A doctor told the High Court yesterday he was "100 per cent" certain that a needle he was using to stitch up a woman patient had not pierced her bladder.
Dr Motillal Ramnarain said alleged damage to the bladder of the 53-year-old woman was not caused when he was using the needle for stitching purposes after an operation to remove her womb.
Dr Ramnarain was giving evidence in an action taken against him and the South Eastern Health Board by Mrs Susan Kelly, a nurse, of Ceol na hAbhainn, Brandondale, Graiguenamanagh, Co Kilkenny.
Mrs Kelly claims she has suffered pain and depression for the past six years following damage to her bladder during an operation carried out by Dr Ramnarain in St Luke's Hospital, Kilkenny, on July 10th, 1992.
Dr Ramnarain and the health board deny Mrs Kelly's claims and, alternatively, plead that she was guilty of contributory negligence.
In court yesterday, the doctor said he was 100 per cent certain that a needle had not pierced the bladder when he was stitching up the patient. He had thought that perhaps the damage to the bladder had occured as a result of deterioration of bladder wall tissue because of a paucity of blood supply.
Professor John Bonnar said the operation had been a simple hysterectomy and the instance of the type of fistula (hole) would be less than one in a thousand. He thought that this hole could occur where a small area of the bladder - despite all due care - was "devitalised".
This could occur because a surgeon had to separate the bladder (from the area of the operation), Professor Bonnar said. As a result the blood supply to the base of the bladder would be disturbed. There could be "devitalisation" in a small area and a deterioration in tissue.
The hearing was adjourned until today.
