A neurosurgeon told the High Court yesterday that there was always the risk things could go wrong in brain surgery even when it was conducted by an expert pair of hands.
Mr Robert D. Illingworth said there was no record of any explanation of the risks involved in such surgery having been given to a Co Leitrim man by the neurosurgeon who had performed an operation on him in St Vincent's Hospital, Dublin, on April 23rd, 1987.
Mr Illingworth was giving evidence during an action taken by Mr John Rooney (45), a school art teacher, of Keenaghan, Carrick-on-Shannon. He is seeking damages for alleged negligence on the part of the hospital and the doctor who carried out the brain surgery, Mr Fergus Donovan. Both defendants deny the claims.
In evidence Mr Rooney said he was left semi-paralysed on his left side as a result of the operation. Because of his disability he has lost his job as an art teacher and is now living on £75.50 a week disability allowance.
The operation on Mr Rooney was for the removal of an enlarged blood vessel in his head, described as an arterio-venous malformation.
On the fourth day of the hearing yesterday, Mr Illingworth, a witness for the plaintiff, said a competent surgeon without encountering any major problems should take about three to four hours to perform this type of operation. It was a complex procedure.
The operation should not be undertaken for the treatment of epilepsy alone. In fact, performing it for this purpose might even provoke epilepsy in a patient who did not have it previously, he said.
Mr Illingworth said he had examined slides following an X-ray examination of Mr Rooney's brain at the weekend and had found two large clips very close to the middle cerebral artery. If that artery was blocked, there was a major risk of a stroke and paralysis of the type Mr Rooney had suffered.
Cross-examined by Mr John Fitzgerald SC, for both defendants, Mr Illingworth agreed there was a risk of brain haemorrhage even if the operation had not been performed on Mr Rooney. But most haemorrhages did not mean death or injury.
In this case, there were three options open to the surgeon and patient: to do nothing, to operate, or to wait and see if a haemorrhage did occur in the future and then decide whether to operate or not.
There were always dangers in any brain operation. Even in the most skilled hands, complications could occur. There were risks involved in every surgical procedure, he said.
The brain was a very fragile object and could be damaged by surgery. If handled roughly, it could result in brain damage, bleeding, swelling and infection both of the brain itself and spinal fluid.
The hearing continues today.