Connacht Tribune
Inquest hears that patient choked on piece of meat
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An inquest into the death of a patient in University Hospital Galway who apparently choked on a piece of red meat has been adjourned to establish how the elderly man on a moist mince diet could have been served the wrong meal.
Galway West Coroner, Dr Ciarán MacLoughlin adjourned the hearing until next year so that a former catering employee on duty that day could be located to give evidence.
The Coroner’s Court last week heard three hours of evidence into the death of Patrick Monaghan (85) of St Jarlath’s Court, Tuam, who was found dead in a chair beside his hospital bed on October 4 last year shortly after eating his lunch.
His lunch tray was still on his bed trolley and staff noticed it was a beef dinner though a sign over his bed stated he was only to be fed ‘moist mince meals’ which would not have any chunks of food in them for easy digestion.
However, it transpired that the late Mr Monaghan may have inadvertently been given the wrong tray carrying the wrong type meal on the day.
Mr Monaghan had been in hospital for four months at the time and had been waiting to be discharged once a bed was available in a nursing home. He had had difficulty swallowing food which is why he was on a modified diet.
Consultant Pathologist, Dr Sheena Phelan, told the Inquest that the cause of death had been asphyxia due to a piece of food obstructing his larynx. She had found pieces of red meat and carrots measuring about three to four centimetres.
Annemarie Burke, Clinical Nurse Manager on St Dominick’s Ward, remembered that the patient had been given a regular dinner on September 24 and when he couldn’t digest it, the catering staff had been reminded of his modified diet.
On cross-examination by Paul McGettigan, SC for Mr Monaghan’s family, and Ian Thomas, representing Aramark Catering Company which provides meals to patients, she said she had written up the incident on the day but couldn’t remember if she followed up with a phone call.
In the course of her evidence, she remembered seeing Mr Monaghan slumped on a chair beside his bed and that his tray was still on his bed trolley. Later she remembered noting it had contained the remnants of a regular beef meal.
However, at the time she didn’t make the connection as she hadn’t known or expected him to have died from choking.
Gavin O’Shea, Campus General Manager with Aramark at UHG, told the Inquest that the company had since 1984 provided 766,000 patient meals per annum at GUH, serving 1,200 patients daily across the group which included both UHG and Merlin Park in Galway as well as Mayo General Hospital. In that time, he said, this was the first time a patient had choked on a meal at the hospital.
At UHG, the food is cooked by professional chefs in the main kitchen and served from pantry kitchens on each floor across four separate buildings on the campus. Two members of staff served the food on each ward per meal service which included, breakfast, lunch and supper.
Most patients were served regular meals while some were on modified diets such as an easy chew or liquified. These modified meals were served on red trays which also indicated if a patient needed assistance while feeding.
The red tray list was compiled by the clinical staff each day and cross checked the following day by the serving staff who made changes on a white board to ensure each patient got the right meal, which were identified by bed numbers.
The modified meals were clearly distinguishable from others in marked containers. These were delivered to the beds but away from patients to be assessed by clinical staff, not Aramark staff, he said. Staff were fully trained by Aramark on the serving of these blue and red trays.
Mr O’Shea said that his own investigation of the incident showed that his staff received a photocopy list of the previous day’s meals requirements for October 4 and according to that list, Mr Monaghan should have got a normal meal. That didn’t happen, he added, because of information on traceability sheets which showed the serving staff that he should be given a modified meal, which was the correct meal for him on the day.
“He received a mince moist meal instead of a normal meal on that day because we knew he was a long-term patient and that the catering staff went down the ward to confirm verbally what he did receive. If we had followed instruction that morning, he would have been delivered a normal meal,” he added.
The Coroner, Dr McLoughlin asked how he could marry that evidence with that of the previous witness, Ms Burke, who said she saw evidence of a normal meal on the patient’s tray that day.
Mr O’Shea said he couldn’t explain how a piece of meat was in his oesophagus that day but added if Mr Monaghan had been given the wrong meal, another patient would have complained of getting a mince moist meal. Mr Monaghan was the only patient of 28 on the ward on a mince moist meal that day.
The mince moist meal on the day was turkey mince with pureed vegetables and mashed potatoes. The normal meal was a beef stew. He said that there had been nothing unusual about the food service on the ward that day.
“If there had been some mix-up, this would have been brought to our attention,” he said. It was a tried and trusted method and only clinical staff assisted patients to eat, not the serving staff.
Since the death of Mr Monaghan, they had taken steps by providing further training to staff, and he offered his condolences to the patient’s family.
Mr O’Shea said he had been informed six days later that a patient had choked to death. Replying to the Coroner, he said there was no investigation following an alleged incident of a wrong meal delivered over a week previously because he had never received an incident report or been informed by phone or email.
Dr McLoughlin said that it appeared that the wrong meal had been in front of the patient and that it was now associated with how he died. He said he appreciated it was laborious to write lists but he was concerned about such lists being photo-copied.
In reply to Mr McGettigan, representing the Monaghan family, he asked why the catering assistant who served meals on the ward that day wasn’t available to give evidence.
Mr O’Shea explained that the person, whom he called Michael (he couldn’t remember his surname) was no longer a staff member.
Legal representatives for the HSE agreed that this witness be made available to the Inquest.
Mr McGettigan said that nobody had complained about receiving a wrong meal – but Mr Monaghan had been served a wrong meal because he was served one with chunks of beef in it.
Mr O’Shea said he had just been made aware 48 hours before the Inquest of a beef dinner being in front of Mr Monaghan when he was found slumped in his chair.
He said he accepted that hypothetically it could happen but he still stood over his own statement that a modified meal had been prepared and delivered that day to the patient.
But Mr McGettigan said that the person who served the meal to Mr Monaghan hadn’t confirmed directly to the Inquest if that had been the case. He said that Michael’s presence was required so he could give that evidence.
The Coroner agreed and it was decided to adjourn the Inquest until the March sitting of the Coroner’s Court. He further asked all parties concerned to produce all documents in relation to the case before that date as there was conflicting evidence on what meal had been delivered to Mr Monaghan that day, as well as other issues that had to be teased out.
Connacht Tribune
West has lower cancer survival rates than rest
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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.
Connacht Tribune
Galway minors continue to lay waste to all opponents
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Galway 3-18
Cork 1-10
NEW setting; new opposition; new challenge. It made no difference to the Galway minor hurlers as they chalked up a remarkable sixth consecutive double digits championship victory at Semple Stadium on Saturday.
The final scoreline in Thurles may have been a little harsh on Cork, but there was no doubting Galway’s overall superiority in setting up only a second-ever All-Ireland showdown against Clare at the same venue on Sunday week.
Having claimed an historic Leinster title the previous weekend, Galway took a while to get going against the Rebels and also endured their first period in a match in which they were heavily outscored, but still the boys in maroon roll on.
Beating a decent Cork outfit by 14 points sums up how formidable Galway are. No team has managed to lay a glove on them so far, and though Clare might ask them questions other challengers haven’t, they are going to have to find significant improvement on their semi-final win over 14-man Kilkenny to pull off a final upset.
Galway just aren’t winning their matches; they are overpowering the teams which have stood in their way. Their level of consistency is admirable for young players starting off on the inter-county journey, while the team’s temperament appears to be bombproof, no matter what is thrown at them.
Having romped through Leinster, Galway should have been a bit rattled by being only level (0-4 each) after 20 minutes and being a little fortunate not to have been behind; or when Cork stormed out of the blocks at the start of the second half by hitting 1-4 to just a solitary point in reply, but there was never any trace of panic in their ranks.
For more, read this week’s Connacht Tribune.
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Connacht Tribune
Gardaí and IFA issue a joint appeal on summer road safety
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GARDAÍ and the IFA have issued a joint appeal to all road users to take extra care as the silage season gets under way across the country.
Silage harvesting started in many parts of Galway last week – and over the coming month, the sight of tractors and trailers on rural roads will be getting far more frequent.
Inspector Conor Madden, who is in charge of Galway Roads Policing, told the Farming Tribune that a bit of extra care and common-sense from all road users would go a long way towards preventing serious collisions on roads this summer.
“One thing I would ask farmers and contractors to consider is to try and get more experienced drivers working for them.
“Tractors have got faster and bigger – and they are also towing heavy loads of silage – so care and experience are a great help in terms of accident prevention,” Inspector Madden told the Farming Tribune.
He said that tractor drivers should always be aware of traffic building up behind them and to pull in and let these vehicles pass, where it was safe to do so.
“By the same token, other road users should always exercise extra care; drive that bit slower; and ‘pull in’ that bit more, when meeting tractors and heavy machinery.
“We all want to see everyone enjoying a safe summer on our roads – that extra bit of care, and consideration for other roads users can make a huge difference,” said Conor Madden.
He also advised motorists and tractor drivers to be acutely aware of pedestrians and cyclists on the roads during the summer season when more people would be out walking and cycling on the roads.
The IFA has also joined in on the road safety appeal with Galway IFA Farm Family and Social Affairs Chair Teresa Roche asking all road users to exercise that extra bit of care and caution.
“We are renewing our annual appeal for motorists to be on the look out for tractors, trailers and other agricultural machinery exiting from fields and farmyards,” she said.
For more, read this week’s Connacht Tribune.
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The Connacht Tribune Live app is the home of everything that is happening in Galway City and county. It’s completely FREE and features all the latest news, sport and information on what’s on in your area. Click HERE to download it for iPhone and iPad from Apple’s App Store, or HERE to get the Android Version from Google Play.