Cancer patient rendered paraplegic ‘would have lived longer without op’
Assistant State Pathologist Dr Margot Bolster said the death of Nora McCarthy, of 35 Ravensdale Road, Ringmahon, Cork, was “accelerated” by the consequences of a celiac plexus block (CPB), a procedure designed to block the transmission of pain from the abdomen, but which resulted in spinal cord damage in Mrs McCarthy’s case.
However Dr Bolster said she could not say by how much the mother-of-four’s death had been accelerated, whether it was “an hour or a day”.
Dr Bolster was giving evidence yesterday at an inquest into the death of Mrs McCarthy, 53, who died at St Patrick’s Hospice on Jan 27, 2012, 18 days after the surgery that damaged her spinal cord.
Michael McCarthy, husband of the deceased, told the inquest that his wife had started to complain of pain in her right side two weeks before she was due to have knee surgery in January 2011. Subsequent tests revealed she had pancreatic cancer.
Mr McCarthy said at the time, the prognosis ranged from 18-24 months in a worst-case scenario and five to seven years in a best-case scenario.
Surgery to tackle the cancer was carried out at the Mercy University Hospital in June. A chemo- therapy treatment plan was drawn up and was due to run until February 2012. However, Nora, known to her family as “Norma” was in a lot of pain. A scan in December 2011 showed the cancer had spread to her liver and stomach.
The best-case scenario, Michael said, was reduced to 18 months, against a backdrop of continued chemotherapy. Nora was subsequently put on a cocktail of drugs which Michael felt had transformed her. When he visited her in hospital on Jan 8 he “hadn’t seen her looking so well in the last six months”.
On Jan 9, the procedure that resulted in Nora’s paraplegia was performed by consultant anaesthetist Dr Donal Harney. It had been previously mooted as an option for managing pain and improving quality of life. Asked by coroner Frank O’Connell if the paraplegia was a result of a complication of the CPB, Dr Harney said from his interpretation of the radiology notes and the pathology notes, that was “most likely”. Mrs McCarthy’s chemo options were severely curtailed by the outcome of the surgery.
Dr Bolster said the cause of death was bronchial pneumonia for which the risk factors are hospitalisation and immobilisation. However, Mrs McCarthy’s outlook “was grim, even before the operation”.
The coroner recorded a verdict of death by bronchial pneumonia, “on a background of advanced metastatic carcinoma of the pancreas, complicated by medical mishap, namely paraplegia, caused by anterior spinal artery syndrome, on foot of celiac plexus block”.
