Doctor refuses to be silenced on Tallaght Hospital trolley cases

Inquiry ordered into leaking of the details of patient (91) left ‘festering’ on trolley

A heated exchange takes place in the Dáil during Leaders Questions as TDs react to a letter from Dr James Gray, an emergency department consultant in Tallaght Hospital.

Tallaght Hospital should concentrate on dealing with its "failures" rather than on those responsible for highlighting them, according to the doctor whose leaked memo revealed a 91-year-old patient spent over 24 hours on a trolley this week.

Emergency department physician Dr James Gray was responding to the hospital's plan to conduct an internal review into the "disclosure and characterisation" of confidential patient information to the national media.

One reason for the delay in finding a bed for the man was because the allocated bed was in a wifi “blackspot”, according to sources, where wireless monitoring of his blood pressure could not be conducted.

The hospital said the 91-year-old man has expressed “strong dissatisfaction” with the manner in which his personal clincal circumstances were revealed “and elements of his care misrepresented in the media and other public channels over the past 24 hours”.

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The patient, who suffers from a chronic condition and requires regular attendance at the hospital, has expressed his appreciation for the standard of treatment he has received in Tallaght, it said.

“While the hospital apologises that the patient in question was subject to an unacceptable delay prior to being transferred to a ward bed on Monday, the hospital also has a strong duty of care to safeguard the interests of all its patients and will take necessary steps to ensure these are upheld at all times.”

In the Dail, Taoiseach Enda Kenny said he did not understand how such a thing could happen to a 91-year-old. He said he agreed with the consultant who highlighted the matter and called on Tallaght hospital for a response.

Dr Gray's memo to hospital management, which was copied to Minister for Health Leo Varadkar and colleagues, said the man was left "festering" on a trolley in a corridor and his wife, also 91, spent over nine hours on one. Another patient spent at least 59 hours on a trolley, it claimed.

Dr Gray said patients’ basic human rights at the hospital were being violated by “grave and dangerous governance failures”.

He said two of the 19 patients on trolleys on Monday were there for over two days, while four were there for more than 24 hours.

Because of overcrowding, he had to examine the 91-year-old man “on a trolley on a conduit between the psychiatric rooms and some cubicles”.

The case was an example of how a dysfunctional system treated senior citizens disgracefully, by allowing them “fester” on a trolley.

“This man, like the others in non-designated patient conduits, have no privacy, no dignity, are subjected to constant noise torture, constant light torture, resulting in major sleep deprivation, (and) pressure effects causing pain . . . as well as boarding conditions that constitute an infection control hazard.

“Nobody of any age should be subjected to this inhumanity.”

He said the extra trolleys constituted a fire hazard and claimed two patients requiring isolation were accommodated in a cubicle surrounded by three walls and a curtain. One of these patients was “festering for two days and 11 hours at the time of writing as an admitted boarder”.

Meanwhile, a dedicated high-tech isolation room along with eight cubicles remain idle in the emergency department “for want of staffing”.

“Grave and gross governance failures will continue to be highlighted when there is a duty to disclose as a patient advocate. It is only a matter of time before we disclose our next crowding-related death at Tallaght Hospital while crowding is tolerated.”

In June, there was controversy when a 101-year-old woman spent 26 hours on a trolley at the hospital.

Overcrowding in Tallaght has worsened since Monday, with 34 patients waiting for admission yesterday morning, according to the TrolleyWatch count by the Irish Nurses and Midwives Organisation.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.