The High Court dismissed Sonia Laycock’s claims against a consultant obstetrician and gynaecologist and the hospital’s governing body over two operations in 2004. Mr Justice John Quirke found that the evidence did not establish negligence in either case.
The first claim concerned a diagnostic laparoscopy at St Joseph’s Hospital, Raheny, on 22 January 2004. Laycock said a misplaced instrument punctured a major blood vessel, causing bruising, pain and distress. She told the court that she later saw the consultant, who said a blood vessel had been damaged and apologised. The consultant had no recollection of that visit or conversation.
The judge accepted that Laycock experienced more discomfort than after earlier procedures and significant bruising in the days afterwards. But he was not satisfied, on the balance of probabilities, that the consultant had punctured her right inferior epigastric blood vessel. The court heard that such a major artery would cause obvious bleeding, while the port was placed on the left side, contrary to the assumption underpinning the plaintiff’s expert’s opinion. The judge said a minor vessel may have been penetrated, but no expert evidence established that this was negligent. He dismissed that claim against both defendants.
The second claim concerned a right salpingectomy on 19 March 2004, after an ectopic pregnancy was confirmed. The consultant began the operation laparoscopically but converted to open surgery because blood obscured his view of the fallopian tube. Laycock’s case was that the operation should have been completed laparoscopically. The necessity of the salpingectomy itself was not disputed.
The pleadings had also alleged inadequate monitoring, incorrect advice about the pregnancy and delay in investigation and treatment. The judge said the plaintiff’s expert evidence fell short of establishing the pleaded negligence on those matters. The claim was confined to the choice of open surgery.
The consultant told the court he was not comfortable performing that operation laparoscopically and believed the patient needed urgent intervention to stop bleeding. He said he did not seek a laparoscopically trained practitioner because it was 6pm on a Friday and he believed delay could put her safety at risk. Defence experts supported proceeding by open surgery in those circumstances. The judge accepted that evidence, finding it would not have been appropriate to suspend treatment to look for another practitioner.
Although the evidence recognised cosmetic and recovery advantages to laparoscopic surgery, the judge concluded that the plaintiff had not shown that a practitioner of similar specialisation and skill, exercising ordinary care, would not have chosen open surgery in the circumstances. He dismissed the second claim and ordered that the plaintiff’s claim fail.