A hospital consultant has said he may have made an error in not carrying out a procedure in a case in which a priest died from complications linked to the replacement of an intravenous line.
Consultant anaesthetist Dr James O'Rourke, of Beaumont Hospital, was giving evidence at the inquest of Fr Seamus Giles (74), a resident of Knightsbridge Nursing Home in Trim, Co Meath, who died at the hospital on December 8th, 2013.
Dublin Coroner’s Court heard his death was the result of internal bleeding most likely caused by perforation of his internal jugular vein during a central line insertion.
Fr Giles had a history of illness and was admitted to Beaumont in November 2013 with severe septic shock. He subsequently underwent a number of procedures and was being treated in intensive care.
Clean lines
Dr O’Rourke told the inquest it was necessary to insert “clean lines” following sepsis because antibiotics do not sterilise existing ones.
The procedure was performed on December 8th, 2013, by anaesthetics registrar Dr Charles Goh under Dr O'Rourke's supervision. Dr Goh said he encountered "abnormal resistance" as he performed the procedure and Dr O'Rourke scrubbed in to check it himself. Fr Giles's blood pressure dropped and attempts to resuscitate him failed. Dr O'Rourke said in his opinion the guide wire punctured a major vessel in Fr Giles's chest. This is a recognised complication of the procedure, he confirmed.
He said he felt it was within Dr Goh’s competency to perform the procedure and it had been carried out correctly but he possibly should have done it himself.
“There was no mistake in the procedure, the procedure was done correctly. I guess maybe the mistake was in my judgment not to do it myself,” he said. Following postmortem, the cause of death was given as acute bleeding into the left pleural cavity but the source was not identified.
Pathologist Dr Caoimhe Egan agreed with coroner Dr Brian Farrell there was no other likely source than the internal jugular vein.The coroner returned a verdict of medical misadventure.