A retired consultant who performed a sterilisation procedure on a mother of five, who later gave birth to two more children, told the High Court yesterday that at the time he had completed the operation in the Coombe hospital, Dublin, he was clearly satisfied that it had achieved its objective.
Had he believed there was any problem in relation to the operation performed on Bridget Byrne, Dr Charles Murray said he would have performed a procedure involving the injection of dye which would have indicated whether the tubal ligation was successful or not.
He had not considered that was necessary in this case and had only carried out the injection procedure in about four of "thousands" of sterilisations performed during his career.
Dr Murray agreed there was a recognised failure rate for sterilisations or tubal ligations for a variety of reasons, including a clip being placed on something other than the fallopian tube. That was what appeared to have happened in Ms Byrne's case, he said.
He now had no doubt that a clip which he believed had closed off the left fallopian tube had been placed on a piece of tissue adjoining that tube, he said. He could not explain how this had happened and would reject the idea that he was not careful. "I was a very careful surgeon all my life."
He doubted that the existence of multiple adhesions in Ms Byrne's abdomen would have prevented him from identifying the tube. He assumed he had mistaken a roll of tissue which was adjacent to the tube as the tube.
"Life is not always as clear-cut as seeing everything that you see in retrospect," he said. "I was obviously quite happy that I clipped the fallopian tube."
Dr Murray denied he was negligent but said he was "very unhappy" the procedure had not achieved the end result.
"I regret it," he said. Had he any inkling at the time of what was happening, he would have taken other measures.
He also agreed it would have been reasonable for a doctor to have later sat down with the patient and explain to them clearly that the tubal ligation had failed. He could not recall being told by the hospital the tubal ligation had failed before these proceedings were initiated.
He also agreed that, even where there was a perfectly performed tubal ligation with both tubes clipped, a patient could later become fertile over a long period of time as a result of the tubes reconstituting themselves.
Dr Murray was the concluding witness in the action by Bridget and Daniel Byrne against the Coombe hospital arising from a sterilisation procedure of December 16th, 1999. Ms Byrne already had five children when she underwent that procedure.
After the procedure, she gave birth to her sixth child, a daughter, in September 2000, and to her seventh and last child, a son, in August 2001.
The proceedings have been brought in two separate actions by Ms Byrne, of Lee Drive, Calverstown, Kilcullen, Co Kildare, and her husband.
The couple say the two children are much-loved members of their family but they are entitled to the cost of rearing them to adulthood, the cost of which has been agreed at some €354,000.
The hospital has denied negligence.
Evidence in the case concluded yesterday and it was then adjourned by Mr Justice Peter Kelly to allow both sides to prepare written legal submissions on the issues in the case.
The judge will hear oral submissions on March 6th and is then expected to reserve judgment to a later date.
