Surgeon had no consent to ‘clip’ tube

The decision by a surgeon to ‘clip’ a woman’s fallopian tube without her consent has been described as “quite extraordinary” by a medical expert.

Surgeon had no consent to ‘clip’ tube

Professor Anthony Smith has said he does not believe obstetrician-gynaecologist Dr Declan Egan grasped the gravity of the situation when he clipped the left fallopian tube of his patient, Lorna McKeogh.

He added that it is “extraordinary” that there is so little documentation available backing up Dr Egan’s decision and that he didn’t seem to make any attempt to corroborate it by calling another gynaecologist.

Dr Egan, of Dangan, Co Galway, faces one allegation of poor professional performance at a Medical Council fitness-to-practise inquiry in relation to the procedure he carried out on Ms McKeogh in June 2010 at University College Hospital Galway.

He denies the allegation against him and his barrister has told the inquiry that he clipped the left fallopian tube because of the presence of a hydrosalpinx (collection of fluid which can prevent pregnancy) in both fallopian tubes.

Ms McKeogh has already told the inquiry of her shock and anger when she awoke from an operation to clip her right fallopian tube to be told that her left fallopian tube had also been clipped.

Prof Anthony Smith — a consultant gynaecologist at St Mary’s Hospital in Manchester and an expert witness called by the chief executive of the Medical Council, which is taking the case against Dr Egan — was asked to review the report drawn up following the procedure on Ms McKeogh.

He said the operation was “quite extraordinary” in that Dr Egan made the decision to clip both tubes. “Not only was the express consent not given to do that but I would have expected a really detailed account explaining the justification to do so,” he said.

“I am very surprised to see that making such a big and important decision there wasn’t an explanation of the abnormality of the left fallopian tube and a description about the thought processes. This is a big decision, and it’s not just a little thing to do. You are making a big change to Ms McKeogh and her husband’s fertility approach afterwards.”

Prof Smith said Dr Egan’s notes about the left tube were remarkable in their lack of information and added that he was surprised there weren’t pictures and video clips of the operation.

“There didn’t seem to be any attempt to corroborate it by calling another gynaecologist. My feeling is Dr Egan didn’t grasp the gravity of the situation where the patient was concerned and I find that surprising.”

Prof Smith said he was surprised to see that Ms McKeogh’s left tube appeared to be normal when examined in 2014. He said this brought in to question whether the tube had ever been abnormal and, if it had, what degree of abnormality there was.

“If patients in any case suspect that we are going to do things that they have no knowledge of without their consent, then we will lose their trust and confidence,” he said.

The case has been adjourned until next month.”

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