Mother got to hospital with multi-organ dysfunction

A MOTHER of three who died following an elective hysterectomy was “in shock” with multi-organ dysfunction upon her arrival to…

A MOTHER of three who died following an elective hysterectomy was “in shock” with multi-organ dysfunction upon her arrival to a Dublin hospital following an emergency transfer.

Linda Royal (50), Kingswood Heights, Tallaght, Dublin, was rushed by ambulance from Mount Carmel Hospital to St James’s Hospital on September 28th, 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 AE department at about 11am, Ms Royal had inadequate kidney function and deranged liver function with a fast heart rate and low blood pressure, an inquest heard yesterday.

Consultant surgeon at St James’s, Mr Narayanasamy Ravi, who examined her, told Dublin City Coroner’s Court it was clear that Ms Royal was extremely sick and she needed to proceed to theatre.

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In theatre Mr Ravi found there was an extensive lack of blood supply (ischemia) to all the organs in Ms Royal’s abdomen, including the stomach, the liver and the small and large bowel.

“What was obvious and shocking was the extensive lack of blood supply to all the organs of the abdomen,” he said. “What I found there was very bad. 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.

Dr Ravi said the ischemia or lack of blood supply would have happened within hours rather than days, within a minimum of four to six hours.

Following surgery Ms 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.

The coroner’s court heard Ms Royal had been transferred to the high-dependency unit at Mount Carmel Hospital at 5.15am that morning following a deterioration.

By 7.30am, her abdomen was distended and rigid and she was jaundiced was restless and uncomfortable due to pain. A decision was made to transfer her to St James’s Hospital when she suffered an acute deterioration at 8.50am.

Coroner Dr Brian Farrell adjourned the inquest to October.