I was probably quite tired, surgeon tells inquiry

A consultant surgeon who incorrectly described a proposed mouth operation on a toddler’s hospital records yesterday told a medical inquiry he was probably quite tired and put it down to human error.

The two-year-old ended up having two operations to her mouth on the same day when the wrong procedure was carried out first at Our Lady’s Children Hospital, Crumlin, in Apr 2010.

Yesterday her paediatric consultant, Prof Martin Corbally, told a Medical Council inquiry he had been on call for five nights in the week before he met the little girl, known as Patient X.

“I was probably quite tired. It is human error,” he said.

The girl was supposed to have an operation to release skin in her upper lip but ended up having a tongue tie release operation she did not need first.

Prof Corbally, who was giving evidence by video link from Bahrain, said only one code existed at the time in the hospital system for these types of mouth operations and he thought when he added in upper frenulum it would describe the intended procedure.

“I booked the patient according to hospital policy. That is the key to what happened,” he said.

The Medical Council is considering allegations of poor professional performance against the consultant paediatric surgeon.

The surgeon appeared before a council inquiry two years ago in a case involving the removal of the wrong kidney from a young boy. The case was halted as the council decided Prof Corbally and another medic did not have a case to answer and the two doctors undertook not to repeat the conduct complained of.

Yesterday, Prof Corbally said when he was at Our Lady’s he saw 80 to 100 patients a week and would not really remember their names. He carried out about 1,200 operations a year.

On the day of the toddler’s operation, he said he was called to intensive care where there were three critically ill patients including one patient who had been transferred to him at short notice by a colleague going on holiday.

He had delegated Patient X’s operation to another surgeon. He said every surgeon would be happiest doing surgeries himself but the pressure of work and to reduce waiting lists was too great.

After he found out the wrong procedure had been carried out he asked the doctor who operated on the child to talk to the parents. “If I had not had a patient asleep on the table I certainly would have gone to the parents myself.”

He said he later called the parents and apologised for the confusion in the management of their daughter.

The proper procedure on the day, he said, would have been to call a halt when concerns were raised about the procedure to be carried out on the toddler and the consultant contacted.

The hearing was told that the computer booking system in he hospital has since been revised and a new policy in relation to theatre brought in.

Prof Corbally said afterwards he advised hospital management that he was reducing his patient intake. He said he found he was trying to achieve too much.

He said he thought appropriate steps were taken to address what happened. In Patient X’s case: “Human error can occur. Everybody can make a mistake. Error is a part of practice in general,” he said.

The hearing continues.