AN INVESTIGATION into how an extra heart, extra liver and extra set of kidneys ended up in the body of a British tourist after a postmortem examination at Dublin's Beaumont Hospital has found a technician in the hospital put them there. EITHNE DONNELLAN, Health Correspondent, reports
The independent investigation found that postmortems had been carried out on two bodies at or about the same time in the same autopsy room at the hospital, in August 2006. One was on an Irish woman, the other was on the male tourist, 55-year-old Louis Selo.
The senior anatomy pathology technician (APT) responsible for reconstructing the body of the woman had "stitched the body and returned it to the fridge" when he noticed a tray of organs on her side of a dissection bench in the autopsy room.
"It passed through his mind that they could belong to the body of the female, but just as quickly he dismissed this idea as he couldn't see how he could have missed them when collecting the organs and reconstructing the body," the independent report into what happened states.
The report, which has been obtained by The Irish Times, adds that even though the organs were on her side of the bench, he assumed they were from the male body. "He placed them in the bag for the male body without making any further checks or asking anybody else if they knew the origin of the organs."
Asked what he was thinking when he did this, he told the inquiry he was simply tidying up.
What happened in August 2006 would never have come to light, the inquiry report states, were it not for the fact that Mr Selo underwent a further postmortem when his body was returned to London.
The report also states that while Beaumont's mortuary policy stated that all tissue should be retained on the autopsy table, the APTs and pathologists in the hospital confirmed this part of the policy was seldom followed.
It adds: "If two postmortems had been performed at the same time, the pathologists and APTs confirmed that there was no specific way of tracking which organs belonged to which body."
There was no written or agreed protocol or procedure at the hospital for ensuring the correct organs were returned to a body. It was to be understood, though, that organs on one side of the dissection table went into the body on autopsy Table 1, and those on other side went into the body on Table 2.
The senior APT responsible for misplacing the organs in Mr Selo's body expressed remorse about the incident and the distress it caused, the report says.
It also says that new procedures have been introduced at Beaumont to avoid a recurrence. Two different coloured bags are now used for each body in the autopsy room, and the bags are labelled with the patient's name.
The independent investigation, carried out by Dr Barry MacKellar in the UK, makes several recommendations which Beaumont says it already has in place, or is in the process of implementing. Asked whether action had been taken against any member of staff, Beaumont said: "Appropriate disciplinary procedures have been completed."