A pregnant woman with appendicitis died after a bungling trainee surgeon mistakenly removed one of her healthy ovaries, a tribunal heard today.
She died 19 days later after suffering a miscarriage. Inexperienced medic Dr Yahya Al-Abed admitted he made a number of errors during the procedure, including removing her right ovary instead of her appendix.
Senior surgical consultant, Dr Babatunde Coker, is accused of failing in his role by not attending theatre to carry out the surgery himself or supervising the registrar. Mrs De Jesus, who was 21-weeks pregnant, was discharged ten days after the October 23 operation, but returned to the Romford hospital on November 7, still in serious pain.
The mother-of-three gave birth to a still-born boy and died on the operating table on November 10 following a second operation to remove her appendix, the tribunal heard.
Both doctors are facing fitness to practise proceedings at the Medical Practitioners Tribunal Service in Manchester, where they could face being struck off.
The General Medical Council, represented by Peter Horgan, say the doctors’ treatment of Mrs De Jesus, who is referred to as Patient A at the hearing, amounted to misconduct.
Opening the case today Mr Horgan told the panel Mrs De Jesus was admitted to hospital with severe abdominal pain on October 21, 2011, and was diagnosed with appendicitis two days later.
Trainee surgeon Christopher Liao, who had been working at the hospital for less than three weeks, decided she needed her appendix removed and Mr Coker agreed.
The consultant was told Mr Al-Abed, a fifth-year trainee, who had also only been at the hospital for three weeks, was performing emergency operations and she was added to his list.
There were a number of other staff present in the theatre on Sunday October 23, including a young doctor ‘keen to get some experience’, Osman Chaudhary.
Mr Chaudhary was allowed to make the first incision, but when complications arose Mr Al-Abed took over. ‘Patient A had begun to bleed quite heavily. Something was not right,’ Mr Horgan said.
‘In the midst of this, Mr Al-Abed removed what he clearly believed to be the appendix. He thought he found it, removed it and gave to a nurse what later turned out to be Patient A’s ovary.’
A colleague later reported that the medic ‘appeared reluctant to call for help’ and Mr Coker was never called. He had been in the coffee room while the operation took place and received no information it was underway.
‘He had lunch, then went home and didn’t become aware until Monday,’ said Mr Horgan. ‘Thereafter Patient A remained in hospital until she was discharged on October 31. She returned to hospital and was readmitted on November 7 suffering abdominal pains.
‘On November 9 it was discovered by another doctor that in fact the histology report showed an ovary had been removed and not the appendix.
‘Tragically on November 11 Patient A gave birth to a still-born male baby.’ Mrs De Jesus was again consented to go under the knife and this time her appendix was removed by Mr Liao.
‘But sadly later that afternoon Patient A died whilst on the operating table,’ Mr Horgan said.’ The post-mortem concluded she had died of multiple organ failure brought on by septicemia, the panel heard.
Mrs De Jesus’ condition failed to improve after the mistake was noticed and she died on the operating table at Queens Hospital, Romford
‘The GMC’s case against Mr Coker centres on his responsibilities and actions on October 23,’ Mr Horgan added.
‘This was a potentially complicated operation as it was to be performed on a pregnant woman.’
Dr Coker, represented by Neil Sheldon, admits to failing to appropriately undertake his role in not attending or supervising the operation, but denies several other similar charges on the basis that that his admission ‘renders them redundant’.
‘The GMC’s case against Mr Al-Abed centres on his responsibility and actions before, during and immediately after the operation on October 23,’ said Mr Horgan. ‘In short it is alleged that Mr Al-Abed performed the surgery as he did and acted outside the limits of his competence.’
Dr Al-Abed, represented by David Morris has admitted to the majority of the charges, leaving two outstanding factual matters. If the panel, chaired by Carrie Ryan-Palmer, find any of the facts admitted or found proved amount to misconduct the medics could face sanctions ranging from conditions to erasure from the medical register.
At an inquest in Walthamstow, east London, coroner Chinyere Inyama said a lost window of opportunity could have saved Mrs De Jesus. Barking, Havering and Redbridge Hospitals Trust admitted liability for her death apologised to her family. The hearing continues.
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