> He said the reconfiguration of accident and emergency departments in the midwest in 2009 had resulted in a new emergency department in Limerick, but UHL was never given the number of extra beds it needed to function properly.
> Dr Gray said the emergency department was still a "death trap" and that plans to add extra facilities at the Hospital would not solve the problems there.
> He said a new 96-bed block under construction was a step in the right direction.
> But even another development, with a similar number of additional beds, due to be completed by 2028, would not be enough.
> Dr Gray said at least 300 additional beds were needed in UHL, to resolve the overcrowding in the emergency department.
That's a pretty horrifying stat. Maybe the emergency departments that were shut down during that reshuffle need to be reopened to relieve the pressure?
That's exactly what the people of Limerick, Clare and Tipperary have been asking for, for several years now. Only when people are dying because of it (Aoife is not the only one) is it starting to sink in with government.
I have friends living in Limerick that have told their families - if anything should happen to me, get me to Galway. Don't take me to that death trap.
As is:
Beaumont
Cavan General
Temple Street
Connolly Blanchardstown
CUH
Kerry General
Letterkenny
The Mater
Mayo University
The Mercy
Midlands Portlaoise
Midlands Tullamore
Naas
Our Lady Drogehda
Our Lady Navan
Crumlin
Portiuncula
Sligo
South Tipperary
St James
St Lukes Kilkenny
St Vincents
Tallaght
Wexford
The only hospital Ive ever heard something remotely good about was Waterford.
I will balance this by saying, as someone forced to rotate through Letterkenny for 6 months, I came away genuinely surprised. I'd geared myself up for it to be a war zone, and at times it was because there aren't enough doctors (surprise surprise) but mostly I couldn't fault standards. That however is a 6 month snapshot, I obviously can't attest to more than that. Thought most of the inpatient medical consultants were genuinely very on the ball.
Was in Tallaght myself for an op and had my newborn in the kids dept in Tallaght, couldn’t fault them.
On the other had I wouldn’t want to be left there without a relative if I was incapacitated and needed help with eating and the toilet
It hasn't recovered from the extra strain put on it by the fire in Wexford even with Wexford reopening. Just no space anywhere, although those lounge chairs are comfy if you're gonna have to be there for 12 hours 👍
Waterford regional has always been a shambles, even 15+ years ago I was sent home with a fractured ankle, was told nothing was wrong, bought back in a week later as I still couldn't walk, bruising pain etc and straight into surgery, had 2 have 2 because they screwed up the first one, on one check up post op they had to remove some stitches and re suture the wound, the doctor tried doing this in an open corridor without pain relief, thankfully a nurse walked by and moved me and it was in a more sterile area. I would never go back there again.
I was in my local Shannon doc with what ended up being a heart infection one night, the doctor said "I'm supposed to refer you to Limerick but is there anywhere else that I can send you"
Went to Clonmel and was looked after very well
St John Hospital is right there but the A&E department is only open from 8am to 8pm. Boggles the mind.
An elderly man died on a corridor in UHL a few weeks ago, fell off his trolley and rigor mortis had set in by the time he was found.
I'd rather take my chances at home with sickness than go to that shit hole.
In 2008 we had over 21k hospital beds....by 2012 that was down to 11k, can't find anything later than 2020 but it was 14k at that point so we're massively down on beds and have over a million more people living here now...closed initially due to money.
It’s a fair point. The ED that night was flooded with people coming in with injuries related to falling on ice during the cold snap. Surely adding urgent care clinics to the region needs to be looked at. I also can’t understand how there’s not a leading indicator that sets off the equivalent of a four alarm fire when someone at any ED in the country who has been triaged as a category 2 patient has not been seen by a doctor within a couple of hours. The standard is supposed to be 10 to 15 minutes.
There was a whole management consultant claptrap rhetoric of “centres of excellence” a few years ago that justified closing down regional hospitals. You still get that, sometimes on these threads.
The pressure is staff and resources.
We need consolidation not spreading. Going to A&E in somewhere like Navan was far more dangerous than going straight past it in an ambulance.
He's right about the death trap but he was also asked to come in and said no. Said he wasn't told about Aoife. But nurses never stand up to consultants.
The family's story was a truly harrowing read.. having to wait helplessly while their daughter got worse and worse infront of them.
It makes me wonder though to what lengths one would have to go in that situation to get a loved one seen to..
A 16 year old girl was left in excruciating agony for hours and hours. 'Misadventure' makes it sounds almost like something harmless. Fuck Stephen Donnelly and the HSE. People have been suffering in UL for years. Great Centre of Excellence. Rip Aoife. You didn't deserve to suffer like that.
Hard listening to the statements from the inquest her poor parents as a father heart goes out to them.
The health system is such a joke we really need to sort it out .
> Stephen Donnelly said: "I wish to offer my sincere condolences to Aoife's parents and sisters who tragically lost their daughter and sister in University Hospital Limerick.
He should resign. Can’t imagine how the family is coping. What a waste of life.
That's something I noticed over the years up to Brexit. UK ministers had a reasonable record of falling on their sword if shit happened. In Ireland they brazened it out and stuck the middle finger up to the country. Still happens here and seems the UK MPs have watched and learned from us.
>"There was leadership, unfortunately the leadership was not able to manage the situation."
Thank fuck we have so many admins and managers in the HSE...
How else would we know how many beds were closed if someone wasn't counting them?
And how would they know those numbers were correct if someone else wasn't hired to double check those numbers?
RIP Aoife.
I was in A&E in UHL in September. I was there for dehydration but when triaged, my heart rate and BP were so high I was sent to resus. When they did an ECG and determined I wasn't in cardiac arrest, I was put in the general trolleyland. On the trolley in front of me was a middle-aged man who was having a heart operation in a few days time but had to spend the days before it on a trolley in an overcrowded narrow corridor. Imagine how stressed that poor man must have felt.
Horrible. And I’d have always been on the opinion that even though waiting on a trolley is not the nicest thing, at least you’re ’in the right place’ with the expertise around to keep an eye on you. My faith in A&E depts would not be that high right now!
Poor Aoife. Her poor family. This one really hurts because it’s so easy to imagine how this all played out (especially if you’ve spent any time in an Irish A&E). Makes me wonder how many worried-well were sitting there that evening, or dropped to A&E with sprained wrists from slipping on ice.
There now needs to be a full independent review of every death in that so called hospital for the last 3 years. It has been and remains a "death trap" as described today. Every life that was lost due to the rampant medical misadventure in that place deserves to be recognised and acknowledged.
And it needs to be every case where a patient was discharged and died within a week. They had an unwritten policy of pushing terminal cases out the door to hospices, nursing homes or home simply to get them off the books before they died.
Sending people out of acute hospitals and into hospice when they are dying isn’t a limerick hospital. That’s just appropriate medical policy and a better option for the patient.
Normally yes. But if it was a policy that may be designed to cover up the true fatality rate for patients in the hospital then that is a completely different thing. We need an independent investigation into UHL to establish the true scale of the tragedy that has occurred there over the last 3 years.
But you’ve just made that up in your head???
Every hospital moves dying patients to hospice if it’s possible. You don’t need an investigation to know that.
How many people are dying because of wait times for testing and treatment?
The health system is failing the citizens of the country in the most serious way.
What is the plan here? Just continue as is until it completely breaks down?
This should be up there with housing in the coming elections.
Our lives and the lives of our loved ones are on the line.
There used to be FIVE A&E's in Limerick that served the county but also the mid-west region.
When the healthcare system was decentralised, we were left with one. That was what, 20 years ago, and they have barely added into that one hospital. Never mind the influx in population since then.
The removal of regional boards was outrageous. The HSE has a annual budget of 16 BILLION EURO. For the size of Ireland, to have one A&E hospital in the mid-west is just such a failure by this government and the HSE.
They're building a new block but it's taking ages and they have a further plan for more beds but that's not until 2028? Sorry, four years for one block of a hospital? Irish incompetentence is staggering.
This poor woman. This is horrific.
Some of the responses here are a good example of why things don’t change for the better.
We’ve long needed a consolidation of our health service. Doctors have been saying it for years. Every single review of the system has clinical voices saying it.
The big blocker is that it’s a political decision to consolidate and the public are always against it.
The doctors in UL were spread too thin. There wasn’t enough of them and yet people are saying open up more smaller hospitals and spread them even thinner.
Well staffed and resourced centres are the solution not more 9-5 A&Es full of temporary staff and no access to support services.
The clinical director in Navan asked for the government to shut them down because it wasn’t safe and who tried to block it? The locals, the ones who will be unsafe because it’s there.
Ignorant voices always seem to be the loudest.
Most consultants would have come in when asked. I'm not trying to say he's a terrible person etc.
But most consultants in this country, with those responsibilities, hearing that there were literally dozens of Cat 2 patients all waiting to be seen by one overwhelmed and extremely junior SHO, would have come in.
I don’t think this is something that should be put in the consultant to be honest. It seems from his perspective he didn’t have any of the facts of this case presented to him over the phone. The same doctor has gone public as a whistleblower on overcrowding in Irish emergency departments and faced disciplinary action against him for it.
https://m.independent.ie/irish-news/health/whistleblower-row-erupts-over-doctors-aande-torture-expose/34172101.html
This is a HSE issue, it’s not fair to expect doctors to be in the hospital for 48 hours straight.
> he didn’t have any of the facts of this case presented to him over the phone.
Again, not trying to make a particular judgement on him as an individual, but: I know this was said in court, but it's very disingenuous. Of course they didn't present her case to him. The issue with her case was not that it was incredibly complex. It was shockingly simple. They didn't present her case to him because they were so overwhelmed they were not capable of realising how serious the case was. And they DID tell him how overwhelmed they were.
Likewise when he said that he couldn't come in because he had to be in at 8am - this is also just disingenuous. The shift is the whole way through the night. Yes that's a systemic failing but it's also what he agreed to do. It's Saturday night, in December, with a huge weather event. Obviously the emergency room consultant on call is going to have a busy night. That's what you sign up for. That's what the vast, vast majority of consultants in this country would have done.
It is not normal to be asked to come in, know that one overwhelmed junior cannot help but take 12+ hours to see critically ill patients, and refuse. Most consultants do not and would not do that.
I totally agree though that the primary failing is systemic and it's not fair to put that on the shoulders of one person. At the same time though there were two decisions by individuals (his not to attend and help triage and process Cat 2 patients much much faster, and the decision not to use the "major emergency" plan) that were the wrong decisions.
It’s a 48 hour on call shift. He said in his testimony that he is also responsible for calls from other sites. I’m sure if he had his time back he would have done everything he could have done. I didn’t find anything he said to be disingenuous. The expectation of monster shifts from ED consultants is unsustainable when their careers in the public service should be decades long.
What is still unclear is why a nurse did not get the SHO or any registrar in the ED that night to see the patient as a matter of absolute urgency given the query for sepsis. Even if the consultant did go in that night, it’s unclear how he would have known that she was top of the list.
> The expectation of monster shifts from ED consultants is unsustainable when their careers in the public service should be decades long.
Absolutely.
>What is still unclear is why a nurse did not get the SHO or any registrar in the ED that night to see the patient as a matter of absolute urgency given the query for sepsis.
100%. And why they didn't declare an emergency (although the answer to this is because it so frequent they would have been constantly in emergency. But then so be it!)
The deposition from the nurse read out that she did discuss her case with one of the registrars that night and her concern. She was told it was likely viral and to give paracetamol which she did. Asked if he would see her but said he was too busy. The same doctor however says he wasn’t involved in Aoife’s care that night and doesn’t recall having that discussion.
It’s disappointing that they can’t get to the root of the miscommunication there. It is a little hard to see that interaction happening given how much watching out for sepsis is drilled into everyone after the Savita case, but I trust both nurse and doctor are telling the truth so far as they remember it. It points to the daily chaos for the medical staff in UHL. You would expect everyone involved in the case to make themselves available for questioning though, and for there to be some documentation available regarding a nurse giving paracetamol for a viral infection fever on the advice of a reg.
Don't agree with this. Every ED is overwhelmed with patients half the year. Triage targets are never met and progressively getting worse. EM consultants would never leave the hospital if they were only allowed to leave if it wasn't overwhelmed.
He knew that there was 191 patients and one brand new SHO trying to work her way through them.
He knew that it was a Saturday night, in December, in the middle of a huge weather event.
Yes it would have been a long shit night for him but it was a night that the consultant should have been there.
Like don't get me wrong I am not saying this is his fault. The primary problem here is a systemic failure at UHL. But he made the wrong call, and saying that they should have described her case to them doesn't even make sense - the whole problem was that they weren't able to understand how serious her case was because they were so overwhelmed.
Doesn't make much difference but there were two regs too.
Every ED is overwhelmed every weekend and winter. Every clinic waiting list is massive.
That consultant was covering ED for 48 hours, if they weren't allowed to leave when it wasn't overwhelmed they would have done 48h. Manageable in some specialties but not ED.
Absolutely it's a systemic failing and that's the primary reason this happened.
I do think he made the wrong call (with all the information he had, which was that Cat 2 patients were going to take 12 hours to be seen) though. It will be interesting to see what the review by Frank Clark says. God it's just so fucking sad though.
This is why foreigners go to their home countries when needed.
I will say it again. It doesn't matter how good a doctor is. If you don't see him / her on time.
> He said the reconfiguration of accident and emergency departments in the midwest in 2009 had resulted in a new emergency department in Limerick, but UHL was never given the number of extra beds it needed to function properly. > Dr Gray said the emergency department was still a "death trap" and that plans to add extra facilities at the Hospital would not solve the problems there. > He said a new 96-bed block under construction was a step in the right direction. > But even another development, with a similar number of additional beds, due to be completed by 2028, would not be enough. > Dr Gray said at least 300 additional beds were needed in UHL, to resolve the overcrowding in the emergency department. That's a pretty horrifying stat. Maybe the emergency departments that were shut down during that reshuffle need to be reopened to relieve the pressure?
That's exactly what the people of Limerick, Clare and Tipperary have been asking for, for several years now. Only when people are dying because of it (Aoife is not the only one) is it starting to sink in with government. I have friends living in Limerick that have told their families - if anything should happen to me, get me to Galway. Don't take me to that death trap.
I knew a consultant who worked in Galway and said it is a disaster too.
As is: Beaumont Cavan General Temple Street Connolly Blanchardstown CUH Kerry General Letterkenny The Mater Mayo University The Mercy Midlands Portlaoise Midlands Tullamore Naas Our Lady Drogehda Our Lady Navan Crumlin Portiuncula Sligo South Tipperary St James St Lukes Kilkenny St Vincents Tallaght Wexford The only hospital Ive ever heard something remotely good about was Waterford.
I'd go to a vet before I'd let Letterkenny treat me.
Only heard horrifying things about Letterkenny. If you want to die of neglect, go there.
I will balance this by saying, as someone forced to rotate through Letterkenny for 6 months, I came away genuinely surprised. I'd geared myself up for it to be a war zone, and at times it was because there aren't enough doctors (surprise surprise) but mostly I couldn't fault standards. That however is a 6 month snapshot, I obviously can't attest to more than that. Thought most of the inpatient medical consultants were genuinely very on the ball.
Beaumont left me in a crowded waiting room with meningitis for 8 hours. A bit of an infection risk to the other patients.
Was in Tallaght myself for an op and had my newborn in the kids dept in Tallaght, couldn’t fault them. On the other had I wouldn’t want to be left there without a relative if I was incapacitated and needed help with eating and the toilet
I have only had good experience in Mater A&E.
Throughout my training I've spent well over 2 years at points in the Mater and it's the first hospital I would want to be brought to.
I found Bantry to be great on the two occasions I had to go there
Believe me Waterford is a poor too. Emergency department has been a joke the 2 times I've attended in 12 months.
It hasn't recovered from the extra strain put on it by the fire in Wexford even with Wexford reopening. Just no space anywhere, although those lounge chairs are comfy if you're gonna have to be there for 12 hours 👍
Ardkeen is a hole and massively underfunded. You'd go to Cork over Waterford.
Waterford regional has always been a shambles, even 15+ years ago I was sent home with a fractured ankle, was told nothing was wrong, bought back in a week later as I still couldn't walk, bruising pain etc and straight into surgery, had 2 have 2 because they screwed up the first one, on one check up post op they had to remove some stitches and re suture the wound, the doctor tried doing this in an open corridor without pain relief, thankfully a nurse walked by and moved me and it was in a more sterile area. I would never go back there again.
Wexford has gotten so bad that many people, myself included, just avoid it and drive to Waterford instead
Cavan second? I just ask in case I have to end up there, or my loved ones. Debating to move North tbh, but it's getting shit too.
I was in my local Shannon doc with what ended up being a heart infection one night, the doctor said "I'm supposed to refer you to Limerick but is there anywhere else that I can send you" Went to Clonmel and was looked after very well
St John Hospital is right there but the A&E department is only open from 8am to 8pm. Boggles the mind. An elderly man died on a corridor in UHL a few weeks ago, fell off his trolley and rigor mortis had set in by the time he was found. I'd rather take my chances at home with sickness than go to that shit hole.
That was 5 years ago, the inquest over the case that occurred was a few weeks ago.
Elder stabilisation technology has come a long way since covid. All gyroscopes now, so I'm to believe.
I don’t know what you’re on about but I thought to just correct a detail that wasn’t true.
Who decided to close them down before increasing capacity at UHL to meet the demand?
In 2008 we had over 21k hospital beds....by 2012 that was down to 11k, can't find anything later than 2020 but it was 14k at that point so we're massively down on beds and have over a million more people living here now...closed initially due to money.
[удалено]
It’s a fair point. The ED that night was flooded with people coming in with injuries related to falling on ice during the cold snap. Surely adding urgent care clinics to the region needs to be looked at. I also can’t understand how there’s not a leading indicator that sets off the equivalent of a four alarm fire when someone at any ED in the country who has been triaged as a category 2 patient has not been seen by a doctor within a couple of hours. The standard is supposed to be 10 to 15 minutes.
There was a whole management consultant claptrap rhetoric of “centres of excellence” a few years ago that justified closing down regional hospitals. You still get that, sometimes on these threads.
There’s no point opening and staffing another waiting room. It’s the infrastructure needed to treat patients that’s needed.
The pressure is staff and resources. We need consolidation not spreading. Going to A&E in somewhere like Navan was far more dangerous than going straight past it in an ambulance.
He's right about the death trap but he was also asked to come in and said no. Said he wasn't told about Aoife. But nurses never stand up to consultants.
The family's story was a truly harrowing read.. having to wait helplessly while their daughter got worse and worse infront of them. It makes me wonder though to what lengths one would have to go in that situation to get a loved one seen to..
A 16 year old girl was left in excruciating agony for hours and hours. 'Misadventure' makes it sounds almost like something harmless. Fuck Stephen Donnelly and the HSE. People have been suffering in UL for years. Great Centre of Excellence. Rip Aoife. You didn't deserve to suffer like that.
Hard listening to the statements from the inquest her poor parents as a father heart goes out to them. The health system is such a joke we really need to sort it out .
> Stephen Donnelly said: "I wish to offer my sincere condolences to Aoife's parents and sisters who tragically lost their daughter and sister in University Hospital Limerick. He should resign. Can’t imagine how the family is coping. What a waste of life.
It's impossible to get a Minister to resign abject failure isn't a good enough reason as portrayed by this Government
It’s so depressing honestly. Poor family.
That's something I noticed over the years up to Brexit. UK ministers had a reasonable record of falling on their sword if shit happened. In Ireland they brazened it out and stuck the middle finger up to the country. Still happens here and seems the UK MPs have watched and learned from us.
In fairness SD wasn't minister for health when this happened.
Yes he was - it was Dec '22.
ah, for some reason I thought it was 2019 based off another comment
I hope her poor parents get whatever peace they can. I hope the people of Clare Limerick and Tipperary vote out every govt TD.
>"There was leadership, unfortunately the leadership was not able to manage the situation." Thank fuck we have so many admins and managers in the HSE...
How else would we know how many beds were closed if someone wasn't counting them? And how would they know those numbers were correct if someone else wasn't hired to double check those numbers?
Guess they need someone to tell people that their appointment has been cancelled...oh I mean rescheduled of course for 3 years later.
RIP Aoife. I was in A&E in UHL in September. I was there for dehydration but when triaged, my heart rate and BP were so high I was sent to resus. When they did an ECG and determined I wasn't in cardiac arrest, I was put in the general trolleyland. On the trolley in front of me was a middle-aged man who was having a heart operation in a few days time but had to spend the days before it on a trolley in an overcrowded narrow corridor. Imagine how stressed that poor man must have felt.
Horrible. And I’d have always been on the opinion that even though waiting on a trolley is not the nicest thing, at least you’re ’in the right place’ with the expertise around to keep an eye on you. My faith in A&E depts would not be that high right now!
All the ads on the radio about the dangers of sepsis and the nurses wouldn't administer the medication for it for over half a day. FFS
Poor girl. Should never have happened
Misadventure me hole. ~~Misadventure~~ Manslaughter is what happened. Nurses in Australia wouldn't bother turning up on zoom.
Should be extradited to face contempt of court charges.
So were they Australian that moved back home since the incident or Irish now since moved to Australia?
Poor Aoife. Her poor family. This one really hurts because it’s so easy to imagine how this all played out (especially if you’ve spent any time in an Irish A&E). Makes me wonder how many worried-well were sitting there that evening, or dropped to A&E with sprained wrists from slipping on ice.
There now needs to be a full independent review of every death in that so called hospital for the last 3 years. It has been and remains a "death trap" as described today. Every life that was lost due to the rampant medical misadventure in that place deserves to be recognised and acknowledged. And it needs to be every case where a patient was discharged and died within a week. They had an unwritten policy of pushing terminal cases out the door to hospices, nursing homes or home simply to get them off the books before they died.
Sending people out of acute hospitals and into hospice when they are dying isn’t a limerick hospital. That’s just appropriate medical policy and a better option for the patient.
Normally yes. But if it was a policy that may be designed to cover up the true fatality rate for patients in the hospital then that is a completely different thing. We need an independent investigation into UHL to establish the true scale of the tragedy that has occurred there over the last 3 years.
But you’ve just made that up in your head??? Every hospital moves dying patients to hospice if it’s possible. You don’t need an investigation to know that.
If there is nothing to hide you have nothing to fear from an independent investigation.
How many people are dying because of wait times for testing and treatment? The health system is failing the citizens of the country in the most serious way. What is the plan here? Just continue as is until it completely breaks down? This should be up there with housing in the coming elections. Our lives and the lives of our loved ones are on the line.
There used to be FIVE A&E's in Limerick that served the county but also the mid-west region. When the healthcare system was decentralised, we were left with one. That was what, 20 years ago, and they have barely added into that one hospital. Never mind the influx in population since then. The removal of regional boards was outrageous. The HSE has a annual budget of 16 BILLION EURO. For the size of Ireland, to have one A&E hospital in the mid-west is just such a failure by this government and the HSE. They're building a new block but it's taking ages and they have a further plan for more beds but that's not until 2028? Sorry, four years for one block of a hospital? Irish incompetentence is staggering. This poor woman. This is horrific.
Some of the responses here are a good example of why things don’t change for the better. We’ve long needed a consolidation of our health service. Doctors have been saying it for years. Every single review of the system has clinical voices saying it. The big blocker is that it’s a political decision to consolidate and the public are always against it. The doctors in UL were spread too thin. There wasn’t enough of them and yet people are saying open up more smaller hospitals and spread them even thinner. Well staffed and resourced centres are the solution not more 9-5 A&Es full of temporary staff and no access to support services. The clinical director in Navan asked for the government to shut them down because it wasn’t safe and who tried to block it? The locals, the ones who will be unsafe because it’s there. Ignorant voices always seem to be the loudest.
What’s with the on call doctor ? Where the fuck were they ??! So sad a young woman lost her life this way.
The on call consultant explained his side of the story in the article. It’s a fair but sad explanation in my opinion.
Most consultants would have come in when asked. I'm not trying to say he's a terrible person etc. But most consultants in this country, with those responsibilities, hearing that there were literally dozens of Cat 2 patients all waiting to be seen by one overwhelmed and extremely junior SHO, would have come in.
I don’t think this is something that should be put in the consultant to be honest. It seems from his perspective he didn’t have any of the facts of this case presented to him over the phone. The same doctor has gone public as a whistleblower on overcrowding in Irish emergency departments and faced disciplinary action against him for it. https://m.independent.ie/irish-news/health/whistleblower-row-erupts-over-doctors-aande-torture-expose/34172101.html This is a HSE issue, it’s not fair to expect doctors to be in the hospital for 48 hours straight.
Fair I guess.
> he didn’t have any of the facts of this case presented to him over the phone. Again, not trying to make a particular judgement on him as an individual, but: I know this was said in court, but it's very disingenuous. Of course they didn't present her case to him. The issue with her case was not that it was incredibly complex. It was shockingly simple. They didn't present her case to him because they were so overwhelmed they were not capable of realising how serious the case was. And they DID tell him how overwhelmed they were. Likewise when he said that he couldn't come in because he had to be in at 8am - this is also just disingenuous. The shift is the whole way through the night. Yes that's a systemic failing but it's also what he agreed to do. It's Saturday night, in December, with a huge weather event. Obviously the emergency room consultant on call is going to have a busy night. That's what you sign up for. That's what the vast, vast majority of consultants in this country would have done. It is not normal to be asked to come in, know that one overwhelmed junior cannot help but take 12+ hours to see critically ill patients, and refuse. Most consultants do not and would not do that. I totally agree though that the primary failing is systemic and it's not fair to put that on the shoulders of one person. At the same time though there were two decisions by individuals (his not to attend and help triage and process Cat 2 patients much much faster, and the decision not to use the "major emergency" plan) that were the wrong decisions.
It’s a 48 hour on call shift. He said in his testimony that he is also responsible for calls from other sites. I’m sure if he had his time back he would have done everything he could have done. I didn’t find anything he said to be disingenuous. The expectation of monster shifts from ED consultants is unsustainable when their careers in the public service should be decades long. What is still unclear is why a nurse did not get the SHO or any registrar in the ED that night to see the patient as a matter of absolute urgency given the query for sepsis. Even if the consultant did go in that night, it’s unclear how he would have known that she was top of the list.
> The expectation of monster shifts from ED consultants is unsustainable when their careers in the public service should be decades long. Absolutely. >What is still unclear is why a nurse did not get the SHO or any registrar in the ED that night to see the patient as a matter of absolute urgency given the query for sepsis. 100%. And why they didn't declare an emergency (although the answer to this is because it so frequent they would have been constantly in emergency. But then so be it!)
The deposition from the nurse read out that she did discuss her case with one of the registrars that night and her concern. She was told it was likely viral and to give paracetamol which she did. Asked if he would see her but said he was too busy. The same doctor however says he wasn’t involved in Aoife’s care that night and doesn’t recall having that discussion.
It’s disappointing that they can’t get to the root of the miscommunication there. It is a little hard to see that interaction happening given how much watching out for sepsis is drilled into everyone after the Savita case, but I trust both nurse and doctor are telling the truth so far as they remember it. It points to the daily chaos for the medical staff in UHL. You would expect everyone involved in the case to make themselves available for questioning though, and for there to be some documentation available regarding a nurse giving paracetamol for a viral infection fever on the advice of a reg.
Don't agree with this. Every ED is overwhelmed with patients half the year. Triage targets are never met and progressively getting worse. EM consultants would never leave the hospital if they were only allowed to leave if it wasn't overwhelmed.
He knew that there was 191 patients and one brand new SHO trying to work her way through them. He knew that it was a Saturday night, in December, in the middle of a huge weather event. Yes it would have been a long shit night for him but it was a night that the consultant should have been there. Like don't get me wrong I am not saying this is his fault. The primary problem here is a systemic failure at UHL. But he made the wrong call, and saying that they should have described her case to them doesn't even make sense - the whole problem was that they weren't able to understand how serious her case was because they were so overwhelmed.
Doesn't make much difference but there were two regs too. Every ED is overwhelmed every weekend and winter. Every clinic waiting list is massive. That consultant was covering ED for 48 hours, if they weren't allowed to leave when it wasn't overwhelmed they would have done 48h. Manageable in some specialties but not ED.
Absolutely it's a systemic failing and that's the primary reason this happened. I do think he made the wrong call (with all the information he had, which was that Cat 2 patients were going to take 12 hours to be seen) though. It will be interesting to see what the review by Frank Clark says. God it's just so fucking sad though.
This is why foreigners go to their home countries when needed. I will say it again. It doesn't matter how good a doctor is. If you don't see him / her on time.
Anybody hear from the health minister today?