A 33-year-old woman died after a hospital failed, upon her first attendance at the emergency department, to detect she had swallowed her denture, the High Court has heard.
The case of Beata Kunicka, a mother from Kanturk, Co Cork who was “wrongly discharged” home has now led to changes in hospitals across the country.
The High Court on Friday heard Cork University Hospital (CUH) has apologised to the woman’s family “for the deficiencies in the care”.
Ms Kunicka returned to CUH 17 days after first being discharged from the emergency department when she collapsed at home and was vomiting blood. She died more than 20 hours later, on October 12th, 2021, and hours after the embedded denture was removed from her oesophagus.
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The family’s senior counsel, Gabriel Gavigan, told the court liability was never contested by the Health Service Executive and the proceedings brought by Ms Kunicka’s partner, Kamil Jarzembski, were settled for €450,000 after mediation.
Ms Kunicka first went to the hospital emergency department on September 25th, 2021, complaining of chest pain and reporting that she believed she had recently swallowed her denture which comprised two front teeth, a supportive pallet and wiring.
A plain film X-ray of her chest was arranged, and she was given a small test meal to assess her ability to swallow. She was also given painkillers to treat her chest pain.
However, no foreign body showed up on the X-ray and Ms Kunicka, who was able to eat and drink, was discharged.
Counsel told the court that, in a letter to Mr Jarzembski last year, hospital chief executive David Donegan said an external review into the care of Ms Kunicka makes clear “we failed to identify that her dental plate had indeed been swallowed and as such wrongly discharged her when she first presented to ED [emergency department]”.
Medical staff, the letter stated, were not aware at the time that some denture plates would not show up on X-ray and “mistakenly decided that because she was able to eat and drink it was safe to discharge her”.
It added that CUH has taken action to highlight these risks nationally to regulators and the HSE and amended its local clinical training.
Counsel said Ms Kunicka returned to CUH on October 12th after 1am.
She was not assessed in the ED until 7am and she was vomiting blood. It was ordered she be given blood and a CT scan was arranged. She collapsed again and later underwent surgery where the embedded denture was removed. However, she suffered severe bleeding and had to be again stabilised.
It was claimed that there was a delay in further treatment due to there being disagreement as regards the diagnosis and in the hours that followed there was prolonged discussion of the case.
Ms Kunicka became critically unstable and was haemorrhaging from her ear nose and mouth. She continued to deteriorate and went into shock and died from cardiac arrest after resuscitation efforts failed.
Counsel told the court the letter from the hospital chief executive stated that the review also outlined the care of Ms Kunicka in the hospital when she returned there on October 12th.
It said it was a complex and challenging presentation but “it is clear that a number of elements for care were not delivered promptly enough. Furthermore, clinical differences of opinion about the source for continued bleeding, the right course of corrective action and the availability of the necessary expertise to deliver it, all delayed her receiving the care she needed.”
Ms Justice Leonie Reynolds offered her condolences to Mr Jarzemnski and their young daughter, Julia, over “the very tragic series of events”. She said she hoped they took some comfort from the review and that the recommendations have been shared nationally to ensure such an incident does not happen in an Irish hospital again.
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