Inquest raises questions about Castlederg man’s care after surgery

AN inquest into the death of a Castlederg man several days after undergoing surgery in hospital five years ago has raised significant questions regarding his post-operative treatment.

John McHugh (66), who lived at Lurganboy Road, died at Altnagelvin Hospital, Derry on August 3, 2019, shortly after an operation to remove a tumour from his tongue.

His family, including brother Maoliosa McHugh, a West Tyrone MLA, want a number of questions about his treatment and subsequent death to be answered.

The inquest into his death, which opened at the Coroner’s Court in Belfast last Monday, will resume this week to hear what lessons have been learned in the wake of Mr McHugh’s tragic passing.

Last week, the Coroner heard evidence from his partner, Diane Swatosh, as well as consultants and others involved in his treatment and care.

The Western Health and Social Care Trust initiated a Serious Incident Investigation into the case.

A report carried out by two experts in cancer care has also called into question some aspects of Mr McHugh’s treatment.

It will be up to the Coroner to decide the cause of death and make conclusions on what, so far, has been almost a week of evidence from family members, experts and medical witnesses.

Members of the McHugh family have been in attendance throughout the inquest.

It has been probing a number of issues arising from Mr McHugh’s treatment and death.

Among them is why a tracheostomy tube was removed from Mr McHugh. There have also been questions on a build-up of edema, which is swelling caused by too much fluid trapped in the body’s tissues.

Consultants, Dr Manu Patel and Dr Andrew Baldwin, prepared a report into the death.

‘Excessive’

Dr Patel claimed that the dimensions of the clearance of the tumour from Mr McHugh’s mouth ‘did seem excessive’.

He added that, in his opinion, it was ‘completely unnecessary’ to take such a large section away.

His opinion on this was backed by Dr Baldwin, who said that the extent of the operation could have been kept much more restrained for what he described as a ‘small tumour’.

They also claimed in their report that the length of the operation could have been significantly reduced.

Both consultants also questioned the removal of a tracheostomy tube.

This piece of equipment is used to help air and oxygen reach the lungs by creating an opening in a person’s wind pipe.

The removal of this tube, and an instruction given to ‘push all fluids’ against what they claimed as the advice of a speech and language therapist, could have contributed to later issues experienced by Mr McHugh, including distressing coughing.

Dr Patel said that it was ‘completely inappropriate’ to give fluids, and that Mr McHugh should have remained ‘nil by mouth’.

‘Significant edema’

In relation to the possible cause of death, Dr Baldwin said Mr McHugh had been coughing violently and distressingly, and that this can result in ‘significant edema’.

Their view was that the sudden deterioration in Mr McHugh’s condition in the early hours of August 3, 2019, was down to the airways coming to the point where an obstruction made it difficult for him to breathe.

A solicitor for Mr McHugh’s next of kin also raised the observation that no tracheostomy tube was in place when they saw him on the hospital bed following his death, but that this was then in place when they later viewed his remains in the mortuary.

When asked could they provide any explanation for this, Dr Baldwin said he had ‘no explanation’.

In response, Dr Patel described this as ‘unusual’, to which his colleague added the word ‘very.’