The Irish Times
Man died after perforation of intestine
The family of a man who died when his small intestine was perforated during a procedure to repair a hernia say they hope lessons can be learned from his death.
Sligo coroner Eamon MacGowan returned a verdict of death by medical misadventure following an inquest into the death of Liam McCauley, of Ballinacarrick, Ballintra, Co Donegal, who died at Sligo Regional Hospital on March 22nd, 2013.
His brother Eamon said Liam (53) had told the family he was going in for “a day procedure”, but the inquest heard he died three days after the elective laparoscopic hernia repair .
Mr McCauley recalled receiving a phone call from the hospital on the morning of March 22nd to tell him his brother was dead. “I was shocked. We were never told that Liam’s life was in danger.”
Pathologist Dr Clive Kilgallen, who did the autopsy, told the inquest the death was caused by abdominal sepsis due to perforation of the small intestine.
Consultant surgeon Dr Zaib Khan, who performed the procedure, said he had first met the patient in 2012 when he presented with a small bowel obstruction.
He said that during the procedure Mr McCauley’s small bowel was noted to be adherent to the abdominal wall and he used a laparascopic scissors to carefully dissect it from the abdominal wall.
He thoroughly examined the bowel for any injury. “I found no evidence of a perforation,” he said.
After repairing the hernia he again looked for any bowel injury and found no evidence. The following morning the patient complained of pain but appeared stable apart from that, and his vital signs were in the normal range.
Blood tests carried out that evening showed a raised CRP (C Reactive Protein) of 25.
Roger Murray, solicitor for the family, suggested to Dr Khan that the normal CRP range was zero to one and that a raised level can mean serious infection or chronic illness.
The inquest heard that on March 21st, repeat blood tests were done and the CRP was 178. Dr Khan said he ordered repeat tests and an abdominal CT scan to check for signs of bowel injury or perforation.
When he arrived at the hospital the following morning he was told that Mr McCauley had had a cardiac arrest and was being resuscitated. He passed away at 8.45am.