A surgeon has admitted professional misconduct in a fitness-to-practice inquiry. Among his errors was not consulting specialists and not seeking help during surgery involving a patient who died after an operation, according to reports in the Irish media.
Dr. Ashish Uday Lal performed the surgery on Jessica Sheedy to remove a benign tumor from her abdomen on 8 May 2018 while practicing as a consultant surgeon at University Hospital Limerick, according to a 20 January article in the Irish Times. During the procedure, the patient sustained a significant bleed and died three days later.
During the inquiry, Neasa Bird, counsel for the Medical Council, said that Lal, who specialized in breast surgery, made full admissions to three allegations of professional misconduct and ten allegations of poor professional performance over his care of Jessica Sheedy.
Sheedy died of multiple-organ failure after sustaining massive blood loss during surgery at UHL on 8 May 2018 to remove a benign 14-cm tumor from her abdomen. An inquest into Sheedy's death at Limerick Coroner's Court in November 2019 recorded a verdict of medical misadventure, stated an RTE report.
The inquiry heard that Lal performed the operation with the support of two junior doctors only, despite lacking adequate experience to perform the operation. Bird said that Lal had underestimated the surgery’s complexity and had “failed to plan adequately for the potential risks and adverse outcomes associated with the procedure.”
Lal had not reviewed CT images of the tumor with a radiologist before the operation, and had provided a misleading statement claiming that he had obtained a second opinion about performing a biopsy on Sheedy, the RTE article continued.
Additionally, Lal had presented the case for carrying out the surgery at an oncology multidisciplinary team meeting in January 2018, at which no other surgeons were present.
Lal's failure to consider a nonoperative approach for managing the tumor was cited during the inquiry as poor professional performance.
Lal then failed to seek assistance from a vascular surgeon "in a sufficiently timely manner" after the patient suffered major blood loss from a damaged aorta during the procedure, refusing help twice before a clinical nurse manager asked a vascular surgeon to assist.
Eamon Kavanagh, the vascular surgeon, informed the Medical Council in a statement that there was a “long-standing practice” of having two consultants present for complex surgery.
Lal admitted that his delay in seeking assistance from a vascular surgeon constituted professional misconduct.
The inquiry also heard that Lal had continued to work on removing the tumor after the hemorrhaging began. Bird said that Sheedy had to undergo further emergency surgery due to inadequate blood flow to her legs and to have her entire large intestine removed.
Lal’s counsel said at the inquiry that Lal wanted to offer an unqualified apology for the shortcomings in care, while respecting that Sheedy’s family did not want to hear it; Lal requested that the apology be noted during consideration of any sanctions.
