Bank worker loses negligence suit against doctor

Justice Mark Mohammed, presiding in the Port-of-Spain High Court, dismissed the claims made by Doreen Dyall and ordered that she pay costs to Dr Earl Brewster and Stanley’s Medical Clinic Ltd.

After the ruling, Dyall told reporters she was totally disappointed with the judgment. "I am very hurt. It is a sad day in the history of Trinidad and Tobago to see that despite all this evidence, I could not convince the court. I am very displeased with the decision. I plan to appeal, I will explore my options to see how far things can go," she added.

Apart from the ill-fated operation, Dyall and her husband of 14 years were separated in 2000. She has one daughter, aged 17, and since the operation, has secured a law degree.

Odai Ramischand, who represented Dyall, said he would study the judgment before making his next move. Douglas Mendes and Shabaki Cazabon appeared for Brewster, while Simon de la Bastide and Lisa Fulchan represented Stanley’s Medical Clinic.

The case was outlined by Mohammed who read out the entire judgment in court. He said that after the birth of Dyall’s daughter in the 1980s, she experienced difficulties with recurring fibroids in her uterus, problems with the blockage of her fallopian tubes and recurrent pelvic infections.

Her problems required surgery to be performed on three occasions prior to 1998. Dyall, he said, was desirous of having another child and was anxious to find a solution to her various gynaecological problems.

In 1998, one of two ultrasound scans performed within close proximity of each appeared to reveal a cystic mass in one of Dyall’s ovaries. Dyall’s complaint was that she was not properly counselled by Brewster as to the risk to which she was exposed in undergoing a left ovarian cystectomy, and in particular she was not told that there was a danger that a hysterectomy might have to be performed.

Dyall said she told Brewster that if during the operation, he discovered cancer, then he was given consent to remove the cancerous portion, that is the ovary.

On the other hand, Brewster asserted that before the surgery to remove what was thought to be an ovarian cyst, he told Dyall about the possibility of the removal of her uterus. A cystectomy was performed at Stanley’s to remove what was thought to be a cystic mass, but which turned out to be a "false cyst."

Dyall’s case was that notwithstanding her expressed instructions to the contrary, Brewster removed her uterus, fallopian tubes and her ovaries, none of which was cancerous, and the removal of which put her in menopause.

Brewster claimed that multiple previous surgeries had led to substantial internal scarring in Dyall’s abdominal area, and that during the surgery, the cutting of the internal scar tissue which had caused several of her internal organs to adhere, caused significant bleeding.

Brewster consulted with Dr Ralph Hoyte, a senior gynaecologist, and because of serious concerns over the bleeding, coupled with other factors such as Dyall’s problem with recurring fibroid, her age at the time and the general likelihood that she would conceive, it was decided that it was therapeutically necessary to remove all of her reproductive organs.

In his judgment, Mohammed said Dyall failed to discharge the burden of proving a negligent diagnosis on the part of Brewster with respect to the left ovarian cyst.

With respect to the removal of the productive organs, Mohammed said the woman presented no evidence that was capable of supporting the conclusion that Brewster failed to investigate and treat the patient and her various complaints in a timely fashion.

Mohammed found several areas of Dyall’s case falling short. "There are, in my respectful view, exaggerations and embellishments in parts of her evidence. On some aspects, her case is totally bereft of evidence.

"There are examples of radical divergences between the pleaded case and the evidence which emerged. There are examples of contemporary records contradicting parts of the plaintiff’s evidence, and yet again, instances of the plaintiff’s own witness contradicting parts of her claim."