A CORONER has found Hobart surgeon Stephen Wilkinson contributed to the cause of death of a Geeveston woman who died after lapband surgery in 2010.
Mr Wilkinson performed gastric banding surgery on Joanne Jean York, 26, at the Hobart Private Hospital on January 21, 2010.
Mrs York died 10 days later in the Royal Hobart Hospital from sepsis-induced multiple organ failure.
Coroner Rod Chandler held an inquest into her death last year and handed down his findings at the Hobart Magistrates Court this morning.
Mr Chandler said that Mrs York was discharged after her surgery but returned to hospital on January 26 with an apparent infection.
He said that Mr Wilkinson formed the view that the infection was in Mrs York's lungs and proscribed intravenous antibiotics.
Mr Chandler said that Mr Wilkinson decided not to investigate the possibility that the infection was in Mrs York's abdomen, and did not perform a laparoscopy.
``By electing not to take this course, Mr Wilkinson denied Mrs York her best chance of avoiding death,'' Mr Chandler said.
Mr Chandler said that Mr Wilkinson did not revisit his diagnosis despite Ms York's condition continuing to deteriorate in the next four days in hospital, and authorised her discharge on January 30.
He said that the failure of a nurse to pass on Mrs York's latest observations and the concern of another nurse that she not be discharged contributed to the ``ill-informed, ill-conceived, and incorrect'' decision to discharge her, but did not contribute to her death as by then her chance of surviving the infection had passed.
Mrs York's condition deteriorated at home that afternoon, and she was taken by ambulance to the Royal Hobart Hospital for emergency surgery.
She died at 1pm the next day.
Mrs York's mother, Christine Caudwel, said she welcomed Mr Chandler's findings but they did not bring her closure.