A 76-year-old mother of six died after losing 17 litres of blood during surgery for the treatment of pancreatitis, an inquest has heard.
Freda Fox from Castlerea, Co. Roscommon, died following surgery at St Vincent’s Hospital in Dublin. Her family say they have been left with questions unanswered as the two trainee surgeons who carried out the operation were not present at an inquest into her death.
“Mammy was kind, thoughtful generous and open-hearted,” daughter Sandra Collins said in a family statement.
"She loved her home, she loved to dance and she had great style. She was young at heart, courageous and funny.
Mrs Fox was admitted to St Vincent’s Hospital for a Whipple procedure, most commonly carried out to remove cancerous cells from the pancreas on September 1, 2017. The five-hour surgery began shortly before noon. Complications arose one hour into surgery, Dublin Coroner’s Court heard.
A bleed in the mesenteric vein was identified and repaired but Mrs Fox went into cardiac arrest.
Doctors successfully conducted CPR, which was described as vigorous by Consultant General at St Vincent's, Mr Anthony Stafford.
“Each time she arrested (the vessel) required further repair,” Mr Stafford said.
He said the two trainee surgeons that conducted the operation were in their second year of a fellowship at St Vincent’s and both had previous experience of conducting similar surgery.
Mr Stafford said the surgery involves dissection of blood vessels in possibly critical areas with 50% of all pancreatic dissections resulting in a bleed. The average bleed is 700 millilitres, the court heard.
“I’d never have predicted the extent of this (bleeding),” Mr Stafford said.
The surgery was stopped at 4.05pm and Mrs Fox was transferred for palliative care to the intensive care unit where she died the same day.
The cause of death was hypovolemic shock secondary to massive blood loss occurring during an operation to perform a Whipple procedure.
Pathologist Dr Niamh Nolan found no obvious defect in the affected blood vessel but noted Mrs Fox had undergone previous surgery and the gall bladder was removed.
Coroner Dr Myra Cullinane returned a verdict of death due to a complication of surgery.
“She had a decision to make about undergoing surgery ...and tragically the outcome was not what was expected,” the coroner said.