It was just a routine operation in a private hospital. What could go wrong?
At 52, with a devoted family, Susan McGee had everything to live for. Then she went for surgery at a Dublin clinic...
‘The smell was rancid. We know now it was sepsis’
IT’S A smell Melissa Barry will never be able to forget — the foul odour that hit her as soon as she stepped into her mother’s room at The Hermitage Medical Clinic in Dublin on a humid Saturday morning in July 2013. ‘I noticed it as soon as walked in there. I can’t even to this day describe it properly, I’ve never smelt anything like it before or since,’ she says. ‘It was obnoxious, it was rancid, I can’t even liken it to anything.
‘Poor mam was so distressed by it, she told me it was making her nauseous. I helped her to shower and then I went out to find a nurse to ask them about it. They said it was probably something to do with the clinic’s maintenance, that it could be a drain problem and because it was July the heat was making it worse.
‘They said they would just get her moved to another room, but it didn’t make a difference, it followed her, of course it did. Because as we know now, it was sepsis.’
For the rest of that weekend Melissa and her family looked on helplessly as her mother’s condition continued to deteriorate.
‘We all questioned the staff on the Sunday, I’m just so sorry to this day that I didn’t shout louder,’ says Melissa. ‘Myself and Dad had spoken about getting her moved to a different hospital, that’s how strongly we felt. But I thought: “I’ll sort it out in the morning.” It was too late at that stage.’
The previous week Susan McGee, a gregarious 52-year-old motherof-two, had undergone a routine hernia operation, which the surgeon declared to be a success.
A few days later, after being discharged, Susan fell ill and had to be readmitted. The family was told there had been a minor complication, a small blockage in her bowel, which meant she would need to stay in the clinic over the weekend of July 19-21 so that the bowel could be rested.
It was nothing to worry about, they were assured, and it was being dealt with. Melissa and her brother Johnny believed that their mother was in the hands of ‘professionals’.
‘We trusted them,’ Johnny says. ‘We also never thought for one moment that anything like this would ever happen to us.
‘We knew she was very sick but we had no idea of how bad it actually was,’ says Melissa. ‘I totally believe that if it had been midweek or in a public hospital, mam would still be alive. I believe there would have been more staff on if it had happened on a weekday and that the staff in a public hospital are more familiar with severe infection than a private hospital.’
It would later emerge that Susan had contracted C-Diff, clostridium difficile, a bacterial infection of the bowel.
‘It wasn’t recognised early enough and I believe with the smell in that room, that had the right person walked in there and smelt it, they would have known what it was,’ says Melissa.
‘I will never, for the rest of my life, forget what sepsis smells like.’
Susan McGee died shortly after midnight on Tuesday, July 23, 2013. Last week the Hermitage Medical Clinic apologised at the High Court over failures in the care provided to Susan. The apology was read as part of a €300,000 settlement made to her family.
Lawyers for the McGee family claimed there was a failure to respond adequately, or at all, to the deterioration in Susan’s condition over the weekend of July 1921. Liability was admitted.
At her home this week in Rush, North Dublin, Melissa Barry is measured and detailed as she recounts the nightmare she and her family endured while watching their mother getting sicker and sicker.
Although separated since 2003 and later divorced from her husband John, the couple had remained close and all of the McGees worked together at C McGee Ltd, a family-run fruit and veg wholesale business.
‘Dad had remarried but Mam and him were still very good friends,’ Melissa, 35, explains.
Susan lived at the family home in Rush with her son Johnny, 30, and his fiancée, Gina. Just before the summer of 2013 and after losing an astonishing 8st in weight, Susan decided she wanted to get rid of a hernia she’d had for some time.
‘She did Slimming World for over a year and she was so determined,’ says Melissa. ‘She was out on her bike all the time and was down to a size 16. She was delighted with herself and was only just starting to get the life she really wanted.
‘She was able to do so much more stuff and had bought herself a whole new wardrobe, in fact she wore a pair of shorts for the first time in my living memory the day before the surgery.
‘The hernia had been protruding a lot more once she lost the weight and it was bothering her. She went to see a consultant in Beaumont Hospital, Professor Hill, and he told her she could either go on a waiting list or he could do it the following week in the Hermitage.
‘She went with the Hermitage and when she told me, I suppose I thought: It’s a private facility, you get what you pay for. I thought you’d get a better standard of care. So we said: “Fire ahead.” We could never have anticipated the outcome.’
Susan went in for her operation on Saturday, July 13, 2013. ‘After the surgery that afternoon we were told everything went fine, went as planned, there were no problems,’ says Melissa. ‘She was discharged on the Tuesday, She was a bit sore, but she expected that.’
That night, however, Susan became extremely unwell and when Melissa called into her the following morning she immediately drove her back to the Hermitage Clinic.
‘I’ve never seen her so sick in all my life,’ says Melissa. ‘She was pale, vomiting, distressed, sweating, panicking, we knew something was wrong. They did an ultrasound and told us there was a small blockage in the bowel.
“They said it was standard, a regular occurrence and over time it would rectify itself. She was to stay there for a few days and be monitored while her bowel was rested.’
The family later found out, through Susan’s medical records, that there was also a small tear in her bowel and she was administered extra antibiotics. Up until that Friday they had dealt with Professor Arnold Hill, the surgeon who carried out her operation and who she initially met in Beaumont Hospital.
‘Professor Hill went on his holidays on the Friday evening, which was fine,’ says Melissa. ‘We were told they were going to keep an eye on her and if everything went as planned, she would be discharged on Monday.’
In the High Court, the McGees’ lawyer told how Susan was left in the care of consultant surgeon Colm Power, and another doctor. But it emerged the other doctor was not available as he was rostered to work in a different hospital that weekend.
And that although Susan’s condition deteriorated significantly over the weekend, she was not seen by a doctor of consultant status until the Monday morning.
‘I went into her early on the Saturday morning, about 10am,’ Melissa explains. ‘She wasn’t great and it was then that I noticed the rancid smell in the room. She needed me to help her into the bathroom so she could wash.
‘I was told a registrar (doctor) had been in to see her minutes before I arrived. Apparently I’d just missed him.
‘We later found out he was rostered to be on duty in another hospital... I never saw him or talked to anyone above nurse level the whole weekend.’
After questioning a nurse about the odour in her mother’s room and being told Susan would be moved, Melissa, who was six months pregnant, went home.
‘Her form wasn’t great, she was tired and wanted to sleep,’ says Melissa. ‘It was hot, she was probably agitated and had a blockage in the bowel, we thought maybe it was par for the course her being so unwell, we didn’t really know.
‘Her brother David, my uncle, went in on the Saturday evening and she became very sick with vomiting and diarrhoea, he had to run and get a nurse. Mam texted me that night to say she was very embarrassed about it all and asked if I would go in the next morning, that she needed a shower.
‘This time she had to sit on a chair while I showered her, she just didn’t have the energy. Afterwards I tried to get her dried but she collapsed. A nurse came in and helped me get her back to the bed. I clearly remember saying to that nurse: “Look, she’s deteriorating, she’s not well, is this normal?”
‘And the nurse said to me: “Oh really? God, I think she’s much better today.”
‘Later that day my dad was in with his wife and he spoke to the nurse about her condition. None of us asked to see a doctor, we didn’t realise the severity of the situation. I thought: “Well it’s a weekend, they’ll come see her tomorrow.”
‘But in saying that, I would have assumed that if her condition was really bad, someone would have
‘I was told she’d recover... 24hrs before she died’
been there on call.’ Johnny adds: There’s a level of trust there. When they tell you stuff, you believe them, you’re not the professional.’
‘Exactly,’ says Melissa. ‘You don’t drop your car off at the garage and tell them how to service it. You trust people to do their jobs, that they’re competent enough to do their jobs.’
Much of what the McGees now know about their mother’s condition over that weekend was learned after her medical charts were released to them about six months after her death.
‘For instance, we now know her blood pressure dropped on the Saturday night and had to be artificially reinstated with IV fluids,’ says Melissa. ‘We weren’t told that. It’s not like we weren’t asking questions, on the Sunday especially we all could see how unwell she was. Her best friend Mary went in and to this day she still says she’s sorry she didn’t say it to the nurse. We went home that evening and at this stage the texts from Mam were dwindling. She was a textaholic, the phone was never out of her hand, so that was another indicator to us that something wasn’t right.
‘She did manage to text me overnight saying she really wasn’t well and was in a different room, with loads of tubes coming out of her now.
‘It wasn’t until her inquest that we learned Mam’s blood pressure had dropped again on the Sunday night, but this time when they gave her the fluids it didn’t go back up. By 10.30pm the resident medical officer, who attends to anyone in the clinic who needs them, was called.
‘He had 80-something patients under his care that night. Originally they said in the inquest there were 110 patients or so, but then it changed to 80 because the others were due for discharge. It’s still a lot of people to be under one doctor.
‘He stayed with Mam pretty much for the whole night. In the inquest he said he tried not to leave the woman’s side. We didn’t know how bad it was.
‘My cousin went into the clinic at 6am on the Monday morning while I sorted out childcare for Jayden. She walked straight past Mam’s room because she didn’t recognise her, she looked that bad.
‘I got in there for about 8am but I was only in her room for a couple of minutes before I was asked to leave. The consultant went into her while I waited in the day room, it was across from her room and it was like a bus station, so many people were going in and out. Then the consultant came out to me. As far as he’d been concerned, he was there to discharge her. But as far as we’re aware, the hospital didn’t contact him on the Sunday to tell him how sick she was.
‘He told me she was very ill, that her organs were failing. As soon as they could get a slot in the theatre, she was going for emergency surgery, that they were going in to remove the blockage in her bowel and hopefully it would solve the problem.
‘She was moved to isolation from the high dependency unit. We weren’t allowed in to see her.
‘We met with the consultant again about 6pm, who said they had a slot for 9.30pm. That was when he told us there was a bug in her system.
‘I still didn’t understand what was going on, so just asked what bug? It was C-Diff — none of us had ever heard of it before so we were pretty oblivious to how serious it was. At 7pm we were allowed into see her. She was awake but heavily sedated.
‘We were worried, but we still trusted the staff to do their jobs, we thought they were on top of things. We spent the guts of an hour-and-a-half with her before she was prepared for theatre.
‘There was no point in us hanging around so we were going home. At 9pm we kissed her goodnight, told her we loved her. That was the last time she was conscious.’
Shortly after 2am the surgeon rang them to say the surgery had gone well and the blockage had been cleared. He also told them Susan had needed a blood transfusion and was now on a machine to help her breathe.
‘His words to me where that he expected her to make a full recovery,’ says Melissa. ‘That was less than 24 hours before she died.
‘He also told me that she was being transferred to Beaumont because they had an intensive care unit, which the Hermitage didn’t have, and still doesn’t have.’
The McGee family were asked by Beaumont Hospital to hold off from visiting Susan until noon that Monday. When they got there they were brought straight to a day room. ‘They told us she was comfortable, not in any pain but that her condition was critical and the next 12 to 24 hours would be crucial,’ Melissa says.
Susan passed away later that night at 12.15am, her room filled with dozens of friends and family who had come to say goodbye.
Her children struggled to comprehend how she had died after what they had been repeatedly assured was a minor operation that had gone well.
‘Luckily my dad had his head screwed on,’ says Melissa. ‘He was able to see what was going on more so than us, and within a couple of days he had us signing forms to have her charts released. I had no idea at this stage of the failures in the care The Hermitage had provided.
‘Once they were released, we sent them off to be independently examined and that’s when we realised we had a problem. After the medical review we knew they had completely missed the infection until it was too late. The staff didn’t monitor her vitals. It was brought up in the inquest and the nurse said mam was resting and she allowed her to sleep.
‘Her blood pressure wasn’t monitored properly so by the time it was noticed on Sunday night...’
Several framed photographs of Susan are dotted around the sitting room, in all of them she is smiling broadly for the camera.
‘God, she was such a character,’ Melissa says, nodding at her brother Johnny. ‘Wasn’t she? So bubbly and outgoing. She’d a great social life, that was her favourite thing to do, meeting friends, going to parties and going on holidays.
‘She was mad about kids. She was close to my stepson, Dylan, who’s now 17, they got on great. And my own eldest boy, Jayden, is eight now, mam just idolised him. I was six months pregnant on my daughter Megan when she died, so she never got to meet her.’
Last week’s court outcome was a bittersweet experience for the family.
‘We knew they had completely missed the infection until it was too late,’ says Melissa. ‘We needed someone to hold their hands up and say that yes, they had missed it, it was our fault, we messed up.’
‘It was never about money,’ adds Johnny. ‘It was about admitting what they did and apologising.
‘And to stop it happening to anyone else, we don’t want another family to go through what we did, it was horrific and we miss mam every single day.’
‘They missed the infection until it was too late’