Belfast Telegraph

Thursday 24 July 2014

It should have been a routine op ...but Lynn died from a swollen brain and massive blood loss

A mother-of-two died in tragic circumstances when a routine operation at a private hospital went badly wrong – fatally causing her brain to swell.

Portadown woman Lynn Lewis (38) lost nearly a third of her blood when she unexpectedly began to haemorrhage during an operation to remove a large benign growth from her uterus at the Ulster Independent Clinic, an inquest in Belfast heard yesterday.

The court heard how the young mother died suddenly on July 7 2011 from a combination of haemorrhage and hyponatremia (abnormal levels of sodium in the blood which can cause the brain to swell). While the blood loss was serious, two medical experts concluded the patient probably would not have died from it alone.

This was described as a "very rare" incident in this type of operation by a leading UK gynaecological pathologist.

Distressing details were outlined at Laganside Court yesterday as the inquest heard how the operation took an unexpected turn – leaving staff fighting to save the married woman's life.

Mrs Lewis died following complications with her surgery to remove the benign fibroid using the 'hysterocopic' technique, which requires an insertion of a narrow tube with a telescope to allow the surgeon to examine inside the womb. Among the questions the four-day inquest will be considering is how the bleeding began, how her fluid levels were checked and whether the patient should have had open surgery instead.

What is known is that as surgeon Professor Neil McClure carried out the operation, Mrs Lewis began to bleed heavily.

At one point in the operation, a fluid tube came loose, spilling onto the floor, while the surgeon had to stop to reattach it.

Despite concerted attempts for over an hour by the medical team to resuscitate Mrs Lewis after her condition deteriorated, she was pronounced dead.

Described after her death by close friends as "a great girl and a real homebird", Mrs Lewis lived with her husband Mark and daughters Jane and Maggie, then aged eight and five, at Ahorey, Portadown.

The courtroom was full to capacity yesterday with Mrs Lewis' close relatives and friends in attendance and solicitors appearing for the surgeon involved, Prof McClure, anaesthetist Dr Damien Hughes, the Ulster Clinic and the Lewis family.

Among those who gave evidence yesterday was Dr Janitha Costa who told the coroner John Leckey that the operation was her first time assisting in this type of procedure, having previously only observed as a general surgical trainee. Dr Costa said that her primary role was to hold the hysteroscope for the surgeon.

She had difficulty in recalling certain aspects of the procedure, saying: "This is all blurred in my memory. It was a traumatic situation for me as a trainee."

A solicitor representing the Ulster Clinic responded: "Your memory is poor now and was poor then."

The medical evidence was led by state pathologist Professor Jack Crane and corroborated by gynaecological pathologist Dr Harry Millward-Sadler.

Prof Crane concluded that it was the combination of haemorrhaging during the operation and hyponatremia, which caused her brain to swell, which caused the surgical complications.

Both medical experts were said to be "in total agreement" that it was the combination of both but that the hyponatremia was the most "significant" factor.

Described as a former Department of Health government advisor on gynecological surgical deaths, Dr Millward-Sadler said that he only come across one other case were hyponatremia had been caused during an operation and this death was very rare. He also said he did not think that the haemorrhage alone would have proved fatal but that it did "exacerbate" the hyponatremia.

Prof Crane said the post- mortem examination could not determine how and when exactly the bleeding was caused during the operation.

The inquest continues.

FACTFILE

Hyponatraemia is a condition where you have abnormally low levels of sodium in your blood which regulates the levels of water in your body. It causes water levels to rise and body cells to swell, including the brain and can prove fatal. An inquiry is currently being held in Banbridge, looking into the role of hyponatremia in the deaths of five children in hospital. A hysterocope is used in a surgical technique of an insertion of a narrow tube with a telescope to allow the surgeon to examine inside the womb.

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