Nine women have been informed that hysterectomy operations performed on them over the past three years may have been unnecessary. The women, ranging in age from 20 to 38, were told yesterday by their general practitioners their cases would now be examined by an expert group. The consultant obstetrician at the centre of the controversy performed 21 caesarean hysterectomies on mothers in the past three years. He has now received a letter from the health board requesting that he take paid "administrative leave" while a review is carried out. Health board representatives who went to his house last Friday to deliver the letter had found his letter-box was sealed. If it is proven that some of these hysterectomies were unnecessary the consultant and the hospital involved may face one of the biggest medical compensation claims in the State.
The consultant was working until last Thursday despite the expression of concern by two midwives last October. An agreement was reached in early November that he would continue working but would liaise with the medical director regarding caesarean surgery and a second opinion would be sought in all such cases. The health board was not responding to queries yesterday on whether this had been honoured.
The nine women are patients of three GPs in the health board area. The GPs yesterday agreed to the health board's proposal that they contact the women seeking to explain the situation. It is understood this course of action was deemed more sensitive than having the health board contact them directly. Two of these GPs are understood to have expressed concern about the consultant in the recent past.
A woman who contacted The Irish Times said she had recognised her own case from the information contained in yesterday's newspaper. "I heard from my doctor today," said the woman, who did not wish to be named. "Reading about it in the paper was the first I heard of all this. It was very distressing. At the time it all happened I was led to believe that I should be glad to be alive and not to have ended up in a box." The cases of the nine women have already been assessed by UK experts, and a report of this assessment was written by Prof Michael Maresh, professor of obstetrics at the University of Manchester. The report was commissioned by the health board involved. When contacted yesterday Prof Maresh said he had no comment to make. Dr Maresh's report is understood to have said that a hospital of the size of the one involved in this case should see an average of one caesarean hysterectomy per year. However, for the past three years this hospital had an average of nine.
Dr Maresh reported that in many cases the consultant's decisions to perform hysterectomies were taken too quickly and unnecessarily. In a number of the cases surgical notes written by the consultant stating that there were uterine or placental abnormalities were not borne out by subsequent pathological examination of the removed uteruses.
Legal representatives of the consultant and senior Irish Hospital Consultants' Association (IHCA) officials are believed to have discussed their approach to the case last night. However, the secretary general of the IHCA, Mr Finbarr Fitzpatrick, refused to comment yesterday.
Some weeks ago the consultant involved obtained a document from three Dublin-based consultants which is believed to run counter to the assessment commissioned by the health board.
A caesarean hysterectomy is a radical and uncommon procedure performed when there is uncontrollable bleeding from a woman's uterus following birth by caesarean section. It is usually performed only when other measures to control the bleeding have failed and there is concern over the woman's life.