Date Published: 11-Sep-2009
The West Galway Coroner has issued a finding of medical misadventure in relation to the death of a patient who did not receive antiobiotics for 36 hours after developing an infection following a routine cyst removal operation at the Galway Clinic.
An inquest was held yesterday into the death of Saundra O’Connor (42), of Gardenhan, Claregalway, who fell into a coma and was left in a semi-vegetative state after suffering severe multiple organ failure following a laparoscopy at the Galway Clinic in Doughiska on January 25, 2005.
The mother-of-two, who ran a beauticians salon in Claregalway, died on February 19, 2008 at University Hospital Galway, where she was cared for round-the-clock since the operation at the clinic.
The cause of death was recorded as bronchial pneumonia due to post operative Streptococcal A infection, which caused sceptic shock and in turn led to cardiac arrest, multiple organ failure and brain injury.
Coroner Dr Ciarán MacLoughlin declared Mrs O’Connor’s death a case of medical misadventure.
Her husband, Martin O’Connor, reached a €580,000 settlement in the High Court with the Galway Clinic and consultant gynaecologist Dr Andrea Hermann last year when he sued for wrongful death. The parties had denied medical negligence.
However at the inquest in Galway, Dr Hermann said she “fully accepted” that Mrs O’Connor should have received antibiotic treatment sooner than she did.
“Earlier implementation of antibiotics would have been better and would have led to a better outcome . . . if I would have any opportunity to turn this clock back, by God I would,” she said under cross examination by the barrister for the family, Maura McNally.
The inquest was told Mrs O’Connor attended her GP, complaining of a dragging sensation on her left side and suffering from day flushes and night sweats. Dr Joan Davern referred her to Dr Hermann, who diagnosed polycystic ovarian syndrome and scheduled the keyhole investigative procedure called laparoscopy for January 25, 2005. She performed a diathermy, which involves lasering a cyst. After the day procedure, Mrs O’Connor complained of nausea and had a high temperature so she was detained overnight.
The nursing notes stated that Mrs O’Connor suffered from abdominal pain, was not responding to pain killers, had bouts of vomiting and recorded a temperature of 39 (102) degrees. Dr Hermann told the inquest she believed her patient was suffering from the flu and did not recommend antibiotics. Dr Hermann did not consider the possibility of an infection as the patient had a bowel movement.
After failing to answer her phone for 45 minutes, the consultant returned to the hospital at 4am on January 28 when the patient’s condition had further deteriorated and she decided to perform a second laparoscopy. When two litres of brown fluid was discovered inside the peritoneum cavity, Dr Hermann called consultant general surgeon Dr William Joyce to assist. He believed there may have been a perforation or tear of the bowel wall so he performed a laparotomy, but found no evidence of tears.
Culture tests taken from the tissue found the presence of the bacteria Streptococcal A. Doctors then treated her with extremely strong antibiotics but the infection produced toxins that caused her organs to fail, including the heart, kidneys, lungs and finally the brain. She had a heart attack and was transferred to the intensive care unit of the Galway Clinic.
Medics used the defibrillator 18 times over 45 minutes. When she was stabilised, she was transferred to the University Hospital Galway where tests revealed she had sustained a devastating neurological injury. While in a “near persistent vegetative state” and with the help of a ventilator, she was cared for at the hospital for three years until she passed away.
Dr Hermann said she had three other patients who suffered from nausea and a high temperature that day after similar procedures so was not overly concerned at Mrs O’Connor’s condition.
When it was put to her that there was no indication on the nurses notes that there had been a bowel movement, Dr Hermann said it was likely she got this information from the patient.
She told the inquest that Streptococcal A septicaemia was “exceptionally rare”.
“Most probably anyone who is coming in contact with a patient with this particular disease is finding it difficult to figure it out,” the German native said.
However, Dr Joyce in his evidence said he saw this infection “all too infrequently”. “It’s not rare. Certainly over the last 20-30 years it has become more common, probably because of the overuse of antibiotics,” he stated.
When asked what his assessment would be if a patient had undergone an abdominal procedure and developed a temperature of 102, Dr Joyce replied: “Obviously sepsis would be the initial thought process”. To confirm this diagnosis tests such as a white cell count could be conducted, which would take just 40 minutes to get results.
When Dr Hermann expressed her condolences to the family of Mrs O’Connor, three of her sisters shook their heads.
Outside the inquest, solicitor for the family Roger Murray said they were very pleased with the verdict of medical misadventure and would be happy to cooperate with the Medical Council should they wish to initiate an investigation. A solicitor for the CEO of the Medical Council attended the proceedings and maintained a watching brief.
Dr Hermann was suspended late last year by the Galway Clinic over concerns about patient outcomes in a number of cases. Dr Hermann sought an interlocutory injunction in the High Court last November against the hospital to stop it withdrawing her rights to practice at the clinic.
The mother of two girls, Sarah (17) and Lauren (13), Mrs O’Connor was well known from her time working behind the Clarins cosmetic counter in Brown Thomas, before she set up her own salon in Claregalway.
The way we were – Protecting archives of our past
People’s living conditions less than 100 years ago were frightening. We have come a long way. We talk about water charges today, but back then the local District Councils were erecting pumps for local communities and the lovely town of Mountbellew, according to Council minutes, had open sewers,” says Galway County Council archivist Patria McWalter.
Patria believes we “need to take pride in our history, and we should take the same pride in our historical records as we do in our built heritage”. When you see the wealth of material in her care, this belief makes sense.
She is in charge of caring for the rich collection of administrative records owned by Galway County Council and says “these records are as much part of our history as the Rock of Cashel is. They document our lives and our ancestors’ lives. And nobody can plan for the future unless you learn from the past, what worked and what didn’t”.
Archivists and librarians are often unfairly regarded as being dry, academic types, but that’s certainly not true of Patria. Her enthusiasm is infectious as she turns the pages of several minute books from Galway’s Rural District Councils, all of them at least 100 years old.
Part of her role involved cataloguing all the records of the Councils – Ballinasloe, Clifden, Galway, Gort, Loughrea, Mountbellew, Portumna and Tuam. These records mostly consisted of minutes of various meetings.
When she was cataloguing them she realised their worth to local historians and researchers, so she decided to compile a guide to their content. The result is For the Record: The Archives of Galway’s Rural District Councils, which will be a valuable asset to anybody with an interest in history.
Many representatives on these Councils were local personalities and several were arrested during the political upheaval of the era, she explains.
And, ushering in a new era in history, women were allowed to sit on these Rural District Councils – at the time they were not allowed to sit on County Councils.
All of this information is included in Patria’s introductory essay to the attractively produced A4 size guide, which gives a glimpse into how these Rural Councils operated and the way political thinking changed in Ireland during a short 26-year period. In the early 1900s, these Councils supported Home Rule, but by 1920, they were calling for full independence and refusing to recognise the British administration.
“I love the tone,” says Patria of the minutes from meetings. “The language was very emotive.”
That was certainly true of the Gort Rural District Council. At a meeting in 1907, following riots in Dublin at the premiere of JM Synge’s play, The Playboy of the Western World the councillors’ response was vehement. They recorded their decision to “protest most emphatically against the libellous comedy, The Playboy of the Western World, that was belched forth during the past week in the Abbey Theatre, Dublin, under the fostering care of Lady Gregory and Mr Yeats. We congratulate the good people of Dublin in howling down the gross buffoonery and immoral suggestions that are scattered throughout this scandalous performance.
For more from the archives see this week’s Tribunes here
Real Galway flavour to intermediate club hurling battle in Birr
Date Published: 23-Jan-2013
Athenry fail to take chances as they bow out of Junior Cup
Date Published: 29-Jan-2013
Athenry FC 1
Kilbarrack United 2
(After extra time)
For the second year in succession Athenry were done in extra time in the FAI Junior Cup as last season’s beaten finalist’s came from behind to snatch an excellent game in Moanbawn on Sunday afternoon.
On a heavy pitch that was only playable following extensive groundwork by club officials all morning, the home side were by far the better side in the opening half, but failed to take advantage of a number of opportunities that came their way.
An Alan O’Donovan penalty gave them a merited advantage just after the restart, but thereafter were on the back foot as Kilbarrack took over, but for all their pressing, the home rearguard were dealing comfortably with their forays.
However they were struck a body blow just six minutes from time, as big striker Keith Kirwan was left all alone at the far post to head the equaliser and from that point on the Dubliners were the better side.
They started off the extra time in the ascendancy and enjoying all the momentum before striking for a good winning goal on 104 minutes. A strong bench allowed them to make some necessary changes and it was not a facility that was available to Athenry manager Gabriel Glavin.
With Gary Forde and Gary Delaney out through suspension following their sending off against OLBC in the previous round, and Seamie Crowe injured, it left their bench rather threadbare with just a number of young squad players available.
Playing with the aid of the slight incline and any wind advantage going, the home side had a Connor Cannon effort on target in the opening minute, while John Meleady was just over with a flick at the other end.
Meleady then tested Andrew Walsh who saved comfortably, before the goalkeeper pulled off a brilliant double save on 14 minutes.
Firstly he went full length to push away a Meleady shot and was then back on his feet to parry David Jackson’s close-range rebound.
For more, read this week’s Connacht Sentinel.