News
Coroner claims death had echoes of Savita
A young mother of two collapsed unconscious at home, days after being sent home from A&E due to a shortage of doctors, an inquiry into her death heard.
Coroner for West Galway, Dr Ciaran MacLoughlin, compared the break-down in communications at the hospital to the incidents that led to the death of Savita Halappanavar three years earlier.
He said that this ‘final and terminal event’ may not have occurred had anomalies seen in one of her blood tests – her troponin levels, which is used to indicate damage to the heart muscle, were elevated – had been communicated to her or her family.
“It is a sad situation for all of us when we have a hospital with the best experienced staff in the country, and yet it cannot function – something is radically wrong,” Dr MacLoughlin said.
He added that the staff shortages and overcrowding at UHG – which has the second busiest emergency department in the State – was a question of national policy, but also of major public concern.
Eniola Adekeye (41), of Gleann Rua, Renmore, died from cardio respiratory failure, due to a bilateral pulmonary thromboemboli on February 5 2015. She was studying for a B.A. degree in Child Studies at the time.
Her husband, Adedotun, told the Inquiry at Galway Courthouse on Thursday that she had initially been rushed to hospital in the early hours of Friday, January 30, after collapsing at home.
A blood sample was taken and she was sent for an x-ray, but was discharged at 5pm that evening with a prescription for iron tablets. She was told to go straight to her GP if there was any relapse over the coming days.
Her situation did not improve over the weekend and, on Monday morning, he took her to their GP practice.
“He asked if the hospital had carried out a brain scan, and when we said no he said that she needed to go back – he said ‘take this note to A&E, she needs a full medical assessment,’” Mr Adekeye recalled.
They arrived just after 11am that morning but the medical assessment unit was full to capacity and she was referred to A&E. However, 12 hours after arriving, she still had not been seen by a doctor.
“A few minutes before 11pm, a nurse came out – she said she was in charge of A&E and that there were over 40 of us waiting over 12 hours (to be seen). She said that all of us could not be attended to because there were not enough doctors.
“I asked what position were we in on the priority list, I saw that we had all been divided into four groups – we were in the third of four sections (fourth being standard cases).”
He said that the nurse did not think that Mrs Adekeye would be seen by a doctor that night, so her husband took her home.
The following morning, he brought her back to the GP practice, where they saw their own GP. He checked her heart and prescribed painkillers – he thought she may have broken a rib in her fall on January 30.
She seemed to be feeling better the next day, Thursday, but that night she collapsed again and fell unconscious.
An ambulance arrived within 45 minutes, but Eniola never regained consciousness, and died just before midnight on February 5.
Dr MacLoughlin said that Mrs Adekeye seemed to have received an appropriate examination on her first admission in January, and that an embolus would have shown up in the chest x-ray that was taken on that date.
“On the second occasion she presented with a letter from her GP – he felt something serious had happened, but was not in a position to make a diagnosis, so he made a recommendation that she be admitted (to the medical assessment unit) for further investigation and observation,” the Coroner said.
“This is all we can expect from the GP, now that we know this (pulmonary embolism) was difficult to diagnose.”
However, he said that the break-down in communication happened when she arrived in A&E, as the ‘clinical impression’ expressed in the GP’s letter – that she was in need of admission for monitoring and investigation – was not treated with any degree of urgency.
“The triage nurse did all the bloods that an experienced doctor would have done, the difficulty is who sees them, and who sees them if the patient leaves the hospital (unseen),” he added.
Solicitor for the HSE, Imelda Tierney, accepted that there had been a ‘difficulty in (staff) resourcing’ on that day, which meant that the anomalies in the blood results were not followed up after Mrs Adekeye left A&E without seeing a doctor on February 2.
Dr Pat Nash, UHG’s Clinical Director, in a letter to the Coroner, acknowledged that the A&E department at the hospital was not fit for purpose, having been constructed in the 1950s.
He said that it was designed to cater for 100 patients, but that the average daily attendance was 176 and, at its busiest, this figure has reached 250.
As with all hospitals in the country, he said, there are difficulties recruiting and retaining staff, which result in serious shortages.
Consultant pathologist, Dr Teresa McHale, said that a pulmonary embolism had occurred over a number of days prior to Mrs Adekeye’s death, which would correspond with her clinical history, but could offer no clear explanation of why she had developed it.
She described the condition as exceptionally unusual for a woman of her age, and would normally be seen in someone who was less mobile.
“She did not have any apparent risk factors for this condition,” Dr McHale added.
In bringing the hearing to a close, the Coroner described it as “a very tragic narrative of what happened to Eniola.”
He recommended that the blood results for any patients that leave A&E be reviewed, and that they be recalled in the event that any anomalies are discovered.
“If this was done, this final and terminal event may not have occurred,” Dr MacLoughlin concluded, before offering his sympathies to Mrs Adekeye’s husband and children on her untimely and unexpected death.
Significant state investment is required to address ‘shocking’ inequalities that leave cancer patients in the West at greater risk of succumbing to the disease.
A meeting of Regional Health Forum West heard that survival rates for breast, lung and colorectal cancers than the national average, and with the most deprived quintile of the population, the West’s residents faced poorer outcomes from a cancer diagnosis.
For breast cancer patients, the five-year survival rate was 80% in the West versus 85% nationally; for lung cancer patients it was 16.7% in the west against a 19.5% national survival rate; and in the West’s colorectal cancer patients, there was a 62.6% survival rate where the national average was 63.1%.
These startling statistics were provided in answer to a question from Ballinasloe-based Cllr Evelyn Parsons (Ind) who said it was yet another reminder that cancer treatment infrastructure in the West was in dire need of improvement.
“The situation is pretty stark. In the Western Regional Health Forum area, we have the highest incidence of deprivation and the highest health inequalities because of that – we have the highest incidences of cancer nationally because of that,” said Cllr Parsons, who is also a general practitioner.
In details provided by CEO of Saolta Health Care Group, which operates Galway’s hospitals, it was stated that a number of factors were impacting on patient outcomes.
Get the full story in this week’s Connacht Tribune, on sale in shops now, or you can download the digital edition from www.connachttribune.ie. You can also download our Connacht Tribune App from Apple’s App Store or get the Android Version from Google Play.
On the eve of completing his 150th marathon, an odyssey that has taken him across 53 countries, Loughrea’s Marathon Man has announced that he is planning to hang up his running shoes.
But not before Jarlath Fitzgerald completes another ten races, making it 160 marathons on the occasion of his 60th birthday.
“I want to draw the line in 2026. I turn 57 in October and when I reach 60 it’s the finishing line. The longer races are taking it out of me. I did 20 miles there two weeks ago and didn’t feel good. It’s getting harder,” he reveals.
“I’ve arthritis in both hips and there’s wear and tear in the knees.”
We speak as he is about to head out for a run before his shift in Supervalu Loughrea. Despite his physical complaints, he still clocks up 30 miles every second week and generally runs four days a week.
Jarlath receives injections to his left hip to keep the pain at bay while running on the road.
To give his joints a break, during the winter he runs cross country and often does a five-mile trek around Kylebrack Wood.
He is planning on running his 150th marathon in Cork on June 4, where a group of 20 made up of work colleagues, friends and running mates from Loughrea Athletics Club will join him.
Some are doing the 10k, others are doing the half marathon, but all will be there on the finishing line to cheer him on in the phenomenal achievement.
Get the full story in this week’s Connacht Tribune, on sale in shops now, or you can download the digital edition from www.connachttribune.ie. You can also download our Connacht Tribune App from Apple’s App Store or get the Android Version from Google Play.
From the Galway City Tribune – An impassioned plea for a ‘masterplan’ that would guide Galway City into the future has been made in the Dáil. Galway West TD Catherine Connolly stated this week that there needed to be an all-inclusive approach with “vision and leadership” in order to build a sustainable city.
Deputy Connolly spoke at length at the crisis surrounding traffic and housing in Galway city and said that not all of the blame could be laid at the door of the local authority.
She said that her preference would be the provision of light rail as the main form of public transport, but that this would have to be driven by the government.
“I sat on the local council for 17 years and despaired at all of the solutions going down one road, metaphorically and literally. In 2005 we put Park & Ride into the development plan, but that has not been rolled out. A 2016 transport strategy was outdated at the time and still has not been updated.
“Due to the housing crisis in the city, a task force was set up in 2019. Not a single report or analysis has been published on the cause of the crisis,” added Deputy Connolly.
She then referred to a report from the Land Development Agency (LDA) that identified lands suitable for the provision of housing. But she said that two-thirds of these had significant problems and a large portion was in Merlin Park University Hospital which, she said, would never have housing built on it.
In response, Minister Simon Harris spoke of the continuing job investment in the city and also in higher education, which is his portfolio.
But turning his attention to traffic congestion, he accepted that there were “real issues” when it came to transport, mobility and accessibility around Galway.
“We share the view that we need a Park & Ride facility and I understand there are also Bus Connects plans.
“I also suggest that the City Council reflect on her comments. I am proud to be in a Government that is providing unparalleled levels of investment to local authorities and unparalleled opportunities for local authorities to draw down,” he said.
Then Minister Harris referred to the controversial Galway City Outer Ring Road which he said was “struck down by An Bord Pleanála”, despite a lot of energy having been put into that project.
However, Deputy Connolly picked up on this and pointed out that An Bord Pleanála did not say ‘No’ to the ring road.
“The High Court said ‘No’ to the ring road because An Bord Pleanála acknowledged it failed utterly to consider climate change and our climate change obligations.
“That tells us something about An Bord Pleanála and the management that submitted such a plan.”
In the end, Minister Harris agreed that there needed to be a masterplan for Galway City.
“I suggest it is for the local authority to come up with a vision and then work with the Government to try to fund and implement that.”
Families queue up for school’s offer of free house
West has lower cancer survival rates than rest
Galway minors continue to lay waste to all opponents
Gardaí and IFA issue a joint appeal on summer road safety
Marathon Man plans to call a halt – but not before he hits 160 races
