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Patient describes being "traumatised" by her treatment at hands of hysterectomy surgeon

Dr Peter van Geene is the subject of a fitness to practise inquiry by the Medical Council concerning a number of hysterectomies he performed between 2009 and 2011.

Image: TheJournal.ie

A WOMAN HAS described being “traumatised” by the care she received following her hysterectomy surgery at the Aut Even private hospital in Kilkenny in July 2010.

The testimony was given on day three of a Medical Council fitness to practise inquiry regarding the performance of Co Carlow surgeon Dr Peter van Geene.

The woman, a former nurse referred to as Patient B, said she had referred herself to Dr van Geene after he performed her older sister’s hysterectomy the previous year.

Patient B, who was 62 at the time of her surgery, said that her treatment following the procedure (performed on 27 July 2010), where she suffered significant blood loss, displayed a “lack of empathy” on the part of Dr van Geene.

“I would say he had a lack of empathy, in that my condition  didn’t appear of major significance to him,” she said.

I felt traumatised, in that I had lost a lot of blood and felt very ill.

The woman subsequently refused a follow-up appointment at Aut Even describing herself as “having had enough of the whole set-up”.

“I figured I would be ok to recover on my own, and in fact I did make a total recovery,” she said.

At the time I was aware that I had lost blood and was frustrated and angry that everyone was acting as if nothing had happened, that there hadn’t been a blip.

She said that her final interaction with Dr van Geene was prior to her discharge from hospital, when she requested an additional unit of blood be administered to her (she had already had four units administered after she presented significant bleeding following the operation itself).

“We had a difference of opinion,” she said.

I thought that I would need more strength, more energy given I live alone. But he stuck to his guns and refused my request.

Patient B said her biggest gripe with her treatment was that her next of kin and family were at no time informed that there had been complications with her surgery.

“My next of kin were not informed of anything. My family’s first indication that anything was wrong was when my sister called to visit me the next day,” she said.

Appropriate

The inquiry was told by an expert that Dr van Geene’s prescription of Clexane, an anti-clotting drug designed to prevent fatal blood clots in patients, to both Patient B and another, Patient C, was “entirely appropriate”.

Dr Fionnuala Ní Ainle of Dublin’s Rotunda hospital, said that she “agreed entirely” that the prescription of the drug was done with the patient’s best interests at heart.

She agreed that the administration of Clexane, together with the patient being given aspirin following the operation, could have contributed to the intense bleed suffered by Patient B.

It was made clear that, while Clexane was administered to the patient intravenously (it is recommended that it be given subcutaneously, or under the skin), and that this may have prolonged her bleed, Dr van Geene had specifically prescribed that it be administered subcutaneously, and that he had behaved “entirely appropriately” in that matter.

In the case of Patient B, it is alleged that Dr van Geene carried out her hysterectomy in a manner that caused her subsequent significant blood loss. It is further alleged that he failed to communicate adequately, or at all, with the patient as to the fact that an adverse event had occurred.

Meanwhile, Dr Teresa White, consultant anaesthetist at Aut Even, described Dr van Geene as “skillful and calm” in his surgery performance.

Dr White was surgical anaesthetist assisting Dr van Geene in the hysterectomy surgery of Patient C, a woman who suffered a significant post-operative bleed following her operation on 11 October, 2011.

In the case of Patient C Dr van Geene is accused of carrying out her surgery in such a manner as to cause the significant bleed.

He is also accused of performing an unnecessary laparotomy (a large incision through the abdominal wall) on Patient C in an attempt to investigate the source of her bleeding.

Earlier

In the morning session, a nurse at St Luke’s hospital in Kilkenny told the inquiry that Dr van Geene was 8 out of 10 on a rudeness scale in his attitude towards his patient Mrs Helen Cruise.

Dr van Geene had performed a hysterectomy on Mrs Cruise on 23 August 2011.

Nurse Caitriona Kenny told the hearing that Dr van Geene was “very, very rude and abrupt” towards Mrs Cruise in a meeting at the Coronary Care Unit (CCU) of St Luke’s Hospital, Kilkenny, on 31 August 2011.

Ms Kenny could not corroborate previous evidence given to the inquiry that Dr van Geene had physically beaten Mrs Cruise about the legs at that meeting.

Dr van Geene performed the hysterectomy on Mrs Cruise at the Aut Even private hospital in Kilkenny on 23 August that year.

Nurse Kenny said that she arranged the meeting with Dr van Geene on 30 August after Mrs Cruise had expressed discontent with the care that had been afforded her by the surgeon.

Mrs Cruise had been transferred to the CCU at St Luke’s on 26 August after presenting breathing difficulties, agitation and confusion following her surgery.

Nurse Kenny told today’s hearing that she thought Dr van Geene had “been very, very rude and abrupt towards Helen, and exhibited a bedside manner that was not nice”.

“He made reference to Helen smoking, and the word ‘sue’ may have come up,” said Kenny.

Helen was angry and upset and her daughter (Anneka, who was also present) was angry and upset.
I don’t recall Dr van Geene making contact with Helen.
He may have shaken hands, but nothing further.
I would remember something like that as I would have had to report it. That’s the kind of behaviour that I would remember.
If you were to take a scale of 1 to 10, then the doctor was a 7 or 8 in terms of rudeness.

Nurse Kenny said that in her experience, which involved such meetings on an almost daily basis, Dr van Geene’s behaviour was among the most extreme examples of rudeness that she had witnessed.

She could not recall any reference to the doctor saying that he was being paid for his visit to Mrs Cruise at St Luke’s.

“My impression is all that I can remember from the interaction,” she said.

I don’t recall being upset myself but my impression was that he was very rude.

While Nurse Kenny did not file an incident report or speak to her manager regarding Dr van Geene’s behaviour, she said that in retrospect she probably should have.

The Medical Council inquiry concerns Dr van Geene’s fitness to practise. It concerns several incidents of hysterectomies being performed on a number of patients between 2009 and 2011.

In Mrs Cruise’s case, it is alleged that Dr van Geene failed to explain the procedure to be carried out on Mrs Cruise, and that he carried out the procedure in such a manner as to cause a significant post-operative bleed which necessitated a laparotomy.

It is also alleged that the manner in which the procedure was carried out resulted in Mrs Cruise developing a pulmonary oedema thus necessitating her transfer to the CCU at St Luke’s.

The inquiry had earlier heard that Mrs Cruise’s transfer was arranged after her condition “deteriorated” following her surgery.

Dr. Mohammad Akram, consultant physician at Aut Even, described how he thought a transfer to St Luke’s would be the most appropriate course of action for Mrs Cruise given her symptoms of  ”shortness of breath, fluid in the lungs, and anxiety”.

It remains unclear exactly who approved Mrs Cruise’s transfer.

Dr Akram described the transfer as having been “effected perfectly”.

“Sometimes it takes hours to transfer, but in this case it was effected very, very quickly, thank God,” he said.

Read: Patients complain of rude doctors, lack of compassion and misdiagnosis

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