25th Oct 2022
Katherine Deal KC (Instructed by Charles Russell Speechlys LLP (London)) for the appellant.
LORD Stephens and Lord PENTLAND (with whom Lord Reed, Lord Sales and Lord Hamblen agree):
The Board has before it two appeals from the Court of Appeal of the Republic of Trinidad and Tobago in proceedings for medical negligence brought against a private hospital (“the first appellant”), a consultant urological surgeon (“the surgeon”), and a consultant anaesthetist (“the second appellant”). The issues raised are essentially factual in nature and concern the application of well-established legal rules to the proven facts. On the critical factual issues, the courts below have made concurrent findings of fact. The appeals do not, contrary to the appellants’ submissions, raise any question of wider principle. They turn instead on a correct understanding of the parties’ written pleadings, certain aspects of the procedure followed in the High Court and the Court of Appeal, and the expert evidence led on behalf of the claimant, the substance of which went unchallenged at the trial.
2. The core facts
On 13 April 2004 the late Mr Russell Anthony Tesheira (“the deceased”) was admitted to the first appellant’s private hospital in Gulf View La Romaine, Trinidad, for a type of elective surgery known as a trans-urethral resection of the prostate (“TURP”). The procedure was to be carried out by the surgeon, Dr Lester Goetz, whom the deceased had previously consulted. The procedure is well-known to carry with it a high risk of post-operative bleeding. The deceased was a private patient of the surgeon, who frequently carried out surgery at the hospital. The second appellant, Dr Crisen Jendra Roopchand was the anaesthetist for the procedure. The hospital did not employ either the surgeon or the second appellant. Beyond that bare fact, the details of any contractual or other arrangements between the surgeon, the second appellant and the hospital were not explored in evidence and remain opaque.
The TURP having been completed by about 1.10pm on 13 April 2004, the deceased was taken from the operating theatre to a recovery room where nurses noted that his urine was heavily bloodstained. The bleeding could not be contained and at about 3.30pm the deceased was taken back to the operating theatre where the surgeon and the second appellant (latterly assisted by other doctors) attempted various medical and surgical procedures to try to stop the bleeding. After many hours the bleeding was eventually brought under control, but too late to save the deceased’s life. He died on the operating table at 11.30pm while still under general anaesthetic. The cause of death was certified to be “irreversible shock with DIC (disseminated intravascular coagulation)”. At the time of his death, the deceased was 53 years of age.