'I hope I can get the surgery I need. I don’t want to lose my leg'
Sarah Costello and her husband Stephen at their home in Meath. Pictures: Barry Cronin
Waking up on life support, terrified and unable to talk with tubes in her mouth, Sarah Costello was told she was lucky to be alive.
Within seconds of a routine keyhole surgery to check for endometriosis, the scope had pushed far beyond Sarah’s womb above her spinal column and severed her main aorta.
Without urgent surgical intervention and blood transfusions, the then-36-year-old mother-of-two would have died on the operating table in October 2024.
A vascular surgeon operating on an aneurism in a nearby public hospital was rushed to the private hospital where Sarah was dying.
Her heart had stopped and her lungs collapsed throughout the ordeal.
But that surgeon saved her life.
She woke up on life support in a public hospital with no idea what had happened to her.
“I was so scared. I remember looking for my husband,” said Sarah, a mother of two children, from Trim, Co Meath.
“They were just saying ‘you're such a lucky girl, you almost didn't make it’.
“The thought of me not coming home to my kids was just so traumatic.”
The operation was in a private hospital in Belfast at 6.30pm. It was funded through the National Treatment Purchase Fund (NTPF) after Ms Costello had been on a waiting list for a surgical intervention for painful and debilitating endometriosis — a condition where tissue similar to the lining of the womb starts to grow outside the uterus causing pain.
But the trocar — an implement used in laparoscopies — entered her body by her bellybutton but ended up severing her aorta at the top of her spinal column. It almost came out her back, she was told.
She had been cut open from her chest to the bottom of her stomach in the subsequent surgery and her leg had been operated on to try to harvest a vein for her bypass.
She left the hospital in a wheelchair and has been left with multiple life-changing injuries, including constant pain, nerve damage and breathing difficulties. Additionally, her endometriosis was never treated.
“After the surgery, I was told that my bypass was twisted, it's kinked and I had a blood clot in it so I had to go on really strong blood thinners.
“I was told that scar tissue could grow around the bypass as it wasn’t a real body part and I’d have to watch it.”
She was told that it would need to be monitored every six months with scans and blood pressure checks.
But she found it difficult to access the scans and care she needed once she returned home, she said.
Because her operation had been in the North, she felt there was no clear and consistent post-discharge care in the south, although she was referred to a Dublin hospital.
She said that she had to push for the scans she needed and has not received the necessary care through the public system.
Months later she was still suffering severe pain and weakness in her left leg, which was seriously limiting her ability to walk.
This pain was not taken seriously enough by some doctors she attended, she said, despite it being so acute that she attended A&E with it multiple times.
On one occasion she said that she was told to “go back to my primary doctor in Belfast unless my leg is cold and blue". Although investigations were performed in a Dublin hospital, Sarah was still in pain and the family was concerned.
Her husband, Stephen Costello, booked appointments privately with a peripheral nerve doctor in Birmingham and a vascular consultant in Galway.
A GoFundMe was set up to pay for her spiraling hospital bills.
The vascular consultant in Galway found that her bypass was 70%-80% blocked and that a lack of blood getting to her leg was causing her pain.
“The consultant said that if I don't have the surgery within the next 12 months I have a 10% to 15% chance of losing my leg,” Mrs Costello said.
The Costellos have pleaded for the NTPF to fund an operation privately to put a stent in Sarah’s bypass.
Because her vascular condition arose from a procedure arranged under the NTPF, the Costellos believe that the NTPF should ensure that she has this surgery urgently in a private facility, instead of waiting on a public list.
Her vascular consultant in Galway has agreed to carry out the procedure.
This should straighten her bypass and allow oxygenated blood to flow more freely to her leg again.
But the NTPF said that it was recommended for the “patient be treated as a public patient under the HSE pathway, given the need for ongoing duplex and CTA surveillance.
“The patient has been advised that this can be facilitated once her GP sends a referral to the identified consultant in the public hospital,” a statement said.
“The NTPF acknowledges that this patient has experienced an extremely distressing medical episode. Following emergency care, she was transferred back into the public hospital system, where further treatment was arranged at a Level 4 Dublin hospital in line with the approved clinical pathway. The patient subsequently chose to decline the care recommended by the consultant vascular surgeon treating her,” a statement said.
The NTPF said that all correct clinical and procedural requirements were followed in this case.
“Ensuring patient safety is the NTPF’s foremost priority in arranging faster access to treatment and care for public patients,” a spokesperson said.
The Costellos are highly critical of their treatment by the NTPF and many facets of the Irish public health service.
Had they not paid privately for second opinions, they believe Sarah’s leg may have been amputated.
Sarah, aged 37, has called for greater continuity of care for anyone returning from treatment abroad through the NTPF.
Sarah felt that there was no clear pathway and inadequate support when she returned south, seriously wounded after the surgery.
There was no structured HSE aftercare, no rehabilitation, and no assigned point of contact, she said.
Mental health support should also be in place, she said.
It took nine months to access mental health supports and the family has had to fund counselling privately.
She has been diagnosed with Post-traumatic-Stress Disorder (PTSD) following her ordeal.
She is haunted by thoughts of Malak Thawley’s death from a similar medical intervention.
The 34-year-old teacher, originally from the US, went for what was to be a routine 30 minute procedure for an ectopic pregnancy in Holles Street hospital in Dublin in May 2016.
But her aorta was reportedly lacerated and she died.
Her husband sued the National Maternity Hospital, claiming complete mismanagement of the major vascular injury culminating in her avoidable death.
It was also claimed there were no vascular clamps available on site for emergencies.
“Malak Thawley essentially had the same thing as me. I felt so guilty that I’d survived and she died,” Sarah said.
“These gynaecological surgeries are going on without vascular surgeons on site, and without vascular clamps to clamp shut vascular injuries and without people trained to use these clamps.
“This needs to change.” Aortic clamps should at least be available at all these facilities and medics trained to use them, she believes.
“I hope I can get the surgery I need. I don’t want to lose my leg," Sarah said.
“And I don’t want my bypass to completely fail."
Without money, Sarah said that she would not have been able to get the second medical opinions and services she felt she needed.
“We are a rich country with a third world health system and it’s not good enough. It’s time for change. People are being dismissed all the time and made to feel like their symptoms don’t matter or they are all in their head when this is not the case.
“Ordinary working people don’t have thousands and thousands of euros to get extra tests. They will just accept what they’re told and it’s wrong.”
To donate to Sarah’s GoFundMe, visit here
CONNECT WITH US TODAY
Be the first to know the latest news and updates
