Aoife Johnston’s family not consulted on terms of reference of investigation into 16-year-old’s death in hospital

A lawyer acting on behalf of the family of 16-year-old Aoife Johnston has said it is a matter of “great concern” that the terms of reference for the investigation into her death have been decided upon without any input from her family.

Aoife Johnston, from Shannon, Co Clare, died in University Hospital Limerick in December 2022 after waiting for 12 hours to be treated in the emergency department. She was diagnosed with bacterial meningitis and later developed sepsis.

Former chief justice Mr Justice Frank Clarke has been tasked with providing an evidence-based report into the teenager’s death and into “the clinical and corporate governance” of UHL, according to the terms of reference of his investigation.

“The independent investigation will also report on any other factors and/or causes which can be identified for the purposes of improving current and future service delivery,” the terms of reference published by the HSE on Tuesday state.

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Damien Tansey, a senior counsel who is acting on behalf of the family, told RTÉ News on Wednesday that the family had not been consulted in relation to the terms of reference.

“It is a matter of great concern that the terms of reference were decided upon without any input whatsoever from the Johnston family,” he said. “Is there any family on the planet more profoundly interested in this matter than the Johnston family?”

Ms Johnston’s death was the subject of an internal HSE report, which was given to its chief executive Bernard Gloster last month.

This report found there was a 12-hour delay in caring for Aoife Johnston’s developing sepsis. On the weekend she was in the hospital, UHL’s full escalation protocol was triggered despite the number of patients awaiting an inpatient bed varying between 42 and 55.

Overcrowding was endemic in the hospital’s emergency department and that was “little apparent understanding” of the risks this posed, the internal report by two non-UHL doctors also found.

There were insufficient ED nursing and medical staff to adequately monitor patients and a high turnover of staff, leading to “low experience levels and low situational awareness”.

On the day the 16-year-old died, UHL said it was dealing with “unprecedented” demand on its emergency department, which had led the hospital to cancel “all but the most urgent elective surgeries”.

In a statement at the time, the hospital warned anyone with a “less urgent condition” attending the emergency department that they would probably face “an exceptionally long wait for care”.

Doctors and staff had repeatedly raised concerns about overcrowding in the hospital’s emergency department.

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