Doctor did not rush surgery, inquest told
Tuesday 22 September 1992
Mr Albert Singer, a consultant at the Whittington Hospital in north London, was giving evidence at an inquest on Ruth Silverman, 49, who died of septicaemia in University College Hospital, London, on 22 June after two operations at the private Portland Hospital.
Mrs Silverman, whose widower Michael is an influential member of the Conservative Medical Society, was admitted to the Portland for a hysterectomy on 22 May. After the operation, she developed abdominal problems and her condition deteriorated.
Keyhole surgery was carried out at 7pm on 12 June to find out the cause of the problem. According to Mr Singer, both Mrs Silverman and her husband were 'not keen' on traditional surgery which would have left a scar.
He denied that he had planned the operation to fit in with his National Health Service work at the Whittington Hospital. He also denied that he had told the Silvermans' daughter that he wanted to hurry the operation so he could be home for a dinner party, and that he had been working long hours to accommodate private patients.
'I run a busy NHS clinic, but she was my only private patient at that time,' he told the inquest. 'I visited her in the morning, the afternoon, and phoned during the day. On this day I took the afternoon off. I was perfectly relaxed.'
Mr Singer denied that Mrs Silverman was frightened and confused when he suggested keyhole surgery and that he had over-ruled a senior bowel surgeon, Mr Peter Hawley, who favoured traditional open surgery.
The operation, using optical fibres, found the patient's bowel was swollen and that a kink was causing a blockage. The following day, Mr Singer rejected a nurse's test result which showed Mrs Silverman's white blood cells were low. He agreed that if the result was correct, it would have indicated blood poisoning caused by leakage from the bowel.
Mr Singer told the inquest he believed the nurses had either made a mistake, or that the test had been taken at the wrong time. He said the test did not fit in with the patient's 'general clinical picture'. He believed a blood clot in the lungs was the likely cause of complications.
Blood poisoning was his second diagnosis, but he wanted to exclude a blood clot before looking at other possibilities, he said. But when the blood clot had been ruled out, he still did not diagnose blood poisoning. Kidney failure was another possibility, he said.
On 15 June, he found that Mrs Silverman's condition had deteriorated and that she was probably suffering from blood poisoning after all.
The inquest continues.
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