Of all the awfulness contained in an external report commissioned by the health board employing the consultant obstetrician, perhaps the most tragic is the loss of her first baby during pregnancy by a 20-year-old woman.
She will never have children as a result of Dr A's performing a caesarean hysterectomy which, it is understood, the author of the report regarded as not being needed.
It is understood that three of the nine women whose cases were evaluated were having their first baby by caesarean when Dr A removed their wombs, performing a caesarean hysterectomy.
The cases examined by the author, which related to the period January 1996 to October 1998, are understood to have been complicated but, in the author's view, a consultant should have been able to manage them safely. While recourse to hysterectomy might have occurred in a few of the cases if another consultant had been in charge, the author was worried that so many hysterectomies were required over so short a time.
It is believed that the report found that all nine cases examined exhibited features which caused concern, and that these features recurred. It is believed that Dr A reported findings during deliveries of these babies which were not confirmed on the subsequent pathological examination of the uterus.
The report is understood to state that in four cases blood transfusion was not felt necessary at the time of the surgery, despite Dr A's using words such as uncontrollable, copious, non-stop and continuous to describe the haemorrhage.
The report is understood to say that one of the four patients was subsequently found to be anaemic and received a transfusion. Two other women were given transfusions only following surgery, even though Dr A had described the bleeding as massive.
It is believed that the report points out that most of the hysterectomies were undertaken during normal weekday working hours, when facilities, back-up and support would have been at their best. It is understood to point out that five of the seven hysterectomies occurred when planned caesareans were being undertaken.
As three of the women were having their first babies, it would be normal medical practice to have major efforts made to preserve their ability to have further children, particularly in the case of the woman who has lost her baby.
The author of the report is understood to have formed the view that Dr A exaggerated what actually occurred, explaining his actions by commenting that a case had been the most difficult he had ever seen, or that he had spent most of the night in the operating theatre.
The Irish Times understands that having re-examined the cases, the report concluded there were major concerns about Dr A continuing to practise as a consultant obstetrician.