A fit and healthy 70-year-old woman died on the operating table during a routine hip replacement, an inquest heard.
The mother of five was undergoing hip replacement surgery following a fall while out power-walking with friends on May 9th 2016.
Madeline Treacy of Griffith Downes, Drumcondra, Dublin 9 was described as fit, active and healthy. She went to the gym four times a week and was considered an "ideal candidate" for surgery at Beaumont Hospital, with no underlying risk factors.
She had previously undergone surgery performed under local anaesthetic in 2010 and recovered well, Dublin Coroner’s Court heard.
Mrs Treacy was admitted to Beaumont Hospital following the fall on May 9th and surgery was scheduled to take place three days later.
Family members said the woman had been ill the night before surgery.
Anaesthetist Dr Adriana Nizam examined the woman prior to the hip replacement operation.
“She was telling me she wanted to go back power walking with her friends. She did not mention anything from the night before. She was chatting away, her blood pressure was good and she was breathing well,” Dr Nizam said.
Consultant Orthopaedic Surgeon Mr Michael Donnelly said Mrs Treacy was “fit and well” prior to surgery.
Spinal anaesthetic was chosen as it provides better pain relief post surgery. “It wears off slowly, patients can sit up and maintain their oxygen levels quicker and easier,” Mr Donnelly said.
He was less than 90 seconds into the operation when Mrs Treacy’s heart slowed and she went into cardiac arrest.
“I had incised the skin. I didn’t get near the fracture. We stopped immediately,” he said.
At 10.53am on May 12th Mrs Treacy’s heart stopped beating. Attempts to resuscitate her continued for ninety minutes. She was pronounced dead at 12.16pm.
“I was shocked,” Dr Nizam said. Coroner Dr Myra Cullinane asked if she could explain what happened and Dr Nizam said she could not. The coroner asked if Dr Nizam ever had a patient pass away in this manner and the doctor replied no. If Mrs Treacy had an allergic reaction to the anaesthetic the effects would be instant, the court heard.
“It was difficult and very unusual. There was nothing else we could do,” Dr Nizam said.
Pathologist Dr Christian Gulman gave the cause of death as cardiac arrhythmia, mostly likely due to the effects of spinal anaesthesia.
“This most likely relates to anaesthesia at some level,” the pathologist said.
Coroner Dr Myra Cullinane returned a narrative verdict due to a “lack of certainty in relation to events.”
“We’ve heard all the evidence but it still does not bring us to an exact conclusion. This was a rare and very unfortunate occurrence,” the coroner said, extending her condolences to the family.