by a consultant no doubt - I don't have evidence," he said.