A consultant obstetrician, Dr Victor Moore, who was found guilty of professional misconduct because of a delay of three hours in operating on a "dangerously ill" female patient at Sligo General Hospital, was ready and anxious to operate but had to wait while anaesthetists stabilised the woman, the High Court heard yesterday.
The finding of professional misconduct in the case of that patient is being challenged by Dr Moore, along with findings of professional misconduct made against him regarding three other women patients whom he also treated at Sligo General between 2002 and 2004.
In the case of one of the four, a 37-year-old woman with an ectopic pregnancy, the Medical Council found Dr Moore was guilty of professional misconduct because of a three-hour delay in operating on her on January 17th, 2004. The facts of that case were outlined in court yesterday.
Dr Catherine Roche, consultant anaesthetist at the hospital, told Mr Justice Michael Hanna that the woman had lost so much blood following an earlier operation on the morning of January 17th, 2004, that she was required to be stabilised prior to undergoing a second operation. Dr Roche said she would have objected to the woman going to theatre earlier than she had and considered that, had she been operated on earlier, there was a risk of cardiac arrest.
Dr Roche said she was well aware that Dr Moore was ready and anxious to operate on the patient "but she still needed to be stabilised". The patient was not fit for surgery until about 10.30pm on January 17th, the witness said. She did not recall that Dr Moore had disagreed with her approach.
The court heard the patient had been operated on by Dr Moore on the morning of January 17th to remove the ectopic pregnancy and was out of recovery by about 1.15pm.
Her condition deteriorated that afternoon and Dr Roche, when contacted about that deterioration about 5.30pm, had directed the woman be immediately transferred to intensive care. The woman was dangerously ill and had told her she believed she was going to die, Dr Roche said. She had lost a lot of blood.
Dr Roche said she was very upset she had not been contacted earlier about the woman's deterioration as this was an extremely dangerous situation. As she had no help at that time, she had, for the first time in her 21 years in the hospital, contacted a consultant colleague to come in and assist in stabilising the woman.
The court was also told Dr Moore was contacted about 6.15pm about the woman's condition and came quickly to the hospital.
Dr Roche said she accepted this was the first time Dr Moore was informed of the situation. A nurse also said she had endeavoured to contact Dr Moore twice after 4pm via the switchboard of the hospital but was unsuccessful.
In evidence, the patient said she was operated on by Dr Moore on the morning of January 17th and felt very weak after she woke up. That evening, she was transferred to intensive care. There was "a lot of panic" around her with staff trying to get blood into her and she was very nervous about having a second operation.
"I felt I was going to die," she said. Her mother had died on the same day a year earlier at Sligo General, she added.
She had had respiratory problems after the second operation and spent some five more days in intensive care. She had since given birth to her first child.
In addition to seeking to overturn the Medical Council's November 2005 findings of professional misconduct against him, Dr Moore, with an address at Kilwarlin Avenue, Hillsborough, Co Down, is also challenging the council's finding that he was unfit to practise medicine by reason of physical and mental disability.
Among the other patients in relation to whom a finding of professional misconduct was made was a 40-year-old woman whose healthy baby was delivered in October 2003 by Dr Moore.
However, the placenta was partially retained and the woman then underwent three separate procedures to remove it.
The woman suffered severe blood loss and it is alleged there were difficulties contacting Dr Moore to deal with her and that Dr Moore had left the operating theatre at critical times.
Evidence in relation to that patient's case began late yesterday and resumes today.
