Concerns are again being aired about patient safety at Cavan General Hospital following an incident last week in which an elderly man had to be transferred to Dublin for emergency surgery after complications followed an operation on him in Cavan.
The Irish Times has learnt that senior staff at the hospital have begun once again to express concern about safety for patients attending for surgery.
This latest adverse clinical incident has come within weeks of new guidelines being issued for the Cavan surgical unit by the Royal College of Surgeons in Ireland (RCSI). The guidelines state that no patient should be operated on without two surgeons agreeing in advance that the surgery is necessary.
Furthermore, they lift an earlier restriction placed on major gastro-intestinal surgery taking place in Cavan. In March, following his review of 15 adverse clinical incidents at the Cavan surgery unit, Mr Finbar Lennon, the medical adviser to the North Eastern Health Board (NEHB), which runs the hospital, stated that major gastro-intestinal surgery should only be carried out at Our Lady of Lourdes Hospital in Drogheda, the largest hospital in the region.
However, the latest RCSI guidelines say it is no longer necessary to transfer all patients in need of major gastro-intestinal surgery to Drogheda. "Some gastro-intestinal surgery no longer has to be transferred from Cavan to Drogheda," the health board confirmed.
The elderly man who had to be transferred to Dublin's Beaumont Hospital last week had undergone gastro-intestinal surgery in Cavan.
One doctor told this newspaper yesterday of his concern that safety issues at the hospital, which have been highlighted now for several months, had still not been fully addressed, and he claimed patients were being put at risk.
The NEHB confirmed a patient had to be transferred to Beaumont following surgical complications at Cavan in recent days.
Asked how concerned it was about this latest incident, and whether restrictions should again be put on gastro-intestinal surgery being carried out in Cavan, it said the health board was "continually taking advice from the RCSI and will continue to take that advice".
Meanwhile, Prof Arthur Tanner, director of surgical affairs at the RCSI, said that following recent interviews for locum consultant surgeon posts in Cavan and his inspection of surgical training there, he suggested to Mr Lennon that they "redefine the protocols for surgical interventions in Cavan".
He refused, however, to comment on the latest adverse incident in Cavan. "I believe that the leaking of clinical information to you is unethical and dangerous. Unethical, for obvious reasons, and dangerous, as you cannot extrapolate from single isolated case reports any meaningful scientific interpretation," he said.
He added that the RCSI was constantly monitoring the situation in Cavan in conjunction with the health board and the consultant surgical staff.
Controversy has surrounded the Cavan surgical unit since August 2003, when two of its three permanent consultant surgeons were suspended over "interpersonal difficulties". They have been replaced by a series of locums, and concern has been expressed about the resultant lack of continuity of care for patients. Concern was at its greatest earlier this year following the death of nine-year-old Frances Sheridan three weeks after an appendix operation at the hospital. A post-mortem found she died from complications of recent surgery.