Go ‘with eyes open’, Cork coroner warns people opting for overseas surgery
Haemlin, In Who Died Of Gervacio Fermoy, Her Estelita And Turkey 2021 Hazel In Mother
A coroner has highlighted the potential dangers and risks of undergoing surgery overseas and advised people to consider the move carefully, and do so with “their eyes open”.
Cork City Coroner Philip Comyn was speaking after hearing inquests into the deaths of three women who travelled overseas from Cork for surgery — one for a gastric bypass, one for liposuction, and one for major stomach surgery following a cancer diagnosis.
The purpose of these inquests is not to cast aspersions on the medical care but to make people aware that if they go abroad for certain treatments, they need to go with their eyes open and consider it very carefully before they do so.
These cases highlight the dangers of going abroad for surgery, where in some cases hospitals did not take the same steps as would be deemed absolutely necessary here, he said.
A teenager was praised for being a voice for his mother at the inquest into her death just weeks after she underwent major surgery for stomach cancer in her native Latvia.
Artjom Scerbakovs, aged 16, told Mr Comyn that his mother Elena Shcherbakova, 48, who had lived in Castletownbere, Co Cork, for over a decade, felt unwell during a family holiday in Latvia in early 2023 and went to her local GP in Cork in April, where she was diagnosed with ovarian cysts and was told it would take some time to see a specialist.
By September 2023, she had decided to return to Riga in Latvia for surgical treatment, where stomach cancer was identified, the inquest was told.
Ms Shcherbakova underwent surgery at Riga East University Hospital on November 8, 2023 — first a hysterectomy and then the removal of parts of her stomach, duodenum, and small bowel.
She recovered well and returned to Ireland, where on December 11, 2023, she met cancer specialist Dr Seamus O’Reilly to discuss a chemo treatment plan, which was due to start on January 2, 2024.
Dr O’Reilly said many foreign people living here have chosen to return to their native countries for certain surgical procedures due to confidence in their own systems and the language barrier. But he said long waiting lists and concerns about accessing services here were issues in this case.
“That does not help instil confidence in the system here,” he said.
Ms Shcherbakova collapsed at home on December 14, 2023, and was rushed to the Mercy University Hospital.
Vascular surgeon Gavin O’Brien said a CT scan revealed an infection had arisen from a stitch line that had not healed properly, and he said the manner in which the Latvian surgeons had operated left Irish surgeons with very limited surgical options.
He said they decided to treat her infection aggressively but said she was in “a very fragile condition” and deteriorated acutely, before she ultimately crashed and was rushed to theatre, where despite doctors' best efforts, she died on December 17.
Mr O’Brien said it was “an exceptionally rare and complicated medical situation which was particularly difficult for her family to understand”.
“I am very sorry there was nothing more I could do to try to save her life,” he said.
The cause of death was given as haemorrhage due to the rupture of a mesenteric pseudo aneurysm, with complicating sepsis, due to the perforation of an anastomotic site, following the stomach surgery.
The coroner recorded a verdict of death due to a known complication of a medical procedure on a background of a complex medical history.
A woman who suffered a fatal infection days after a gastric bypass in Turkey did not have a standard or recognised bariatric procedure there, the Irish surgeon who tried to save her said.
Prof Micheál Ó Riordáin, a consultant gastrointestinal and general surgeon, made his comments during the inquest into the death of Pamela Canty, aged 53, from Commons Rd, Cork, in MUH on October 23, 2022, just days after a gastric bypass in a hospital in Ismir.
Ms Canty's husband Finbarr told the inquest that he and their son Josh flew with Pamela to Ismir for what was supposed to be a gastric sleeve operation, arriving at around 1am on October 17, 2022.
He said they were collected from the airport and taken straight to the hospital, where tests revealed a hernia in Pamela’s oesophagus, which ruled out a gastric sleeve, with the surgeons suggesting through a translator that she undergo a gastric bypass instead.
He said he told Pamela they should leave and get the hernia dealt with at home first but that she insisted on going through with it.
“She said ‘if I go home now, I won’t come back’,” he said.
He wept as he recalled how he underwent a similar procedure in Turkey the previous January, without incident, and how he now blames himself for what happened.
“If I didn't go to get it done myself, she wouldn't have known. I partly blame myself,” he said.
He told the inquest that he was discharged from the hospital four days after his surgery but Ms Canty was discharged to a hotel two days after her surgery, despite looking tired, pale, drawn, and having a fever.
He said he expressed concerns about her early discharge but said hospital staff told him his wife would be ok with rest.
The family left Ismir on October 21. Ms Canty collapsed at home the next day and was rushed by ambulance to MUH where Prof Ó Riordáin performed emergency surgery.
He said he found no evidence she had undergone a standard bariatric procedure, and in the absence of medical notes from Turkey, and based on what he had heard, he said he felt she was discharged from hospital too soon.
She died the following day, with the cause of death given as septic shock due to discharge of gastro jejunal bypass with abdominal infection.
The coroner said it was clear from the evidence, and assistant state pathologist Dr Margot Bolster and Prof Ó Riordáin agreed, that Ms Canty was showing signs of a post-op infection in Turkey and her symptoms should have been investigated further there.
He returned a verdict of medical misadventure.
A young woman said she felt held against her will in Turkey and wasn't allowed see her mother’s body after she died in a hospital in Istanbul following liposuction.
Hazel Gervacio outlined her horrifying experience during the inquest into the death of her mother, Estelita Haemlin, 46, from Fermoy, Co Cork, in Turkey on October 20, 2021.
Ms Gervacio said her mother got the number of a contact for the hospital from a beautician in the area, and made arrangements for the two of them to travel to the facility on October 18, 2021.
She said they were collected from the airport and brought to the hospital for bloods, before being dropped off at a hotel, where they were collected the next day in a van which was full of people who were also undergoing similar procedures.
She said her mother felt rushed to sign consent forms and signed documents without even reading them properly.
Before Ms Haemlin was taken into surgery, she asked her daughter to go back to hotel to collect some overnight clothes.
“That was the last time I saw my mum alive,” Ms Gervacio told the inquest.
Within hours, Ms Gervacio said she felt something was wrong when her mother had not returned from surgery and she began to panic.
She told of how she approached nurses, and searched the hospital frantically looking for someone who could speak English and tell her what was going on, and even had to show a photograph of her mother to one of the cleaners, in a bid to find her.
She finally discovered from a nurse that her mother had been taken to ICU in critical condition after the procedure.
“The doctors said maybe she had an underlying issues, but she didn’t,” she said.
She was finally allowed see her mother in ICU on October 20, shortly before she died.
She told the inquest how she was accompanied by two nurses back to hotel, was booked out of there, and into another hotel, where she was told the hospital would cover the costs of repatriating her mother’s body and refund the cost of the liposuction.
“I felt the hospital was anxious to send me home,” she said.
Despite engaging a Turkish solicitor, the family could not get Ms Haemlin’s medical files.
An autopsy conducted on her remains at Cork University Hospital by Dr Bolster established the cause of death was haemorrhage and shock due to a liposuction procedure.
Coroner Mr Comyn described Ms Gervacio’s experience as “horrifying” and said despite his best efforts, and high-level diplomatic efforts involving the Department of Foreign Affairs and the Turkish embassy, the hospital has not provided all of Ms Haemlin’s files.
He said whatever his private thoughts about this case, in the absence of full information, he had to record an open verdict.