Linda Royal, 50, of Forest Green, Kingswood Heights, Tallaght, Dublin, was transferred to the high dependency unit (HDU) at Mount Carmel Hospital on the morning of September 28, 2008, six days after a procedure to remove her womb at the hospital.
The mother of three was transferred to St James’s Hospital later that day where she died from the complications of septicaemia the following day.
Staff nurse Marie Madigan, who was looking after Ms Royal on the night of September 27 into the morning of September 28, told an inquest that on transfer to the HDU she thought Ms Royal was going “into shock”.
Her abdomen was distended, her pulse was raised and she had tenderness throughout the abdomen, the inquest heard.
Dublin City Coroner’s Court heard Nurse Madigan telephoned consultant obstetrician and gynaecologist Dr Mona Joyce at 4.45am on the 28th as she was “very worried” about Ms Royal, who was “very distressed”.
Ms Royal’s pulse was high, her blood pressure was abnormal and the nurse was worried there was an “obstruction”.
Ms Royal hadn’t had a bowel movement despite having received two laxatives earlier on the 27th, one of which she described as “potent”.
The nurse discussed her concerns with Dr Joyce and suggested Ms Royal, who was examined by Dr Azizah Osman, be transferred to the HDU, to which the consultant agreed.
Dublin City Coroner’s Court heard that Nurse Madigan had also called Dr Osman to examine Ms Royal earlier that night as her cramps, for which she received medication, were getting worse and her vital signs were “worrying” and she appeared “quite distressed”.
At that point the doctor said she just needed to go to the toilet (evacuate her bowels). Nurse Madigan described Ms Royal’s decline as “sudden at the end”.
She said her symptoms were being “dealt with” and she was being reviewed by her surgeon and other doctors.
Family solicitor Damien Tansey said her husband Louis Royal had given evidence on an earlier occasion that his wife was in constant pain for all of the week.
The inquest heard Ms Royal had complained of pain when urinating on the third post-operative night and had vomited.
The next night she was still complaining of feeling sick but her antibiotic was changed and she later said she felt much improved.
Mr Tansey said a major concern for the family was that Ms Royal was being treated for constipation.
“That five days post operatively, given the history of discomfort and pain and the extent to which she was receiving pain medication, the only diagnosis was constipation,” he said.
Coroner Dr Brian Farrell said it was “quite clear” the requirement for analgesia had increased from the 24th to the 27th. The inquest continues today.