On an autumn afternoon in 2016, Thomas Byrne was among a crowd who gathered outside Naas General Hospital after an ambulance was engulfed in fire outside the emergency department.
A portable medical oxygen cylinder had apparently ignited inside the vehicle.
In the wake of the fire, Thomas was trying to locate his father Christy and was unaware the elderly man had been fatally injured inside the ambulance until the hospital’s manager came out of the main entrance, extended her hand over some people towards him and said: “I’m sorry for your loss.”
“I didn’t even know at this stage because the guards were at the house while I was driving in, all these people were standing there; she could have called me to one side,” said Thomas.
“They said: ‘You’d better come in'; I said: ‘Is it Da?’”
They wouldn’t confirm that his father had died in the ambulance fire “until they got me to a room”, he said.
Christy Byrne died, and two ambulance personnel suffered injuries, in the fire that happened at about 1pm on Thursday, September 22nd, 2016.
Before the devastated Byrne family left the hospital that evening, they were assured by then minister for health Simon Harris and then Health Service Executive chief executive Tony O’Brien there would be a full investigation.
Two days later, the remains of their beloved 79-year-old father were returned to the family in a closed casket. They buried him the following day after a packed funeral Mass in the Defence Forces church in the Curragh in Co Kildare.
More than eight years later, Thomas and his siblings Lil, Francis, Christopher and Sarah – along with Lil’s husband, Michael Davis – are still seeking answers about the circumstances of their father’s death.
They particularly want the Director of Public Prosecutions (DPP) to explain her eleventh-hour decision to withdraw a criminal prosecution by the Health and Safety Authority (HSA) - the State agency responsible for enforcing health and safety in the workplace - against the HSE, in a case that had been set for trial on January 29th last.
Christy Byrne was the centre of his children’s lives, particularly after their mother Betty died, aged just 48, of breast cancer in 1993.
A hard-working stud groom and farm labourer for most of his life, Byrne is described by his family as a man who lived simply, loved his family, horses, animals and nature, and was widely known for his expertise with horses.
After a throat cancer diagnosis in 2014, Byrne underwent a full laryngectomy and other treatment involving lengthy hospital stays, with his family at his side throughout.
By 2016, he had made a good recovery from cancer but, because he had a trachea inserted, he experienced sporadic infections, some requiring hospital admission.
On September 22nd, 2016, he was having respiratory difficulties following a recent infection. Thomas, who had given up work in 2014 to care for his father at his home in Suncroft, Naas, called an ambulance.
It arrived about 50 minutes later and, having advised the paramedics concerning his dad’s treatment, Thomas decided against travelling in the ambulance himself and to drive instead to the hospital.
“I let them go ahead. I thought he would just be sitting in A&E. As I was driving in, I heard something on the radio about a fire at Naas hospital,” Thomas recalled.
He never imagined the fire was in the ambulance transporting his father.
That evening, as the stunned family was escorted from the hospital, Thomas was called back. He was asked to wait in the day chapel where he was comforted by a chaplain before being informed by the hospital manager they would pay for the funeral expenses.
“I was asked what did I think of that. I said I have enough to be thinking about at the minute and walked away. To this day, I haven’t heard a thing from the HSE,” he said.
“Mentally, we were half-prepared for a day like that to happen because Daddy was ill and frail, but not like this,” said Lil.
“We thought we would get into the hospital and, like Mammy, say the rosary at the bed and hold his hand. None of that happened – that is the upsetting part; we never got to say goodbye to him, see him, or touch anything belonging to him. We got a wooden box, a closed casket, that was it.”
The family, she said, feel they have been kept in the dark about the chain of events leading to their father’s death and have not been treated with sensitivity or compassion.
“If we had, we would not be sitting here today.”
On the first anniversary of Byrne’s death, when they were “still quite raw”, they placed a wreath in his memory against the wall past the main hospital entrance, Lil said. It was removed within 30 minutes due to what they were told was a “health and safety issue” and placed in the hospital chapel.
“They said it would be very upsetting for ambulance staff and people coming in and out of A&E to leave it outside,” said Sarah Byrne.
“No one said it was very upsetting for us.”
The family have decided to speak publicly for the first time after being informed on January 27th that a criminal prosecution by the HSA against the HSE, set for trial on January 29th, was being withdrawn.
In an interview with The Irish Times this week in the offices of their solicitor, David Powderly, the family say they want answers, “truth and transparency”, and actions to ensure no other family will endure what they have gone through.
Being told there will be no prosecution was “like a kick in the guts”, said a tearful Lil.
“It was like we were back on September 22nd [2016] again. We should not have to be this upset nearly nine years later.”
They are very upset about persistent false suggestions that circulated publicly in the wake of the fire that their father, to some degree, contributed to his own death by smoking in the ambulance, she said.
“That was very hurtful, cruel. He stopped smoking in 2014 – he had a laryngectomy; he could not smoke.”
“This family have been on a very long road and are back at square one,” said Powderly.
Their initial contact after the fire incident was with gardaí whose investigations established that six or seven fires in the UK, some causing burns and damage but none with fatal consequences, were linked to portable oxygen cylinders.
Gardaí ultimately decided against a criminal prosecution for reasons that include the high threshold of proof, beyond reasonable doubt.
A separate HSA investigation considered there were grounds for a prosecution of the HSE related to the nature of labelling and warnings on the cylinder, based on a report from the Health Products Regulatory Authority (HPRA) suggesting the warnings were insufficient.
A prosecution was commenced and the DPP in 2023 directed a trial on indictment. On January 27th last, the family were informed, in light of a HPRA report contradicting its earlier one, a nolle prosequi – a dropping of the prosecution – would be entered and the trial would not proceed on January 29th.
The inquest into Byrne’s death, which has been put on hold pending the prosecution, can now proceed. In July 2019, then Kildare county coroner Dr Denis Cusack publicly voiced strong criticism of the HSA’s failure to share its expert report with him.
In a letter to Powderly, the coroner dismissed as “without foundation” the authority’s assertion that sharing such reports with a coroner could affect the integrity of the criminal process.
An engineer’s expert report obtained by Powderly in 2019 stated the risk of burning and “exploding” portable oxygen medical cylinders has been known for years and noted various institutions had published recommendations, including training, aimed at preventing this.
The engineer said it was reported to him the Naas ambulance fire was probably due to an internal valve ignition caused by a contaminant in the valve.
An advisory notice issued in late 2002 by the HPRA concerning explosions and fires in aluminium oxygen cylinders noted several reported incidents caused burns in patients and healthcare workers. It recommended that users read, understand and follow all instructions and labelling provided by the manufacturer/supplier, and suggested consideration of the purchase of regulators with brass components.
In July 2017, the HSA issued a revised safety alert on use of portable medical oxygen cylinders, saying it was doing so “following a tragic fatal accident” involving the use of a cylinder in an ambulance situation.
That noted, while oxygen itself does not burn, it can, under high pressure with certain conditions, cause common materials to ignite suddenly. It stressed that vigilance and attention by the operator during preparation/set-up of the cylinder is “of critical importance” and said training should be provided to all users.
The Byrne family have initiated a Circuit Court action over mental distress arising from their father’s death.
That case is against the HSE, as the party responsible for operation and control of the ambulance service at Naas hospital.
The other defendants are BOC Gases Ireland Ltd as supplier of the oxygen cylinder; Luxfer Gas Cylinders Ltd, with registered offices in Manchester, England, as manufacturer/producer of the cylinder; and GCE Holdings AB, a Swedish-registered company, as valve manufacturer/producer.
All four defendants, who are separately represented, deny any liability.
