‘Cascade of negligence’ led to pregnant woman’s death

Court hears two doctors treating Malak Thawley (34) sent to nearby pub to get ice

A man whose wife died during surgery for an ectopic pregnancy at the National Maternity Hospital in Dublin has sued for damages in the High Court.

Malak Thawley, a teacher and US citizen (34), was expecting her first baby at the time of her death on May 8th 2016.

Liam Reidy SC, for Mr Thawley, told Mr Justice Anthony Barr what happened involved "a cascade of negligence" and "one negligent act after another". The doctor who carried out the surgery was an inexperienced junior surgeon and was not supervised, he said.

The ineptness of the entire process at the hospital was illustrated by the fact, when they decided to cool Mrs Thawley’s brain with ice, two doctors were sent across the road to a pub to get ice as there was none in the hospital, he said.

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The fact the Minister for Health ordered a statutory inquiry into the case gave no comfort to Mrs Thawley’s widower who cannot get over his wife’s death and has “severe hopelessness”, he added.

Mr Thawley (31), Brusna Cottages, Blackrock, Co Dublin, claims his wife suffered an untimely death due to negligence in her care and treatment and is also suing for nervous shock suffered as a result of her death.

Liability has been admitted and the case is before the court for assessment of damages only. Aggravated damages and exemplary damages are being sought.

In court on Thursday, Eoin McCullough SC, for the NMH, said it apologised for the events which led to the death of Ms Thawley and extended its deepest condolences to Mr Thawley.

When the proceedings issued in January last year, a letter from the NMH admitting liability, apologising and extending deepest condolence issued the next day, the court heard. The hospital apologised on numerous occasions and an internal inquiry was also set up, Mr McCullough said.

Opening the case, Mr Reidy said the Thawleys had been living in Ireland for three years and were profoundly happy and excited when Ms Thawley became pregnant.

As a surprise gift Mr Thawley arranged a scan at six weeks, but at the scan they were told to go to the NMH for advice about the ectopic pregnancy. An ultrasound there confirmed the ectopic pregnancy.

Counsel said Mr Thawley googled ectopic pregnancy and saw it could be treated with certain medicine but was told, because the foetal sac had a heartbeat, the only option was surgical intervention and the couple felt they should follow the advice.

To this day, Mr Thawley regrets that decision, but the couple were reassured it was a routine procedure which would take 30 minutes, counsel said.

Mrs Thawley was taken to theatre at 4pm and her husband “never saw her again”. At 5.30pm, a nurse told him a lot of blood was found in the abdomen and at 6.30pm a doctor told him his wife had lost 10 units of blood but they were “dealing with it”.

Mr Thawley felt he was not being told the full picture, Mr Reidy said. At 7.30pm, the Master of the NMH Dr Rhona Mahony told him the situation was very serious, doctors were doing everything they could but there was "a chance your wife could die". About 20 minutes later, Dr Mahony returned with a specialist surgeon and said "Malak is dead".

Mr Thawley was told a trocar had been inserted in the abdomen and it had torn the aorta, counsel said. Mr Thawley remembered saying: “Are you telling me it was a mistake?” and the surgeon said, yes, it was medical misadventure.

Mr Thawley was in “a state of shock and disbelief” and, when he returned to the NMH the next day, Dr Mahony said all surgery has risks and what happened was an accident. Mr Thawley spoke to a relative who was a surgeon in another country and had come to the conclusion what happened was not an accident, counsel said.

Mr Thawley felt embittered the Master had not said sorry and the situation was mismanaged and had told him what happened was an accident.

In the action, it is claimed Mrs Thawley suffered a laceration to the surface of her aorta and there was complete mismanagement of the major vascular injury and Mrs Thawley’s deteriorating condition, culminating in loss of opportunity to save her life and her eventual and avoidable demise.

It is also claimed there was failure to have vascular clamps available on site at the hospital for emergencies and a failure to have a red phone installed in theatre for use in emergencies.

Mrs Thawley’s life, it is claimed, was unacceptably endangered during the operative procedure and her death occurred as a result of the injury inflicted upon her and complete mismanagement of the injury afterwards.

Mr Thawley has also sued for nervous shock, claiming his whole life and happiness with his late wife and plans and dreams for their future have been annihilated.

The case continues on Tuesday.