A MAN died of multiple organ failure after a surgeon burnt a hole in his bladder during an operation, an inquest heard.
George Bastick, 84, from Kings Caravan Park, Canvey, was sewn up with the injury untreated, after the surgeon failed to spot the blunder.
Mr Bastick suffered a major internal infection in the 48-hours between the operation and a second one to remove a swab left inside him and died the following day.
He had been admitted to Southend Hospital with abdominal pains, later discovered to have been caused by gall stones.
Chelmsford Coroner’s Court heard locum consultant Robert Buhain carried out keyhole surgery on him on January 31, 2013, but had difficulties removing the gallbladder which appeared to be shrunken.
He changed toamore standard open surgery and was easily able to remove the organ, but ran into further difficulties.
He said: “After I removed it I noticed a lot of bleeding coming from underneath the liver. I controlled the bleeding and asked a senior surgeon to come and assist.”
The more senior consultant took charge and the bleeding was located from an artery that had to be tied off.
It was decided to pack the area with a swab for at least 24 hours to prevent further bleeding and this was sewn inside Mr Bastick.
He was then sent to the high dependency unit to recover, ahead of a further operation to remove the swab 48 hours later.
This was due on February 1, but did not happen due to higher-risk patients needing operations.
On February 2 the removal began.
Mr Buhain said: “When the incision was opened and the pack removed there was a lot of fluid that looked and smelled infected. That prompted me to look for the source of the fluid, and I found a hole in the bladder.”
He said the most likely cause was a laser during the initial keyhole surgery that caused a small burn which was not picked up.
The hole, less than 1cm wide, was treated, but Mr Bastick developed a high pulse and low blood pressure.
Despite being moved into intensive care he died on February 3.
A post-mortem examinationby pathologist Dr Ian Calder gave the cause of death as multi-organ failure caused by infection after the perforation caused during surgery.
Organ failure: Dr Ian Calder
A barrister representing Mr Bastick’s family suggested he was too confused to consent to the operation.
The court heard Mr Bastick gave consent to consultant Robert Buhain and another medic.
But David Manknell, for the family, said Mr Bastick had no family members with him and had been admitted complaining of confusion and hallucinations.
Mr Buhain denied recommending the operation, but told Mr Bastick most consultants would.
Mr Manknell also suggested at 84 years old Mr Bastick would have been unfit for the surgery, but Mr Buhain maintained he would carry out the procedure on a similar patient even after the tragedy.
Mr Manknell added: “Before you sewed up and left for that day, what checks did you do to make sure there was not a perforated bowl?”
Mr Buhain said: “Looking back over this again I cannot for the life of me say when exactly what happened because I was completely unaware of the perforation.”
However, he insisted it was checked and nothing was seen.
Questions: David Manknell
Mr Manknell asked him if the swab had been removed earlier was there are increased chance of survival.
Mr Buhain accepted there was, but maintained observations on Mr Bastick had picked up no sign of infection.
The court heard Mr Buhain had carried out 200 similar procedures over ten years with no similar incidents.
Coroner Eleanor McGann recorded a narrative verdict.
She said: “Mr Bastick underwent an operation to remove his gallbladder.
This started as keyhole surgery, which was converted to an open procedure due to difficulties encountered during the keyhole surgery.
“Duodenal perforation occurred which was not spotted at the time. During a further routine operation, the perforation was seen and repaired, but it was too late to prevent infection.
“The perforation led to organising peritonitis and on February 3, 2013, Mr Bastick died from multiorgan failure.”