MONITORS ATTACHED to a woman who died hours after she underwent surgery were not working properly, a nurse told an inquest yesterday.
Nurse Nancy Kelly was giving evidence at an inquest into the death of Bernadette Reid (48) Redmond Park, Arklow, Co Wicklow. Ms Reid died just under 10 hours after she was discharged from surgery following a failed keyhole procedure to fit a gastric band at Advanced Cosmetic Surgery (ACS), Owenstown House, Owenstown Park, Fosters Avenue, Stillorgan, Co Dublin, on February 27th 2007.
Mrs Reid, who weighed approximately 20 stone, was making a good post-operative recovery, Dublin County Coroner’s Court heard. She received medication for pain relief including morphine from the nurses on duty who monitored her throughout the night. At 4.15am on February 28th the alarm was raised when it became evident she was not breathing. Cardiopulmonary resuscitation was started but anaesthetist Dr Sami Al Ashbal could find no pulse.
Director of clinical services at ACS, which is now in liquidation, Anna Louise (Lou) Kellett said the equipment was brand new and had been calibrated.
Ms Reid’s GP, Dr Siobhán McCabe, told the inquest the deceased was unsuitable for the surgery because she was too overweight and had chronic asthma. She had strongly advised her against having the operation.
“She was unfit because she had never been as heavy as she was at the time and her lungs were very bad,” said Dr McCabe. “I never spoke to the clinic and I would have said she was a high risk for surgery.”
The court heard that twice in a questionnaire Ms Reid denied she suffered from breathlessness. “She was very keen for the operation to go ahead and she probably played down the matter,” added Dr McCabe.
Paris-based surgeon Dr Jerome Manuceau and anaesthetist Dr Ashbal were aware Ms Reid suffered from asthma. Dr Ashbal said he examined the patient in the hour before her surgery and checked her chart and test results – which included an electrocardiogram and liver function and blood tests – but didn’t have access to her GP medical records, and there was nothing in her clinical case notes which required him to talk to her GP.
He said the decision whether or not to make contact with a patient’s GP was made at the clinic, where in January a surgeon and nurses would see if she was fit for the operation.
He graded Ms Reid as a grade 3, according to the American Association of Anaesthetists, because of her morbid obesity and her asthma – indicating a patient with “severe systematic disease, but not incapacitated”.
Dr Manuceau, a specialist in gastric banding who has carried out some 2,000 such procedures, did not proceed with the gastric banding when he discovered a tumour in Ms Reid’s stomach. Aside from that, the operation was uneventful, although Ms Reid proved difficult to intubate because of her obesity problem.
Dr Manuceau said “surgery without risk doesn’t exist and with every operation you can have death”. He told the court obese people are “risky people” and when he first started working in Ireland no anaesthetist wanted to work with him “because it’s too risky.” “But unless we operate, they die,” he said .
Pathologist Dr George Harbourne said Ms Reid died of a cardiac condition with obesity as a contributory cause. He believed it could have happened to her at any time and he didn’t find any typical causes of early post-op death.
The coroner, Dr Kieran Geraghty, recorded a verdict of death by natural causes.
Outside the court, Ms Reid’s son, Michael, said the family had discovered shocking information at the inquest.
“We feel there wasn’t enough consultation done on my mother with her local GP and there was an apparent lack of consultation between the main surgeon and the anaesthetist,” he said.
“I want to call on the Minister for Health to regulate this multi-million-euro industry where people are getting rich on the backs of people who are unfortunately obese.”