Cork woman who claimed she asked consultant to stop procedure did not cry out in pain, judge finds

A High Court judge has rejected a woman’s claims that she was crying when asking a consultant cardiologist to stop as he was carrying out a pacemaker insertion procedure on her.

Mr Justice Paul Coffey said Eileen Tynan, 68, formerly of Tivoli, Co Cork, now living in Spain, “did not cry in an audible, intense, and emotional way during the procedure, nor did she cry inconsolably at its conclusion or on the ward”.

Ms Tynan had told the court she felt she was “being ripped open” and was in “terrible, terrible pain” during a day procedure to insert the pacemaker into her chest. She also claimed she felt the doctor was not listening to her “or my pleas for help”.

The judge said he preferred the evidence of the consultant cardiologist to that of Ms Tynan when he dismissed her action for negligence against him and a hospital.

Ms Tynan sued Bon Secours Health System, with registered offices at College Rd, Cork, and consultant cardiologist Dr Heiko Kindler, with an address at The Cork Clinic, Western Rd, Cork, over the procedure carried out at the Bon Secours Hospital, College Rd, Cork, in July 2018.

She claimed there was a failure to provide adequate anaesthesia or analgesia for the pacemaker.

She alleged she suffers from PTSD and adjustment disorder as a result of the 53-minute day procedure under local anaesthetic.

The claims were denied.

Mr Justice Coffey said that between the two conflicting accounts of the procedure he found Dr Kindler’s evidence was “not only more internally coherent and consistent but also better aligned with the general body of evidence in the case”.

He made findings of fact, on the balance of probabilities including that the anaesthesia and analgesia provided to her were sufficient to prevent avoidable pain resulting from physical trauma.

He found she was actively monitored throughout the procedure by the overseeing or “circulating” nurse and Ms Tynan did not not make repeated complaints of significant pain during the procedure.

While she made a complaint around 22 minutes into the procedure, the pain she reported was “unavoidable despite adequate and effective anaesthesia” and it was promptly relieved by further local anaesthesia and the administration of fentanyl, he said.

The judge found she did experience anxiety during the procedure, likely triggered by the pain she reported at 22 minutes into it and, likely further exacerbated and prolonged by an underlying susceptibility to anxiety of which Dr Kindler and the medical team were unaware.

He found the onset of her anxiety was not caused by any act or omission of the defendants.

That anxiety “caused her to subjectively perceive some degree of trauma for an indeterminate period or periods during the procedure, but not at a level of pain that was excruciating or relentlessly so”.

She also did not report experiencing anxiety during the procedure, he said.

He found she did become tearful at some stage before the procedure concluded, when the drape over the patient was removed.

Her level of distress was likely to have been very similar to that noticed when a cardiac physiologist saw a tear in Ms Tynan’s eye for which she was offered a tissue, he said.

The physiologist said it was not unusual for a patient to be a bit emotional or tearful following a procedure, sometimes due to a sense of relief that the procedure had ended.

The judge said at the conclusion of the procedure, Ms Tynan’s presentation was of a patient who was mildly to moderately upset and tearful, with no indication that she warranted medical attention or pharmacological intervention.

Ms Tynan did not, at that stage, report experiencing any unaddressed pain during the procedure, he said.

Nor did she, despite being asked about pain on seven occasions and having ample opportunity to do so, raise any complaints of pain at any time prior to her discharge from hospital later that day, he said.

He dismissed the claim.