More Noble's staff to give evidence at inquest

Douglas woman died following surgery

An inquest into the death of a woman who died following surgery at Noble's Hospital continues today.

32-year-old Aimee Woodward from Douglas died in August 2017 after a cardiac arrest following keyhole surgery to treat an ovarian cyst.

Miss Woodward went in for a laparoscopic procedure to remove a benign cyst on 31 July, and it had been hoped she'd be able to go home the same day.

The court heard she had a heart condition, left bundle branch block, but the consultant anaesthetist didn't expect this to cause any problems during the operation.

After returning to ward four following the surgery, Miss Woodward was in a stable condition, but suffered a cardiac arrest at 6am the following day. Medics were able to restart her heart, but she was found to have developed global cerebral hypoxia - a condition where the brain is starved of oxygen.

Her family was notified she'd suffered irreversible brain damage and made the decision to withdraw treatment. She subsequently passed away on 9 August.

Dr Keith Wilkinson, who anaesthetised Miss Woodward for the procedure, said her oxygen saturation levels were lower than expected. However, she appeared to recover well after coming out of surgery and returned to a normal ward rather than going to the ICU.

The surgery also took longer and was more complicated than initially expected. Tony Stock, a consultant in the obstetrics and gynaecology department who performed the operation, explained that bleeding occurred when he tried to remove the cyst, resulting in the ovary and fallopian tube being removed.

Mr Stock was on call when the cardiac arrest occurred and told the court he initially thought the collapse could be due to internal bleeding, as this is the most common cause in patients of Miss Woodward's age. 

A statement from the anaesthetist working in ICU at the time of the cardiac arrest confirmed no immediately obvious cause of the cardiac arrest was found following initial CT scans of the head and abdomen.

There were also references to statements from expert witnesses Professor Jonathan Hardman from the University of Nottingham and Professor Jaideep Pandit of Oxford University Hospitals, who were asked for their opinion on this case.

While Professor Hardman raised concerns about the way Dr Wilkinson monitored the intubation of Miss Woodward during the procedure, they agreed her recovery from hypoxia after the surgery showed her low oxygen levels during the operation wouldn't have caused the later cardiac arrest.

Several nurses and doctors who were involved in the treatment of Miss Woodward are still due to speak to the court, and there are also more statements to be read, including from the consultant pathologist who carried out the post mortem, and more from the expert witnesses.

Once all the evidence has been heard, John Needham will deliver his verdict. He emphasised ahead of proceedings that this inquest isn't about apportioning blame, but obtaining the facts to determine whether any recommendations need to be made to the Department of Health and Social Care. 

Mr Needham also confirmed Miss Woodward's mother and stepfather, who have been present throughout the inquest, have made a complaint to Noble's and the independent review body.