Farmer who died after bile duct surgery suffered ‘appalling outcome’

A 65-year-old farmer died following a procedure to remove stones from his gallbladder, an inquest heard. Sean O'Sullivan from Kingscourt, Co Meath died at the Mater Hospital on January 29th, 2018 after undergoing the operation 17 days earlier.

Surgeons found an “extraordinary volume” of stones in his bile duct, an inquest into his death heard.

The bile duct is more commonly cleared using an endoscopic approach due to “enormous improvements” in this area in recent years, the man’s surgeon said.

However, due to the volume of stone his medical team opted to perform a surgical procedure known as common bile duct exploration.

"He had such a volume of stone in his duct that it could not be done endoscopically. It's an unusual scenario. The endoscopic approach has improved enormously in recent years. Common bile duct exploration is rare now," Consultant General Surgeon Mr John Conneely said.

Healthy and fit

“In our practice we perform a dozen to 20 cases per year whereas previously this would have been much more common,” he said.

Described as healthy and fit, Mr O’Sullivan underwent the operation on January 12th, 2018 at the Mater Hospital. Initially he was making a good recovery before his condition deteriorated suddenly.

Mr O’Sullivan’s wife Ann told the inquest said she had lived with her husband for 41 years and the family were expecting him home after the surgery.

“But on the day they moved him to the ward he had a massive bleed and was transferred to the intensive care unit,” she said.

Doctors were concerned there was an intra-abdominal bleed and this was investigated.

Multi-organ failure

A suture was applied to the liver in a bid to save Mr O’ Sullivan’s life. However, his condition continued to deteriorate and he developed multi-organ failure. He died on January 29th, 2018.

“This was an appalling outcome. To say it was unexpected is an understatement. We do a lot of complex surgery. It’s difficult to accept an outcome as tragic as this,” Mr Conneely told Dublin Coroner’s Court.

“Everything that could be done was done, I know that’s very little consolation. It’s a terrible outcome for a lovely gentleman and my team are very sorry,” Mr Conneely said.

The cause of death was multi-organ failure due to hypovolemic shock following massive intra-abdominal haemorrhage, 17 days following common bile duct exploration.

Coroner Dr Myra Cullinane returned a verdict of medical misadventure noting that Mr O'Sullivan developed catastrophic bleeding a number of days after surgery from which he did not recover.