A MAN who died on a trolley in the emergency department of a Dublin hospital had been waiting for five hours to be seen by the medical team when he collapsed suddenly, an inquest has heard.
Thomas Brennan (79) of Green Trees Road, Terenure, Dublin, was taken by ambulance to Tallaght hospital on July 21st last after collapsing at home. He arrived at the hospital at 12.30pm.
His main complaint was of severe abdominal pain, and he was diagnosed with an inflamed gall bladder. A diagnosis had not been finalised, however, and he was referred for a medical review at 8pm with regard to some other symptoms, which included fluid around the heart.
Mr Brennan was on a trolley in the resuscitation room of the emergency department and had still not been reviewed by the medical team or admitted when he suffered a sudden collapse at 1am on July 22nd.
He was pronounced dead almost an hour later, Dublin County Coroner’s Court heard.
Coroner Dr Kieran Geraghty said “it did not seem right” that Mr Brennan had been prioritised by the emergency department as a serious case and that, five hours later, he had not been seen by the medical team.
Acting chief executive of the hospital, John O’Connell, said Mr Brennan “could not have been in a better or safer place” but accepted that if it was his family, he would not want anybody waiting any period of time.
The coroner expressed alarm that one member of the medical team Dr Peter McAuley was working a 36-hour shift. “Anybody having to work for 36 hours without sleep would be at risk,” he said.
The coroner asked Mr O’Connell to take action on the matter and to also take action with regard to a practice where some doctors do not read the patient’s notes, but rely on a handover from other doctors.
Consultant in accident and emergency medicine Dr Jean O’Sullivan said she found it unacceptable that patients who are acutely unwell, and who are seen in a “timely” fashion by the emergency department, remain in the department for “13 hours without having a bed booked or being admitted”.
She also condemned the use of trolleys in emergency departments and called for the introduction of a separate team leader or nurse manager to look after patients on the “virtual ward”. Patients in “virtual wards” have been admitted to hospital but do not yet have a hospital bed.
Mr O’Connell said progress had been made at Tallaght hospital, which had the busiest emergency department in the State, but it was a very difficult situation and the hospital had fewer beds and consultants than other hospitals in the capital, despite a large catchment area.
He said they had capped the number of trolleys in the emergency department at 20.
A postmortem found Mr Brennan’s death was due to a heart attack that had occurred three days earlier.
The coroner’s court heard blood was leaking from a small hole in the heart for a period of nine hours prior to the collapse.
Dr O’Sullivan said there was no evidence of a heart attack on two electrocardiograms carried out.
The coroner recorded a verdict of death by natural causes as the death was a result of a heart attack, and he accepted there had been no evidence any treatment given would have changed the outcome.