A CONSULTANT gynaecologist who worked at the Galway Clinic has admitted professional misconduct in her care of a patient who subsequently died, a Medical Council fitness to practise inquiry was told yesterday.
Dr Andrea Hermann was, the inquiry heard, reported to the council over the care she provided to seven patients at the private hospital between February 2005 and November 2008.
The inquiry opened in public yesterday but details of the care to just two of the seven patients were heard in public. The allegations in relation to the other five were held in private and the inquiry has been adjourned to next month. None of the patients is being named.
Eoin McCullough SC, for the Medical Council, said it was alleged that in relation to Patient 1, Dr Hermann failed to conduct appropriate investigations before a laparoscopy in January 2005, failed to look at conservative management of an ovarian cyst, failed to arrange for early administration of antibiotics to the patient, failed to seek early advice from a surgeon or appreciate the gravity of the patient’s condition, and failed to apply appropriate standards of clinical judgment.
He said these allegations had been admitted by Dr Hermann, as well as that they amounted to professional misconduct.
The patient, he said, was referred to Dr Hermann on January 14th, 2005, by her family doctor having had recent episodes of heavy bleeding. Dr Hermann diagnosed polycystic ovary syndrome.
An ultrasound was arranged and the patient was admitted as a day case for a laparoscopy on January 25th, 2005.
Mr McCullough said the ultrasound was done but not reported until the day after the operation. It showed a cyst on the patient’s left ovary. When the laparoscopy went ahead the cyst was removed.
After the operation, he said, the patient felt unwell. She was running a temperature on the following days and at 3am on January 28th began to decline. She had abdominal pain, nausea, a tachycardia and was distressed. At 4.40am Dr Hermann came in to assess the patient.
A diagnostic laparoscopy was performed and revealed a blood clot around the left ovary and brownish fluid in the abdomen.
A surgeon was called to do a laparotomy and “murky fluid” was found around the liver. There was also oozing from the area where the cyst was removed giving rise to peritonitis.
Mr McCullough said that during the new procedure, the patient’s condition deteriorated, she suffered a cardiac arrest and brain injury and was transferred to Galway’s University College Hospital (UCHG). She did not recover and died in due course.
He said two experts retained by the medical council concluded the ovarian cyst could have been managed conservatively. Secondly they would say antibiotics should have been commenced and the view of a surgeon sought when Dr Hermann saw the patient on January 27th. If this had happened, peritonitis could have been diagnosed and treated. Instead she did not call a surgeon until the next day when the patient was very ill.
The second case being heard in public in which Dr Hermann is accused of professional misconduct relates to a 39-year-old woman with haemophilia who also had to be admitted to UCHG after the consultant carried out an abdominal hysterectomy on March 26th, 2008. Dr Hermann is not making any admission in relation to this patient.